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Glaucoma
Novel hyperparallel optical coherence tomography for angle closure assessment: comparison with swept-source OCT and gonioscopy
  1. Natalia Porporato1,2,
  2. Benjamin Y Xu3,
  3. Bingyao Tan4,5,
  4. Yu Q Chang6,
  5. Tin A Tun1,2,
  6. Shamira Perera1,2,
  7. Rahat Husain1,2,
  8. Ching Lin Ho2,7,
  9. Rehena Sultana2,
  10. Tin Aung1,2,
  11. Leopold Schmetterer1,2,4,8
  1. 1Singapore Eye Research Institute, Singapore
  2. 2Duke-NUS Graduate Medical School, Singapore
  3. 3Ophthalmology, Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  4. 4Ocular Imaging, Singapore Eye Research Institute, Singapore
  5. 5Nanyang Technological University School of Chemical and Biomedical Engineering, Singapore
  6. 6University of Medicine and Health Sciences, Dublin, Ireland
  7. 7Glaucoma, Singapore Eye Research Institute, Singapore
  8. 8Singapore National Eye Centre Ocular Imaging Research Group, Singapore

Abstract

Aim To evaluate reproducibility and agreement of angle closure assessment by a novel hyperparallel optical coherence tomography (OCT) system (HP-OCT, Cylite Optics, Melbourne, Australia), in comparison with swept-source OCT (SS-OCT, CASIA SS-1000, Tomey Corporation, Nagoya, Japan) and gonioscopy.

Methods Cross-sectional study. Phakic subjects >40 years, with no relevant ophthalmic history were consecutively recruited from the glaucoma clinic. Subjects underwent same-day evaluation with HP-OCT, SS-OCT and gonioscopy. The primary outcome was the presence of angle closure, defined as iridotrabecular contact in HP-OCT and SS-OCT images at 0°−180° meridional and as non-visibility of the posterior trabecular meshwork (TM) by gonioscopy. Visibility of TM was also assessed (secondary outcome). Intra and interdevice agreement analysis (Gwet AC1) and logistic regression analysis were performed for primary and secondary outcomes, respectively.

Results 154 sectors from horizontal scans of 77 subjects were analysed. The reproducibility of angle closure assessment by HP-OCT was excellent (AC1 of 0.95 for temporal angle and 1.00 for nasal). Agreement for angle closure detection was very good between HP-OCT and SS-OCT (AC1 of 0.88 for temporal and 0.81 for nasal angle) and good between HP-OCT and gonioscopy (AC1 of 0.71 for temporal and 0.78 for nasal angle). TM was identifiable in 64.4% (94/146) of unprocessed HP-OCT images (both open and closed angles), however not visible in any of the SS-OCT unprocessed images.

Conclusions HP-OCT showed excellent reproducibility for angle closure assessment and good agreement with SS-OCT and gonioscopy. HP-OCT technology also provides a unique capability to visualise regions around TM and Schlemm’s canal, opening new avenues for clinical research of distal outflow pathways.

  • Angle
  • Glaucoma
  • Anterior chamber
  • Imaging

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/bjo-2023-323429

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • X @BenXuLab

    • Contributors Conception and design: NP, TA, LS. Acquisition of data: NP, TAT, YQC, SP, RH. Analysis and interpretation of data: NP, BYX, RS, BT, LS, TA. Editing and revision: All authors. Responsible for the overall content: NP

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.