Digital gonioscopy based on three-dimensional anterior-segment OCT: an international multicenter study
Ophthalmology, 2022•Elsevier
Purpose To develop and evaluate the performance of a 3-dimensional (3D) deep-learning–
based automated digital gonioscopy system (DGS) in detecting 2 major characteristics in
eyes with suspected primary angle-closure glaucoma (PACG):(1) narrow iridocorneal
angles (static gonioscopy, Task I) and (2) peripheral anterior synechiae (PAS)(dynamic
gonioscopy, Task II) on OCT scans. Design International, cross-sectional, multicenter study.
Participants A total of 1.112 million images of 8694 volume scans (2294 patients) from 3 …
based automated digital gonioscopy system (DGS) in detecting 2 major characteristics in
eyes with suspected primary angle-closure glaucoma (PACG):(1) narrow iridocorneal
angles (static gonioscopy, Task I) and (2) peripheral anterior synechiae (PAS)(dynamic
gonioscopy, Task II) on OCT scans. Design International, cross-sectional, multicenter study.
Participants A total of 1.112 million images of 8694 volume scans (2294 patients) from 3 …
Purpose
To develop and evaluate the performance of a 3-dimensional (3D) deep-learning–based automated digital gonioscopy system (DGS) in detecting 2 major characteristics in eyes with suspected primary angle-closure glaucoma (PACG): (1) narrow iridocorneal angles (static gonioscopy, Task I) and (2) peripheral anterior synechiae (PAS) (dynamic gonioscopy, Task II) on OCT scans.
Design
International, cross-sectional, multicenter study.
Participants
A total of 1.112 million images of 8694 volume scans (2294 patients) from 3 centers were included in this study (Task I, training/internal validation/external testing: 4515, 1101, and 2222 volume scans, respectively; Task II, training/internal validation/external testing: 378, 376, and 102 volume scans, respectively).
Methods
For Task I, a narrow angle was defined as an eye in which the posterior pigmented trabecular meshwork was not visible in more than 180° without indentation in the primary position captured in the dark room from the scans. For Task II, PAS was defined as the adhesion of the iris to the trabecular meshwork. The diagnostic performance of the 3D DGS was evaluated in both tasks with gonioscopic records as reference.
Main Outcome Measures
The area under the curve (AUC), sensitivity, and specificity of the 3D DGS were calculated.
Results
In Task I, 29.4% of patients had a narrow angle. The AUC, sensitivity, and specificity of 3D DGS on the external testing datasets were 0.943 (0.933–0.953), 0.867 (0.838–0.895), and 0.878 (0.859–0.896), respectively. For Task II, 13.8% of patients had PAS. The AUC, sensitivity, and specificity of 3D DGS were 0.902 (0.818–0.985), 0.900 (0.714–1.000), and 0.890 (0.841–0.938), respectively, on the external testing set at quadrant level following normal clinical practice; and 0.885 (0.836–0.933), 0.912 (0.816–1.000), and 0.700 (0.660–0.741), respectively, on the external testing set at clock-hour level.
Conclusions
The 3D DGS is effective in detecting eyes with suspected PACG. It has the potential to be used widely in the primary eye care community for screening of subjects at high risk of developing PACG.
Elsevier