Abstract
Aims
Primary angle-closure glaucoma is expected to account for nearly 50% of bilateral glaucoma blindness by 2020. This study was conducted to assess the performance of the scanning peripheral anterior chamber depth analyzer (SPAC) and limbal anterior chamber depth (LACD) as screening methods for angle closure.
Methods
This study assessed two clinical populations to compare SPAC, LACD, and gonioscopy: the Zhongshan Angle-closure Prevention Trial, from which 370 patients were eligible as closed-angle participants and the Liwan Eye Study, from which 72 patients were selected as open-angle controls. Eligible participants were assessed by SPAC, LACD, and gonioscopy.
Results
Angle status was defined by gonioscopy. Area under the receiver operating characteristic curve (AUROC) for SPAC was 0.92 (0.89–0.95) whereas AUROC for LACD was 0.94 (0.92–0.97). Using conventional cutoff points, sensitivity/specificity was 93.0%/70.8% for SPAC and 94.1%/87.5% for LACD. Sequential testing using both SPAC and LACD increased the specificity to 94.4% and decreased the sensitivity to 87.0%.
Conclusion
SPAC has significantly lower specificity than LACD measurement using conventional cutoffs but interpretation of the findings can be performed by modestly trained personnel.
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Acknowledgements
This study was funded by Fight for Sight (London), and the Richard Desmond Charitable Foundation via Fight for Sight, the City of Guangzhou, and private donations from Johns Hopkins affiliates.
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Dr Kashiwagi has a Japanese patent on the SPAC (Japanese patent No. 3878164). Dr Friedman currently has the SPAC instrument on loan from Carl Zeiss Meditec. The remaining authors declare no conflict of interest.
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Andrews, J., Chang, D., Jiang, Y. et al. Comparing approaches to screening for angle closure in older Chinese adults. Eye 26, 96–100 (2012). https://doi.org/10.1038/eye.2011.244
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DOI: https://doi.org/10.1038/eye.2011.244
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