| As a new optical diagnostic techniques, optical coherence tomography (OCT) hasnon-contact, no radiation, no damage, but has the advantages of high resolution. Traditionally,OCT is not only used in the posterior segment of the eye disease, such as theorganizational structure of the retina, retinal nerve fiber layer, macula, optic measurement,to assist in the examination and diagnosis of age-related macular degeneration, macularhole, cystoid macular edema, diabetic retinopathy and glaucoma；but in recent year_s, OCTis also widely used in the inspection of the anterior segment, such as determination of theparameter_s of the organizational structure of the cornea, anterior chamber angle(ACA), iris, ciliarybody, crystal, and posterior chamber and so on. The article analysis and compare the consistencyof the results of examination of the anterior segment OCT(AS-OCT) and gonioscopy, evaluateclinical application value of OCT in glaucoma diagnosis.Objective: To analysis examination results of the slit lamp anterior segment OCT (SL-OCT) and gonioscopy, are consistent or not.Method:(1)General Information: From March to October in2011, in Institute of Ophthalmology ofHenan Provincial People’s Hospital, choose glaucoma inpatients of acute angle closure glaucoma(AACG) patients,8cases (10eyes), primary chronic angle closure Glaucoma (CACG)14patients(20eyes), secondary angle closure glaucoma patients10(12eyes), primary open angle glaucomathe (POAG)8cases (12eyes),19were male and21female patients, in all40patients (54eyes), checked inpatients age range of31-78year_s old(mean age46.5±11.3year_s).(2)The check instrument: the instrument of slit lamp anterior segment OCT (SL-OCT) usingU.S. Optovue produced Fourier OCT (Optovue RTVue OCT), Scan speed is26000times/sec,the resolution can be achieved5um, diode Gaussian light source wavelength is1310nm.Gonioscopy examination is used with Goldmann gonioscopy and the Haag-streit900type slitlamp microscope.(3)General examination: visual acuity, intraocular pressure(IOP), slit lamp anterior segmentOCT (SL-OCT), anterior chamber measurements, ophthalmoscope, non-mydriatic fundusphotography, static threshold perimetry, visual evoked potential (VEP), ophthalmic A/Bultrasound pachymetry, Fourier domain-OCT(FD-OCT) and gonioscopy.(4)Examination of gonioscopy: In a dark room with a slit lamp, examinating the anteriorchamber angle(ACA) of every patient with Goldmann Gonioscopy. Observed anterior chamberangle(ACA) of3,6,9,12-bit4position respectively, and records in Scheie law.(5)Anterior segment OCT(AS-OCT) examination: In the anterior segment OCT(AS-OCT)examination, the checked eyes should rotate to the opposite side, respectively scan3:00,6:00,9:00,12:00corneoscleral surface. In the scan image of AC-OCT, using scleral as thecenter, using500um as the radius of circle, with the inter_section of the inner surface of thetrabecular meshwork and the anterior surface of iris, the angle formed between the both is theanterior chamber angle(ACA); if vicinity iris and scleral contact, compared with angle-closure.(6)recording method: use Shaffer Law and Scheie Law combined classification grading ofthe anterior chamber angle(ACA)(7)Statistical Methods: All data statistically, the two kinds of check measureing results using Spearman rank correlation analysis (Spearman rank correlation analysis as a test), P <0.05;consistency test of both kappa test, a=0.05as the test standard.Results:(1)Comparative analysis of the anterior chamber angle(ACA) on gonioscopy and anteriorsegment OCT (AC-OCT) examination grading results:the Spearman rank correlation coefficient ofgonioscopy and AS-OCT checking the ACA, r_s=0.80, check rank correlation coefficientr_s-border value table,r_s0.05/2,5=1.000, r_s<r_s0.05/2,5,(P <0.05), in a=0.05level, accepts H0,reject H1,in rank correlation analysis between the two kinds of check result, there are nodifferences.(2)Between the two consistency inspection, kappa value=0.78, P <0.01, thereby bothconsistency significantly; if gonioscopy as to check the standard of angle-closure, the sensitivityof the anterior segment OCT(AS-OCT) examination of ACA closure,is81.25%, specificity82.35%,therefore, the consistency of the results of the two kinds of inspection methods is good.Conclusion:Measuring results of the two methods of slit lamp anterior segment OCT(SL-OCT)and gonioscopy, have good consistency, SL-OCT can be used as a novel means ofanterior chamber angle ‘s examination of glaucoma, SL-OCT can reflect the anatomical structureof the anterior chamber angle(ACA), like traditional gonioscopy. |
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