Aims To compare the diagnostic performance of 360° anterior segment optical coherence tomography assessment by applying normative percentile cut-offs versus iris trabecular contact (ITC) for detecting gonioscopic angle closure. Methods In this multicentre study, 394 healthy individuals were included in the normative dataset to derive the age-specific and angle location-specific normative percentiles of angle open distance (AOD500) and trabecular iris space area (TISA500) which were measured every 10° for 360°. 119 healthy participants and 170 patients with angle closure by gonioscopy were included in the test dataset to investigate the diagnostic performance of three sets of criteria for detection of gonioscopic angle closure: (1) the 10th and (2) the 5th percentiles of AOD500/TISA500, and (3) ITC (ie, AOD500/TISA500=0 mm/mm2). The number of angle locations with angle closure defined by each set of the criteria for each eye was used to generate the receiver operating characteristic (ROC) curve for the discrimination between gonioscopic angle closure and open angle. Results Of the three sets of diagnostic criteria examined, the area under the ROC curve was greatest for the 10th percentile of AOD500 (0.933), whereas the ITC criterion AOD500=0 mm showed the smallest area under the ROC (0.852) and the difference was statistically significant with or without adjusting for age and axial length (p<0.001). The criterion ≥90° of AOD500 below the 10th percentile attained the best sensitivity 87.6% and specificity 84.9% combination for detecting gonioscopic angle closure. Conclusions Applying the normative percentiles of angle measurements yielded a higher diagnostic performance than ITC for detecting angle closure on gonioscopy. Data are available upon reasonable request.

中文翻译：

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眼前段扫源光学相干断层扫描检测前房角闭合的诊断标准


目的 通过应用规范百分位数截止值与虹膜小梁接触 (ITC) 来检测房角镜闭角，比较 360° 眼前段光学相干断层扫描评估的诊断性能。方法 在这项多中心研究中，规范数据集中包括 394 名健康个体，以得出角度开放距离 (AOD500) 和小梁虹膜间隙面积 (TISA500) 的年龄特定和角度位置特定规范百分位数，每 10° 测量一次。 360°。测试数据集中包括 119 名健康参与者和 170 名通过房角镜检查发现房角闭合的患者，以研究三组房角镜房角闭合检测标准的诊断性能：(1) AOD500/TISA500 的第 10 个百分位数和 (2) 第 5 个百分位数，（3）ITC（即AOD500/TISA500=0mm/mm2）。由每只眼睛的每组标准定义的角度闭合的角度位置的数量用于生成接收者操作特征（ROC）曲线，以区分前房角镜闭合角和张角。结果 在检查的三组诊断标准中，AOD500 第 10 个百分位数的 ROC 曲线下面积最大（0.933），而 ITC 标准 AOD500=0 mm 的 ROC 曲线下面积最小（0.852），差异为无论是否调整年龄和眼轴长度，均具有统计学显着性 (p<0.001)。 AOD500 ≥90°低于第 10 个百分位的标准获得了检测房角镜闭角的最佳灵敏度 87.6% 和特异性 84.9% 组合。结论 应用角度测量的标准百分位数在房角镜检查中检测角度闭合方面比 ITC 具有更高的诊断性能。数据可根据合理要求提供。