PT  - JOURNAL ARTICLE
AU  - Dolly S Chang
AU  - Lisandro M Sakata
AU  - Tin Aung
AU  - Ming-Guang He
AU  - Raghavan Lavanya
AU  - Kenji Kashiwagi
AU  - David S Friedman
TI  - Single versus sequential testing with scanning peripheral anterior chamber depth analyser, IOLMaster and anterior segment optical coherence tomography for the detection of narrow angles
AID  - 10.1136/bjo.2009.175869
DP  - 2011 Oct 01
TA  - British Journal of Ophthalmology
PG  - 1410--1414
VI  - 95
IP  - 10
4099  - http://bjo.bmj.com/content/95/10/1410.short
4100  - http://bjo.bmj.com/content/95/10/1410.full
SO  - Br J Ophthalmol2011 Oct 01; 95
AB  - Background Scanning peripheral anterior chamber depth analyser (SPAC), IOLMaster and anterior segment optical coherence tomography (AS-OCT) are devices that can screen non-invasively for narrow angles (NAs) and may reduce the need for gonioscopy, especially where the availability of ophthalmologists is limited. When used individually to detect NAs, neither SPAC, AS-OCT nor IOLMaster were able to achieve both high sensitivity and specificity when using gonioscopy as a gold standard.Aims To assess whether sequential testing improves discrimination of NAs over single testing.Methods In a prospective community-based cross-sectional study in Singapore, 2047 phakic right eyes underwent SPAC, IOLMaster and AS-OCT. NA eyes were defined as present when Shaffer scores were 0 or 1 in ≥2 quadrants on gonioscopy. Sensitivities and specificities of single and sequential testing were compared.Results At a fixed specificity of 95%, sensitivities in detecting NA eyes were 57.8% (95% CI 52.7% to 62.7%) for SPAC, 43.3% (95% CI 38.3% to 48.3%) for IOLMaster and 52.1% (95% CI 46.4% to 57.7%) for AS-OCT. After sequential testing using SPAC followed by AS-OCT, the sensitivity rose to 70.3% (95% CI 65.5% to 74.8%) while specificity remained at 94.3% (95% CI 93.1% to 95.4%), with sensitivity significantly higher than single testing alone (p<0.001).Conclusion Sequential testing significantly improves the accuracy of detecting NAs and may be useful in screening settings.