Assessment of Iris Trabecular Contact in Eyes with Gonioscopic Angle-Closure.
Zhang Xiulan, Guo Philip Yawen, Lin Chen, Li Fei, Nguyen Anwell, Sakata Rei, Higashita Risa, Okamoto Keiichiro, Yu Marco, Aihara Makoto
AI Summary
AS-OCT measured iris trabecular contact (ITC) extent, not gonioscopy, better predicts primary angle-closure/glaucoma risk, showing greater ITC correlates with higher disease odds.
Abstract
Purpose
To investigate the extent of iris trabecular contact (ITC) measured by anterior segment OCT (AS-OCT) and its association with primary angle-closure (PAC) and PAC glaucoma (PACG) in eyes with gonioscopic angle-closure and to determine the diagnostic performance of ITC for detection of gonioscopic angle-closure.
Design
Multicenter, prospective study.
Participants
A total of 119 healthy participants with gonioscopic open-angle and 170 patients with gonioscopic angle-closure (94 with PAC suspect and 76 with PAC/PACG) were included.
Methods
One eye of each subject was randomly selected for AS-OCT imaging. Angle-opening distance (AOD500) and trabecular iris space area (TISA500) were measured every 10° for 360°. Two criteria of ITC500 were examined: (1) AOD500 = 0 mm and (2) TISA500 = 0 mm 2 . The association between the extent of ITC500 and PAC/PACG in eyes with gonioscopic angle-closure was analyzed with logistic regression analysis.
Main outcome measures
Sensitivity and specificity of ITC500 for detection of gonioscopic angle-closure; odds ratio (OR) of PAC/PACG.
Results
The sensitivity of ITC500 ≥ 10° for detection of gonioscopic angle-closure ranged from 82.4% (AOD500 = 0 mm) to 84.7% (TISA500 = 0 mm 2 ), and the specificity was 85.7% (for both AOD500 = 0 mm and TISA500 = 0 mm 2 ). The extent of ITC500 determined by AS-OCT, not cumulative gonioscopy score (i.e., the sum of the modified Shaffer grades over 4 quadrants), was associated with the odds of PAC/PACG in eyes with gonioscopic angle-closure; the odds of PAC/PACG increased by 5% for every 10° increase in ITC500 (OR, 1.051, 95% confidence interval [CI], 1.022-1.080 for AOD500 = 0 mm; OR, 1.049, 95% CI, 1.022-1.078 for TISA500 = 0 mm 2 ). Axial length and anterior chamber depth were not associated with PAC/PACG in eyes with gonioscopic angle-closure (P ≥ 0.574).
Conclusions
A greater extent of ITC measured by AS-OCT, not angle-closure determined by gonioscopy, was associated with a greater odds of PAC/PACG in eyes with gonioscopic angle-closure.
MeSH Terms
Shields Classification
Key Concepts4
The sensitivity of iris trabecular contact (ITC500) measured by anterior segment OCT (AS-OCT) for detection of gonioscopic angle-closure ranged from 82.4% (AOD500 = 0 mm) to 84.7% (TISA500 = 0 mm2), and the specificity was 85.7% (for both AOD500 = 0 mm and TISA500 = 0 mm2) in a multicenter, prospective study of 119 healthy participants with gonioscopic open-angle and 170 patients with gonioscopic angle-closure (94 with PAC suspect and 76 with PAC/PACG).
A greater extent of iris trabecular contact (ITC) measured by anterior segment OCT (AS-OCT), not angle-closure determined by gonioscopy, was associated with a greater odds of primary angle-closure (PAC)/PAC glaucoma (PACG) in eyes with gonioscopic angle-closure in a multicenter, prospective study of 119 healthy participants with gonioscopic open-angle and 170 patients with gonioscopic angle-closure (94 with PAC suspect and 76 with PAC/PACG).
The odds of primary angle-closure (PAC)/PAC glaucoma (PACG) increased by 5% for every 10° increase in iris trabecular contact (ITC500) determined by anterior segment OCT (AS-OCT) in eyes with gonioscopic angle-closure (OR, 1.051, 95% confidence interval [CI], 1.022-1.080 for AOD500 = 0 mm; OR, 1.049, 95% CI, 1.022-1.078 for TISA500 = 0 mm2) in a multicenter, prospective study of 119 healthy participants with gonioscopic open-angle and 170 patients with gonioscopic angle-closure (94 with PAC suspect and 76 with PAC/PACG).
Axial length and anterior chamber depth were not associated with primary angle-closure (PAC)/PAC glaucoma (PACG) in eyes with gonioscopic angle-closure (P ≥ 0.574) in a multicenter, prospective study of 119 healthy participants with gonioscopic open-angle and 170 patients with gonioscopic angle-closure (94 with PAC suspect and 76 with PAC/PACG).
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