Gonioscopy versus anterior segment ocular coherence tomography for anterior chamber angle assessment- A comparative study

Abstract

This study was conducted to determine the anterior chamber angle to improve the diagnostic accuracy, treatment modalities and health outcomes in individuals with angle-closure glaucoma. This was a comparative cross-sectional study at the Institute of Ophthalmology Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan. Patients with various ocular conditions presented at Glaucoma clinic, aged 20 years old or above of either gender were included. After obtaining written informed consent, the gonioscopy and anterior segment optical coherence tomography (AS-OCT) imaging was done in all participants.  A trained ophthalmology resident presented the Questionnaire in the local language, while a consultant ophthalmologist performed the complete general ocular evaluation, slit-lamp examination, gonioscopy and anterior segment optical coherence tomography. Out of 178 participants, 146 (82%) patients were male patients, and 32 (18%) were females. The majority of patients, 79 (44.4%), were aged between 41 to 50 years, while 51 (28.7%) were over 60 years old. AS-OCT has shown to enhance health outcomes, diagnostic accuracy, and treatment modalities compared to gonioscopy in patients with angle-closure glaucoma. The findings from anterior segment OCT were significant (p < 0.001) in comparison to gonioscopy.

In conclusion this study revealed that both gonioscopy and AS-OCT imaging identified the upper quadrant as having the highest prevalence of angle closure. However, the relative incidence of closed angles in the other quadrants varied depending on the modality utilized. Some of these variations may be explained by specifics in how each technique’s ACA configuration is assessed and interpreted.