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Lisandro M. Sakata, MD, PhD; Raghavan Lavanya, DO; David S. Friedman, MD; Han T. Aung, MBBS; Steve K. Seah, FRCS; Paul J. Foster, PhD, FRCS; Tin Aung, MBBS, PhD, FRCS(Edin)

Arch Ophthalmol. 2008;126(2):181-185.

Objective  To assess visibility of the scleral spur in anterior segment optical coherence tomography (AS-OCT) images.

Methods  This cross-sectional observational study included 502 participants aged 50 years or older who had no previous ophthalmic problems and were recruited from a community clinic in Singapore. All participants underwent gonioscopy and AS-OCT (Visante; Carl Zeiss Meditec, Dublin, California). Scleral spur location was assessed in AS-OCT images by 2 examiners with glaucoma subspecialty training and was defined as the point where there was an inward protrusion of the sclera with a change in curvature of its inner surface.

Results  Scleral spur location could be determined in 72% of the images of the right eye. Its location on AS-OCT images was less detectable in quadrants with a closed angle on gonioscopy and also in images obtained in the superior and inferior compared with the nasal and temporal quadrants (64%, 67%, 75%, and 80%, respectively; P < .001).

Conclusions  The inability to detect the scleral spur may hamper quantitative analysis of anterior chamber angle parameters that are dependent on the location of this anatomical structure, particularly in the superior and inferior quadrants. New parameters independent of the scleral spur may be useful for detecting eyes at risk of angle closure.

Author Affiliations: Singapore Eye Research Institute and Singapore National Eye Center, Singapore (Drs Sakata, Lavanya, H. T. Aung, Seah, and T. Aung); Wilmer Eye Institute and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Friedman); and Institute of Ophthalmology and Moorfields Eye Hospital, London, England (Dr Foster).

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