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Hon-Tym Wong, FRCS(Ed); Jocelyn L. L. Chua, MRCS(Ed); Lisandro M. Sakata, MD, PhD; Melissa H. Y. Wong, MBBS; Han T. Aung, MBBS; Tin Aung, FRCS(Ed), PhD

Arch Ophthalmol. 2009;127(5):599-603.

Objective  To evaluate the effectiveness of slitlamp optical coherence tomography (SL-OCT) and Scanning Peripheral Anterior Chamber depth analyzer (SPAC) in detecting angle closure, using gonioscopy as the reference standard.

Methods  A total of 153 subjects underwent gonioscopy, SL-OCT, and SPAC. The anterior chamber angle (ACA) was classified as closed on gonioscopy if the posterior trabecular meshwork could not be seen; with SL-OCT, closure was determined by contact between the iris and angle wall anterior to the scleral spur; and with SPAC by a numerical grade of 5 or fewer and/or a categorical grade of suspect or potential.

Results  A closed ACA was identified in 51 eyes with gonioscopy, 86 eyes with SL-OCT, and 61 eyes with SPAC (gonioscopy vs SL-OCT, P < .001; gonioscopy vs SPAC, P = .10; SL-OCT vs SPAC, P < .001; McNemar test). Of the 51 eyes with a closed ACA on gonioscopy, SL-OCT detected a closed ACA in 43, whereas SPAC identified 41 (P = .79). An open angle in all 4 quadrants was observed in 102 eyes with gonioscopy, but SL-OCT and SPAC identified 43 and 20 of these eyes, respectively, as having angle closure. The overall sensitivity and specificity for SL-OCT were 84% and 58% vs 80% and 80% for SPAC.

Conclusion  Using gonioscopy as the reference, SL-OCT and SPAC showed good sensitivity for detecting eyes at risk of angle closure.

Author Affiliations: Tan Tock Seng Hospital (Dr Wong), Singapore National Eye Centre and Singapore Eye Research Institute (Drs Chua, M. H. Y. Wong, and T. Aung), and Yong Loo Lin School of Medicine, National University of Singapore (Dr T. Aung), Singapore.

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