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Comparative Study
. 2014 Feb;62(2):163-6.
doi: 10.4103/0301-4738.116487.

Comparative evaluation of RetCam vs. gonioscopy images in congenital glaucoma

Raj V Azad, Parijat Chandra, Anuradha Chandra  1 , Aparna Gupta, Viney Gupta, Ramanjit Sihota
Affiliations
Comparative Study

Comparative evaluation of RetCam vs. gonioscopy images in congenital glaucoma

Raj V Azad et al. Indian J Ophthalmol. 2014 Feb.

Abstract

Purpose: To compare clarity, exposure and quality of anterior chamber angle visualization in congenital glaucoma patients, using RetCam and indirect gonioscopy images.

Design: Cross-sectional study Participants. Congenital glaucoma patients over age of 5 years.

Materials and methods: A prospective consecutive pilot study was done in congenital glaucoma patients who were older than 5 years. Methods used are indirect gonioscopy and RetCam imaging. Clarity of the image, extent of angle visible and details of angle structures seen were graded for both methods, on digitally recorded images, in each eye, by two masked observers.

Outcome measures: Image clarity, interobserver agreement.

Results: 40 eyes of 25 congenital glaucoma patients were studied. RetCam image had excellent clarity in 77.5% of patients versus 47.5% by gonioscopy. The extent of angle seen was similar by both methods. Agreement between RetCam and gonioscopy images regarding details of angle structures was 72.50% by observer 1 and 65.00% by observer 2.

Conclusions: There was good agreement between RetCam and indirect gonioscopy images in detecting angle structures of congenital glaucoma patients. However, RetCam provided greater clarity, with better quality, and higher magnification images. RetCam can be a useful alternative to gonioscopy in infants and small children without the need for general anesthesia.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
The superior anterior chamber angle in indirect gonioscopy. Angle structures appear hazy in high magnification
Figure 2
Figure 2
The same (as in Fig. 1) superior anterior chamber angle on RetCam showing forest of iris processes, wrap around iris and mid-trabecular meshwork insertion
Figure 3
Figure 3
Gonioscopy image shows anterior chamber angle in a patient of Axenfeld–Rieger's syndrome with prominent Schwalbe's line and iridocorneal adhesions
Figure 4
Figure 4
RetCam image shows rudimentary iris stump in Aniridia anterior chamber angle with no angle structures visible
See this image and copyright information in PMC

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