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Abstract：
OBJECTIVE: To compare the diagnostic performance of 360° anterior segment optical coherence tomography assessment by applying normative percentile cut-offs versus iris trabecular contact (ITC) for detecting gonioscopic angle closure.
METHODS: In this multicentre study, 394 healthy individuals were included in the normative dataset to derive the age-specific and angle location-specific normative percentiles of angle open distance (AOD500) and trabecular iris space area (TISA500) which were measured every 10° for 360°. 119 healthy participants and 170 patients with angle closure by gonioscopy were included in the test dataset to investigate the diagnostic performance of three sets of criteria for detection of gonioscopic angle closure: (1) the 10th and (2) the 5th percentiles of AOD500/TISA500, and (3) ITC (ie, AOD500/TISA500=0 mm/mm2). The number of angle locations with angle closure defined by each set of the criteria for each eye was used to generate the receiver operating characteristic (ROC) curve for the discrimination between gonioscopic angle closure and open angle.
RESULTS: Of the three sets of diagnostic criteria examined, the area under the ROC curve was greatest for the 10th percentile of AOD500 (0.933), whereas the ITC criterion AOD500=0 mm showed the smallest area under the ROC (0.852) and the difference was statistically significant with or without adjusting for age and axial length (p<0.001). The criterion ≥90° of AOD500 below the 10th percentile attained the best sensitivity 87.6% and specificity 84.9% combination for detecting gonioscopic angle closure.
CONCLUSIONS: Applying the normative percentiles of angle measurements yielded a higher diagnostic performance than ITC for detecting angle closure on gonioscopy.
METHODS: In this multicentre study, 394 healthy individuals were included in the normative dataset to derive the age-specific and angle location-specific normative percentiles of angle open distance (AOD500) and trabecular iris space area (TISA500) which were measured every 10° for 360°. 119 healthy participants and 170 patients with angle closure by gonioscopy were included in the test dataset to investigate the diagnostic performance of three sets of criteria for detection of gonioscopic angle closure: (1) the 10th and (2) the 5th percentiles of AOD500/TISA500, and (3) ITC (ie, AOD500/TISA500=0 mm/mm2). The number of angle locations with angle closure defined by each set of the criteria for each eye was used to generate the receiver operating characteristic (ROC) curve for the discrimination between gonioscopic angle closure and open angle.
RESULTS: Of the three sets of diagnostic criteria examined, the area under the ROC curve was greatest for the 10th percentile of AOD500 (0.933), whereas the ITC criterion AOD500=0 mm showed the smallest area under the ROC (0.852) and the difference was statistically significant with or without adjusting for age and axial length (p<0.001). The criterion ≥90° of AOD500 below the 10th percentile attained the best sensitivity 87.6% and specificity 84.9% combination for detecting gonioscopic angle closure.
CONCLUSIONS: Applying the normative percentiles of angle measurements yielded a higher diagnostic performance than ITC for detecting angle closure on gonioscopy.
摘要：
目的：比较360°眼前节光学相干断层扫描评估的诊断性能，通过应用规范的百分位截止与虹膜小梁接触（ITC）来检测前角镜闭角。
方法：在这项多中心研究中，将394名健康个体纳入规范数据集中，以得出角度开放距离（AOD500）和小梁虹膜空间面积（TISA500）的年龄特定和角度位置特定的规范百分位数，每10°测量360°。119名健康参与者和170名通过房角镜检查患有房角闭合的患者被包括在测试数据集中，以研究三组检测房角镜下房角闭合的标准的诊断性能：（1）AOD500/TISA500的第10和（2）第5百分位数，以及（3）ITC（即，AOD500/TISA500=0mm/mm2)。由每只眼睛的每组标准定义的具有角度闭合的角度位置的数量用于生成接收器操作特征（ROC）曲线，以区分前角镜角度闭合和开放角度。
结果：在检查的三组诊断标准中，AOD500的第10百分位数的ROC曲线下面积最大（0.933），而ITC标准AOD500=0mm显示ROC下面积最小(0.852),在调整或不调整年龄和眼轴长度的情况下,差异有统计学意义(p<0.001)。AOD500在第10个百分位数以下≥90°的标准可检测房角镜闭角的最佳敏感性为87.6％，特异性为84.9％。
结论：应用角度测量的规范百分位数，在房角镜检查中检测闭角的诊断性能高于ITC。
方法：在这项多中心研究中，将394名健康个体纳入规范数据集中，以得出角度开放距离（AOD500）和小梁虹膜空间面积（TISA500）的年龄特定和角度位置特定的规范百分位数，每10°测量360°。119名健康参与者和170名通过房角镜检查患有房角闭合的患者被包括在测试数据集中，以研究三组检测房角镜下房角闭合的标准的诊断性能：（1）AOD500/TISA500的第10和（2）第5百分位数，以及（3）ITC（即，AOD500/TISA500=0mm/mm2)。由每只眼睛的每组标准定义的具有角度闭合的角度位置的数量用于生成接收器操作特征（ROC）曲线，以区分前角镜角度闭合和开放角度。
结果：在检查的三组诊断标准中，AOD500的第10百分位数的ROC曲线下面积最大（0.933），而ITC标准AOD500=0mm显示ROC下面积最小(0.852),在调整或不调整年龄和眼轴长度的情况下,差异有统计学意义(p<0.001)。AOD500在第10个百分位数以下≥90°的标准可检测房角镜闭角的最佳敏感性为87.6％，特异性为84.9％。
结论：应用角度测量的规范百分位数，在房角镜检查中检测闭角的诊断性能高于ITC。
