Authors : Yash Gandhi, Trupti M Solu
DOI : 10.18231/j.ijceo.2020.004
Volume : 6
Issue : 1
Year : 2020
Page No : 9-12
Context: Glaucoma is the second leading cause of blindness in the adult population of India. Diagnosis
and management depends on categorization of Glaucoma into open or closed angle.
Aims: To compare the accuracy of Gonioscopy and Anterior Segment Optical Coherence Tomography
(ASOCT) in studying the structures of anterior chamber angle of the eye and find out the agreement between
them in detecting angle closure.
Settings and Design: Cross -sectional observational study.
Materials and Methods: The present study is a hospital based cross-sectional study of patients between
20 to 80 years of age with Glaucoma attending the outdoor patient department in a tertiary care government
hospital (New civil hospital), Surat. Patients having Corneal Opacity, and anti-Glaucoma surgeries done
were excluded. All diagnosed cases of Glaucoma were evaluated by Gonioscopy in the dark with a
Goldman 3 mirror lens Gonioscope at high (16x) magnification for static assessment (without indentation).
A narrow slit beam, 2mm* 1mm, was cast during Gonioscopy, avoiding direct illumination over the pupil.
The angle in each quadrant was graded with the Shaffer grading system. Anterior Segment OCT was done
by TOPCON 3D OCT-1 MAESTRO machine. Imaging was performed in dark room conditions. Patients
were imaged gazing straight ahead. Imaging of a single meridional section of the Anterior Chamber Angle
at superior, inferior, temporal and nasal quadrants were performed. Grading of Anterior Chamber Angles
on AS-OCT is termed as Closed if there is no visualization of Scleral Spur and/or any degree of iridotrabecular
contact.
Statistical Analysis: kappa value, sensitivity & specificity, positive & negative likelihood ratio.
Results: Total 50 Glaucoma patients were examined by Gonioscopy and AS OCT. Total number of Angles
examined were 400. Total number of Angles closed on Gonioscopy were 136 (34%). Total number of
Angles closed on AS OCT were 190 (47.5%).
Conclusion: Agreement between Gonioscopy and AS OCT in detecting angle closure in all 4 quadrants
was ‘Moderate to Good’ by Kappa Value.
Keywords: Glaucoma, Gonioscopy, Optical Coherence Tomography.