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Christopher Wirbelauer, MD; Amir Karandish, MD; Heike Häberle, MD; Duy Thoai Pham, MD

Arch Ophthalmol. 2005;123:179-185.

Objective  To assess the value of noncontact goniometry with optical coherence tomography (OCT) compared with current clinical parameters in the evaluation of the anterior chamber angle (ACA).

Design  Prospective observational study of 138 eyes of 109 patients.

Methods  The ACA parameters and angle-opening distance (AOD) were measured with slitlamp-adapted OCT goniometry. The iris and scleral thickness and the iris convexity were assessed with OCT. Both ACA and AOD were compared with the clinical parameters of gonioscopy grade, limbal anterior chamber depth (ACD), ultrasonographic central ACD, and lens-axial length (LAL) ratio.

Results  Noncontact goniometry with OCT revealed mean ± SD values of 28° ± 16° for the ACA and 381 ± 234 µm for the AOD. The mean ± SD iris thickness was 369 ± 84 µm, and the scleral thickness at the scleral spur was 943 ± 148 µm. There was a significant correlation (P<.001) with the clinical parameters of gonioscopic grading, limbal ACD, ultrasonographic central ACD, and LAL ratio. The sensitivity and specificity of OCT goniometry to detect an occludable angle were 86% and 95% for ACA and 85% and 90% for AOD, respectively.

Conclusions  Noncontact goniometry with OCT was helpful in evaluating the anterior chamber structures and as a screening modality. Goniometry with OCT could improve the noninvasive clinical assessment and treatment of patients with glaucoma.

Author Affiliation: Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin, Germany.

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