Combination of Simple Diagnostic Tests to Detect Primary Angle Closure Disease in a Resource-constrained Region

Ophthalmic Epidemiology
Nikhil S ChoudhariChandra Sekhar Garudadri

Abstract

Purpose : To report on diagnostic accuracy of van Herick (vH) technique performed by a vision technician (VT) as well as on efficacy of a combination of vH technique and central anterior chamber depth (ACD) in detection of primary angle closure disease. Methods : Data was obtained from two cohorts; rural clinic setting (n = 111), and rural population-based research setting (n = 888). Van Herick grading was performed by a VT in first cohort and a glaucoma specialist in second cohort. A reference standard four-mirror gonioscopy was performed by a glaucoma specialist in both cohorts. We did preferential sampling. Cut-off levels for vH technique and central ACD were grade 2 and 25th percentile value, respectively. Data from one eye per participant was analyzed. Results : Three hundred and forty (34%) eyes were gonioscopically occludable. Area under receiver operating characteristic curve (95% confidence interval) for vH test was 0.83 (0.76, 0.9) and 0.81 (0.78, 0.84) in first and second cohorts, respectively. Simultaneous testing achieved sensitivity of 87.8% while sequential testing achieved specificity of 99.3%. Negative predictive value* of simultaneous testing was 98.3% compared to 96.6% of vH technique while positive predictiv...Continue Reading

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Dec 17, 2020·Indian Journal of Ophthalmology·Nikhil S Choudhari, Chandra Sekhar Garudadri

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