Agreement between Gonioscopic Examination and Swept Source Fourier Domain Anterior Segment Optical Coherence Tomography Imaging

Abstract

Purpose. To evaluate interobserver, intervisit, and interinstrument agreements for gonioscopy and Fourier domain anterior segment optical coherence tomography (FD ASOCT) for classifying open and narrow angle eyes. Methods. Eighty-six eyes with open or narrow anterior chamber angles were included. The superior angle was classified open or narrow by 2 of 5 glaucoma specialists using gonioscopy and imaged by FD ASOCT in the dark. The superior angle of each FD ASOCT image was graded as open or narrow by 2 masked readers. The same procedures were repeated within 6 months. Kappas for interobserver and intervisit agreements for each instrument and interinstrument agreements were calculated. Results. The mean age was 50.9 (±18.4) years. Interobserver agreements were moderate to good for both gonioscopy (0.57 and 0.69) and FD ASOCT (0.58 and 0.75). Intervisit agreements were moderate to excellent for both gonioscopy (0.53 to 0.86) and FD ASOCT (0.57 and 0.85). Interinstrument agreements were fair to good (0.34 to 0.63), with FD ASOCT classifying more angles as narrow than gonioscopy. Conclusions. Both gonioscopy and FD ASOCT examiners were internally consistent with similar interobserver and intervisit agreements for angle classification. Agreement between instruments was fair to good, with FD ASOCT classifying more angles as narrow than gonioscopy.

Deep Neural Network for Scleral Spur Detection in Anterior Segment OCT Images: The Chinese American Eye Study

“…[10][11][12][13] AS-OCT measurements also have excellent intradevice, intragrader, and intergrader reproducibility. 6,[14][15][16][17][18] However, a long-standing limitation of AS-OCT is that image analysis is only semiautomated; a trained grader must manually identify specific anatomic structures before angle closure can be detected and quantified. [19][20][21] This time-intensive and expertise-dependent process has significantly hindered the clinical and research utility of AS-OCT.…”

“…However, gonioscopic assessments are subjective, qualitative, and limited by interexaminer variability. 6 Anterior segment optical coherence tomography (AS-OCT) is an in vivo imaging method that provides an alternative to gonioscopy for evaluating the anterior segment and its structures, including the ACA. 7 – 9 AS-OCT images provide qualitative assessments of the ACA and quantitative measurements of ocular biometric parameters, some of which are risk factors for angle closure disease.…”

Quantitative Evaluation of Gonioscopic and EyeCam Assessments of Angle Dimensions Using Anterior Segment Optical Coherence Tomography

“…Gonioscopy also is associated with high inter-observer variability and is poorly predictive of which patients with early PACD will progress to PACG, even when performed by an experienced glaucoma specialist. 2,3 The EyeCam is a wide-field camera capable of taking photographs of the ACA. EyeCam imaging can be performed by a trained technician rather than a physician and shows good agreement with gonioscopy for detection of angle closure.…”

Anterior Segment OCT

“…One of the main application areas for SS-OCT is to evaluate the anterior chamber angle [36]. It has been shown that SS-OCT measurements are comparable to gonioscopy, with the additional benefit of better documentation and a non-contact technique [37]. However, it should be mentioned that indentation gonioscopy should not be replaced by OCT. Due to a large dynamic range and image size, ANTERION images present high scatter in the iris and low scatter in the sclera and lens in one single image, allowing for good visualization of the anterior chamber structures.…”