title: Comparing approaches to screening for angle closure in older Chinese adults.
abstract: OBJECTIVE
  Primary angle-closure glaucoma is expected to account for nearly 50% of bilateral glaucoma blindness by 2020. This study was conducted to assess the performance of the scanning peripheral anterior chamber depth analyzer (SPAC) and limbal anterior chamber depth (LACD) as screening methods for angle closure.
  
  
  METHODS
  This study assessed two clinical populations to compare SPAC, LACD, and gonioscopy: the Zhongshan Angle-closure Prevention Trial, from which 370 patients were eligible as closed-angle participants and the Liwan Eye Study, from which 72 patients were selected as open-angle controls. Eligible participants were assessed by SPAC, LACD, and gonioscopy.
  
  
  RESULTS
  Angle status was defined by gonioscopy. Area under the receiver operating characteristic curve (AUROC) for SPAC was 0.92 (0.89-0.95) whereas AUROC for LACD was 0.94 (0.92-0.97). Using conventional cutoff points, sensitivity/specificity was 93.0%/70.8% for SPAC and 94.1%/87.5% for LACD. Sequential testing using both SPAC and LACD increased the specificity to 94.4% and decreased the sensitivity to 87.0%.
  
  
  CONCLUSIONS
  SPAC has significantly lower specificity than LACD measurement using conventional cutoffs but interpretation of the findings can be performed by modestly trained personnel.
authors: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: J
authors: J
authors: Andrews
authors: D S
authors: DS
authors: Chang
authors: Y
authors: Y
authors: Jiang
authors: M
authors: M
authors: He
authors: P J
authors: PJ
authors: Foster
authors: B
authors: B
authors: Munoz
authors: K
authors: K
authors: Kashiwagi
authors: D S
authors: DS
authors: Friedman
mesh_terms: D000867:Anterior Chamber / Q000473:pathology*; D019540:Area Under Curve; D044466:Asian People; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000473:pathology; D006068:Gonioscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity