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. 2023 Oct 6;12(19):6381.
doi: 10.3390/jcm12196381.

Agreement and Reproducibility of Anterior Chamber Angle Measurements between CASIA2 Built-In Software and Human Graders

Gustavo Espinoza  1   2   3 , Katheriene Iglesias  2 , Juan C Parra  2   3 , Ignacio Rodriguez-Una  4 , Sergio Serrano-Gomez  3 , Angelica M Prada  1   2   3 , Virgilio Galvis  1   2   3
Affiliations

Agreement and Reproducibility of Anterior Chamber Angle Measurements between CASIA2 Built-In Software and Human Graders

Gustavo Espinoza et al. J Clin Med. .

Abstract

Purpose: This study evaluated the agreement and reproducibility of ACA measurements obtained using the built-in software of the CASIA2 (Version 3G.1) and the measurements derived from expert clinicians.

Methods: Healthy volunteers underwent ophthalmological evaluation and AS-OCT examination. ACA measurements derived from automated and manual SS location were obtained using the CASIA2 automated software and clinician identification, respectively. The intraobserver, interobserver reproducibility, CASIA2-human grader reproducibility and CASIA2 repeatability were assessed using intraclass correlation coefficients (ICCs).

Results: The study examined 58 eyes of 30 participants. The CASIA2 software showed excellent repeatability for all ACA parameters (ICC > 0.84). Intraobserver, interobserver, and CASIA2-human grader reproducibility were also excellent (ICC > 0.87). Interobserver agreement was high, except for nasal TISA500, differing between observers 1 and 2 (p < 0.05). The agreement between CASIA2 measurements and human graders was high, except for nasal TISA500, where observer 1 values were smaller (p < 0.05).

Conclusion: The CASIA2 built-in software reliably measures ACA parameters in healthy individuals, demonstrating high consistency. Although a small difference was observed in nasal TISA500 measurements, interobserver and CASIA2-human grader reproducibility remained excellent. Automated SS detection has the potential to facilitate evaluation and monitoring of primary angle closure disease.

Keywords: AS-OCT; agreement; anterior chamber angle; optical coherence tomography; primary angle closure glaucoma; reproducibility.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CASIA2 anterior segment OCT display after obtaining the automatic anterior chamber angle measurements and intentional relocation of the scleral spur (SS) that was performed by the masked observer. Nasal and temporal angle opening distance (AOD) and trabecular iris space area (TIA) are not available due to incorrect positioning of the SS.
Figure 2
Figure 2
CASIA2 anterior segment OCT display after manual localization of the scleral spur (SS) was carried out by the human grader using the CASIA2 software tools to obtain the measurements of the anterior chamber angle parameters. Nasal and temporal angle opening distance (AOD) and trabecular iris space area (TISA) are shown in the image.
Figure 3
Figure 3
Bland–Altman plot: comparison of nasal and temporal ACA parameters between CASIA2 and both observers.
See this image and copyright information in PMC

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