裂隙灯前节OCT与房角镜检查前房角度数一致性分析

Agreement of anterior chamber angle examination by slit lamp optical coherence tomography and gonioscopy

目的探讨裂隙灯前节OCT与房角镜检查前房角度数的一致性。设计病例系列研究。研究对象原发性青光眼患者13例(26眼)及正常人8例(16眼)。方法在同一暗室中依次对双眼颞侧、鼻侧、上方、下方4个象限进行裂隙灯前节OCT和房角镜检查,采用Shaffer法与Scheie法结合的分级系统记录前房角度数,应用Pearson相关分析及Kappa值对两种检查结果进行一致性检验。主要指标前房角度数。结果两种方法检查房角结果的Pearson相关系数为0.86(P=0.00),Kappa值为0.75(P= 0.00),检测可关闭房角(即房角镜检查Shaffer分级≤2级)的敏感性和特异性分别为94.7%和89.4%。结论裂隙灯前节OCT与房角镜检查一致性好,检测可关闭房角的特异性和敏感性较高,可作为青光眼辅助诊断的客观检查手段。(眼科,2007.16:194-196)

Objective To explore the agreement of anterior chamber angle examination by slit lamp optical coherence tomography （SL-OCT） and gonioscope. Design Case series. Participants Thirteen patients with primary glaucoma （26 eyes） and 8 normal persons（16 eyes）. Methods Anterior chamber angle was measured with SL-OCT and gonioscope in turns for temporal, nasal, superior and inferior quadrant. Results of two methods were analyzed and the data were analyzed with Pearson correlation coefficient and Kappa value. Main Outcome Measures Anterior chamber angle. Results The Pearson correlation coefficient of the two methods was 0.86（P=0.00）and the Kappa value is 0.75 （P=0.00）. The specificity and sensitivity of detecting occludable angle were 94.7% and 89.4%. Conclusions Anterior chamber angle examination with SL-OCT and gonioscope are well consistent. The specificity and sensitivity for SL-OCT in detecting occludable angle is satisfying. SL-OCT can be regard as an objective assistant method for the diagnosis of angle closure glaucoma.