Johnson CH TAN, MBBS, MRCSEd(Ophthalmology)

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Presentation transcript:

Johnson CH TAN, MBBS, MRCSEd(Ophthalmology) Assessment of Anterior Chamber Angles – Scanning Peripheral Anterior Chamber Depth Analyser (SPAC) compared to Gonioscopy Johnson CH TAN, MBBS, MRCSEd(Ophthalmology) Colin SH TAN, MBBS, M Med (Ophthalmology), MRCSEd (Ophthalmology), FAMS The authors have no financial interest in any of the products mentioned

Literature Review A newly developed peripheral anterior chamber depth analysis system: principle, accuracy, and reproducibility. K Kashiwagi et al. Br. J. Ophthalmol. 2004;88;1030-1035 Computer installed program automatically evaluate the ACD, CT and CRC. Dummy eye was used for investigation. 3 examiners measured ACD in 10 normal eyes (shaffers’ grade 3 or 4) and inter-observer and intra-obserever reproducibility analysed.

Literature Review Quantitative evaluation of changes in anterior segment biometry by peripheral laser iridotomy using newly developed scanning peripheral anterior chamber depth analyser. K Kashiwagi et al. Br. J. Ophthalmol. 2004;88;1036-1041 Finding cases of angle closure glaucoma in clinic setting using a newly developed instrument. Kashiwagi K et al. Eye. 2006 Mar;20(3);319-24 No studies so far to compare the gradings of SPAC versus that of gonioscopic findings with shaffer’s grading.

Objective To assess the correlation between the scanning peripheral anterior chamber depth analyser (SPAC) and gonioscopy in the assessment of the anterior chamber angles.

Method Prospective analytical study performed at Tan Tock Seng Hospital, Singapore. The temporal anterior chamber angles of patients seen at the ophthalmology outpatient clinic were assessed by SPAC (graded from 1 to 12) and gonioscopy performed by a single masked investigator using the Shaffer’s grading (grades 1 to 4).

Method Exclusion criteria : Patients with peripheral corneal disease. obstructing the view of the angles peripheral anterior synechiae. patients whose pupils were pharmacologically dilated.

Results

Demographics Age distribution Mean 60.6 (SD ±12.6), range 38-83 N = 37

Comparison of SPAC vs Sex

Comparison of SPAC vs Race

Comparison of SPAC vs Gonioscopy

Correlation of SPAC and Gonioscopy Spearman’s correlation coefficient (r) = 0.699 (p<0.001)

Discussions Gonioscopy remains the gold standard in evaluating the angles. However, subjected to inter-observer and intra-observer variability. Limitations of SPAC : unable to pick up peripheral anterior synechiae.

Conclusion SPAC correlates well with the gradings of gonioscopy. All gonioscopy gradings of 2 or less have SPAC grades of 6 or less. But some with gonioscopy gradings of 3 or more have SPAC grades of 6 or less. Performing gonioscopy on SPAC grades of 6 or less appears to pick up the narrow angles.

Thank you