COMPARISON OF GONIOSCOPY AND ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY IN THE ASSESSMENT OF ANTERIOR CHAMBER ANGLE IN GLAUCOMATOUS PATIENTS OF A TERTIARY CARE HOSPITAL OF KUMAOUN REGION

Abstract

AIM:To nd the role of gonioscopy and anterior segment optical coherence tomography in detecting angle closure in different quadrants of anterior chamber angle in glaucomatous patients. Study design:Cross sectional study Material and Methods:65 patients with age >10 years of age with suspected angle closure were recruited from a tertiary care hospital in Kumaon Region. Subjects underwent gonioscopy and AS- OCT imaging in dark.Gonioscopy as gold standard , the ACA was graded using the Spaeth system by a two examiners masked to each other ndings then the results of both the techniques were compared. Results: 130 eyes of 65 patients studied. The angles in all quadrants compared between Gonioscopy and AS-OCT using chi-square test.Closedangle were found to be 5.4%(7%) with AS-OCT and 13.8%(18) with Gonioscopy in superior quardant. Closed-angle were more with Gonioscopy 10.8%(14) as compared to AS-OCT5.4%(7) in inferior quadrants. In temporal qudrant closed-angle with gonioscopy was 11.5%(15) as compared to AS-OCT 5.4% (7). Closed-angles with gonioscopy in nasal quadrant was 12.3%(16) as compared to 5.4%(7) in AS-OCT. Conclusion: AS-OCT is highly sensitive to detect closed angles, probably due to the dark ambient condition and its non-contact nature.With the 3600 analysis, the regional differences or quadrants can be evaluated which are either partially closed or open. Considering angle closure in terms of percentage or degrees could be more accurate than more limited cross-sectional assessment. Gonioscopy showed more number of closed angles as compared to AS-OCT.The angles which seemed closed on gonioscopy were found open in AS-OCT.