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Journal of Ophthalmology
Volume 2012, Article ID 487309, 14 pages
Clinical Study

Reproducibility of Scleral Spur Identification and Angle Measurements Using Fourier Domain Anterior Segment Optical Coherence Tomography

1Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 7.024, Houston, TX 77030, USA
2Ophthalmology Department, Medical School, University of Puerto Rico, Medical Sciences Campus, P.O. Box 365067, San Juan, PR 00936, USA
3Glaucoma Center of San Francisco, 55 Stevenson Street, San Francisco, CA 94105, USA
4Department of Ophthalmology, University of California, San Francisco, 10 Koret Way, Room K-300, P.O. Box 0730, San Francisco, CA 94143, USA
5Robert Cizik Eye Clinic, 6400 Fannin Street, Suite 1800, Houston, TX 77030, USA
6Department of Ophthalmology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Code 6230, San Antonio, TX 78229, USA

Received 10 July 2012; Accepted 5 September 2012

Academic Editor: Norma Allemann

Copyright © 2012 Ricardo J. Cumba et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To evaluate intraobserver and interobserver agreement in locating the scleral spur landmark (SSL) and anterior chamber angle measurements obtained using Fourier Domain Anterior Segment Optical Coherence Tomography (ASOCT) images. Methods. Two independent, masked observers (SR and AZC) identified SSLs on ASOCT images from 31 eyes with open and nonopen angles. A third independent reader, NPB, adjudicated SSL placement if identifications differed by more than 80 μm. Nine months later, SR reidentified SSLs. Intraobserver and interobserver agreement in SSL placement, trabecular-iris space area (TISA750), and angle opening distance (AOD750) were calculated. Results. In 84% of quadrants, SR’s SSL placements during 2 sessions were within 80 μm in both the X- and Y-axes, and in 77% of quadrants, SR and AZC were within 80 μm in both axes. In adjudicated images, 90% of all quadrants were within 80 μm, 88% in nonopen-angle eyes, and 92% in open-angle eyes. The intraobserver and interobserver correlation coefficients (with and without adjudication) were above 0.9 for TISA750 and AOD750 for all quadrants. Conclusions. Reproducible identification of the SSL from images obtained with FD-ASOCT is possible. The ability to identify the SSL allows reproducible measurement of the anterior chamber angle using TISA750 and AOD750.