Assessment of Circumferential Angle Closure with Swept-Source Optical Coherence Tomography: a Community Based Study

Area of Science:

• Ophthalmology
• Medical Imaging
• Diagnostic Technology

Background:

• Angle closure glaucoma is a significant cause of vision loss.
• Early detection is crucial for preventing irreversible optic nerve damage.
• Traditional gonioscopy requires specialized training and can be subjective.

Purpose of the Study:

• To evaluate the diagnostic performance of swept-source optical coherence tomography (SS-OCT) for angle closure detection.
• To compare SS-OCT's accuracy against gonioscopy in a community setting.

Main Methods:

• A community-based study included 2027 phakic subjects aged ≥50 years.
• Gonioscopy was performed by a trained ophthalmologist.
• SS-OCT angle scans were analyzed by a masked examiner, defining angle closure based on iris-scleral spur contact.

Main Results:

• 1857 subjects were analyzed; 91.6% were of Chinese ethnicity, with a mean age of 61.8 years.
• SS-OCT showed an overall AUC of 0.84 compared to gonioscopy.
• For the ≥35% definition, SS-OCT had an AUC of 0.80, sensitivity of 82.5%, and specificity of 78.5%.

Conclusions:

• SS-OCT demonstrates moderate performance for angle closure detection in a community setting.
• The results suggest SS-OCT is a potentially valuable tool for screening angle closure.
• Further research may explore optimizing SS-OCT parameters for enhanced diagnostic accuracy.