Publication: Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris
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Issued Date
2022
Resource Type
Language
eng
File Type
application/pdf
ISSN
23973269
Rights Holder(s)
Scopus
Bibliographic Citation
Pharmaceutics. Vol 14, No.5 (2022), p.-
Suggested Citation
Wanichwecharungruang B., Pattanapongpaiboon W., Kongsomboon K., Parivisutt N., Annopawong K., Seresirikachorn K. Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris. Pharmaceutics. Vol 14, No.5 (2022), p.-. doi:10.1136/bmjophth-2021-000931 Retrieved from: https://hdl.handle.net/20.500.14740/9127
Abstract
Objective To evaluate the diagnostic performance of manual grading of anterior segment optical coherence tomography (AS-OCT) in detection of plateau iris configuration (PIC) based on the presence of standardised ultrasound biomicroscopy (UBM) criteria in at least two quadrants; namely, clinical diagnosis of PIC (DxPIC). Methods and analysis In this cross-sectional study, paired AS-OCT and UBM images were evaluated by three glaucoma specialists. AS-OCT was classified into two mechanisms, PIC versus non-PIC, of primary angle closure disease (PACD) and AS-OCT-PIC diagnostic performance was tested with DxPIC. Results One hundred and seventy-nine eyes of 142 patients were enrolled for analysis, and DxPIC was found in 85 eyes (47.49%). Intraobserver agreement rates of AS-OCT classification by the graders were 0.77, 0.701 and 0.742 (all p<0.001), and interobserver agreement rates, between a senior glaucoma specialist and the other two glaucoma specialists, were 0.68 and 0.702 (all p<0.001). Plateau iris was classified in AS-OCT images by the three graders, rated 32.96%-39.1% and 24.58%-34.08% in the horizontal and vertical axes, respectively. Diagnostic performance was analysed, yielding sensitivity ranging from 56.47% to 77.78%, and specificity of 48.94% to 64.29%. We applied disease prevalence of 30%, revealing positive predictive values varying from 32.16% to 44.44%, and negative predictive values of 72.4% to 85.71%. Accuracy ranged from 51.2% to 65%. Agreement between the two devices was fair, kappa range 0.31-0.351. Conclusion Performance of manual grading of AS-OCT in detection of DxPIC was relatively poor; therefore, unadjusted AS-OCT does not appear to be good for manual PIC screening in PACD patients and cannot serve as a substitute for UBM in PIC detection. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.