Single versus sequential testing with scanning peripheral anterior chamber depth analyser, IOLMaster and anterior segment optical coherence tomography for the detection of narrow angles. Issue 10 (17th January 2011)

• Record Type: Journal Article
• Authors: Chang, Dolly S; Sakata, Lisandro M; Aung, Tin; He, Ming-Guang; Lavanya, Raghavan; Kashiwagi, Kenji; Friedman, David S
• Is Part Of: British journal of ophthalmology. Volume 95:Issue 10(2011)
• Page Start: 1410
• Page End: 1414
• Publication Date: 2011-01-17
• Subjects: Anterior chamber -- angle -- public health -- epidemiology -- diagnostic tests/investigation; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjo.2009.175869
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Background: Scanning peripheral anterior chamber depth analyser (SPAC), IOLMaster and anterior segment optical coherence tomography (AS-OCT) are devices that can screen non-invasively for narrow angles (NAs) and may reduce the need for gonioscopy, especially where the availability of ophthalmologists is limited. When used individually to detect NAs, neither SPAC, AS-OCT nor IOLMaster were able to achieve both high sensitivity and specificity when using gonioscopy as a gold standard. Aims: To assess whether sequential testing improves discrimination of NAs over single testing. Methods: In a prospective community-based cross-sectional study in Singapore, 2047 phakic right eyes underwent SPAC, IOLMaster and AS-OCT. NA eyes were defined as present when Shaffer scores were 0 or 1 in ≥2 quadrants on gonioscopy. Sensitivities and specificities of single and sequential testing were compared. Results: At a fixed specificity of 95%, sensitivities in detecting NA eyes were 57.8% (95% CI 52.7% to 62.7%) for SPAC, 43.3% (95% CI 38.3% to 48.3%) for IOLMaster and 52.1% (95% CI 46.4% to 57.7%) for AS-OCT. After sequential testing using SPAC followed by AS-OCT, the sensitivity rose to 70.3% (95% CI 65.5% to 74.8%) while specificity remained at 94.3% (95% CI 93.1% to 95.4%), with sensitivity significantly higher than single testing alone (p<0.001). Conclusion: Sequential testing significantly improves the accuracy of detecting NAs and may be useful in screening settings.