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Comparison of anterior segment optical coherence tomography versus technician led gonioscopy as a triage tool for
Amit Dhalla1, Thomas Evans2, Joshua Pilling3
1Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. amit.dhalla@nhs.net.
Objective:
Can anterior segment optical coherence tomography (AS-OCT) replace gonioscopy as the preferred triage tool for angle assessments in virtual glaucoma clinics?
Subjects/Methods:
Every new referral into Sheffield Teaching Hospital's glaucoma service over a five-month period were subject to gonioscopy and AS-OCT assessment of their angles. Appropriately trained ophthalmic science practitioners (OSPs) performed the gonioscopy and labelled angles as 'open' or 'closed'. Two glaucoma-subspecialty ophthalmologists reviewed the AS-OCT images independently on a different day and graded the angles as 'open' or 'closed'.
Results:
There was an angle assessment of 384 eyes, with statistical analysis of 358 eyes due to 26 eyes being unable to have gonioscopy. AS-OCT was found to have a sensitivity of 97.11% ± 1.32% and a specificity of 36.17% ± 9.71% for identifying an open angle. The positive predictive value of the test was 95.70% ± 0.63%, while the negative predictive value was 46.08% ± 13.13%.
Conclusions:
As a triage tool, specialist assessment of the angle on AS-OCT is a safe, effective alternative to OSP-led gonioscopy.
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