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Devereux JG, Foster PJ, Baasanhu J, et al. Anterior Chamber Depth Measurement as a Screening Tool for Primary Angle-closure Glaucoma in an East Asian Population. Arch Ophthalmol. 2000;118(2):257–263. doi:10.1001/archopht.118.2.257
To evaluate anterior chamber depth measurement as a method of screening for primary angle-closure glaucoma in an East Asian population.
Two-phase, cross-sectional, community-based study.
Rural and urban locations in the Hövsgöl and Ömnögobi provinces, Mongolia.
Nine hundred forty-two (94.2%) of 1000 individuals in Hövsgöl (1995) and 775 (96.9%) of 1000 individuals in Ömnögobi (1997) aged 40 years or older were examined.
Main Outcome Measures
Anterior chamber depth was measured by optical pachymetry, slitlamp-mounted A-mode ultrasound, and handheld ultrasound. Gonioscopy was used to detect occludable angles, defined as one in which the trabecular meshwork was visible for less than 90° of angle circumference. Primary open-angle glaucoma was diagnosed in subjects with an occludable angle and glaucomatous optic neuropathy with visual morbidity. The area under the curve in a receiver operating characteristic plot was used to compare test performance.
Optical pachymetry outperformed the slitlamp-mounted ultrasound method of anterior chamber depth measurement (area under the curve, 0.93 and 0.90, respectively; z test, P = .001). Handheld ultrasound (area under the curve, 0.86) was inferior to optical measurement (z test, P = .001) but did not differ significantly from slitlamp ultrasound (z test, P = .06). The optical method gave sensitivity of 85% and specificity of 84% at a screening cutoff of less than 2.22 mm for detecting occludable angles.
Measurement of axial anterior chamber depth can detect occludable angles in this Asian population and therefore may have a role in population screening for primary angle-closure glaucoma.
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