Abstract Aim: This study compares the accuracy of Gonioscopy and Anterior Segment Optical Coherence Tomography (AS-OCT) in studying the anterior chamber angle and determines the agreement between them for detecting angle closure. Methodology: A total of 156 patients older than 18 years diagnosed with primary open angle or angle closure glaucoma were selected for the study. All the patients were examined under the slit lamp and further evaluated by gonioscopy performed in a dark room with Volk four-mirror goniolens at high (16x) magnification. OCT examination and imaging of a single meridional section of the anterior chamber angles at superior, inferior, temporal, and nasal quadrants were performed. Results: Of the 1248 angles assessed, the total number of angles closed on gonioscopy were 351 (28%) and those closed on OCT were 676 (54%). The Kappa agreement between AS-OCT and gonioscopy in detecting angle closure for superior, inferior, nasal, and temporal quadrants were 0.52, 0.49, 0.45, and 0.47, respectively. Conclusion: Anterior segment OCT detected more angle closure than gonioscopy, particularly in the superior quadrant. Agreement between the two modalities in detecting angle closure in all 4 quadrants was “Moderate” by kappa value.
Shruthi et al. (Tue,) studied this question.