Van Herick法及河南眼科研究所改进法检查前房深度估测房角关闭的准确性研究

目的:研究Van Herick法及河南眼科研究所改进法检查前房深度估测房角关闭的准确性。方法:随机选取2018-06/2019-01于我院门诊就诊的40岁及以上患者52例100眼分别行Van Herick法和河南眼科研究所改进法检查前房深度,筛选出周边前房深度≤1/3 CT且>1/4 CT与周边前房深度≤1/4 CT人群,对Van Herick法与河南研究所改进法前房检查法结果进行一致性检验,再行房角镜检查与暗室下UBM检查分别检查周边房角是否关闭。结果:在Van Herick法估测周边前房深度≤1/3 CT且>1/4 CT的患眼中,行房角镜检查与UBM检查结果房角关闭的阳性率分别为39%与43%,在河南眼科研究所改进法估测周边前房深度≤1/3 CT且>1/4 CT的患眼中,行房角镜检查与UBM检查结果房角关闭的阳性率分别为46%与42%;在Van Herick法估测周边前房深度≤1/4 CT的患眼中,行房角镜检查与UBM检查结果房角关闭的阳性率分别为67%与89%;在河南眼科研究所改进法估测周边前房深度≤1/4 CT的患眼中,行房角镜检查与UBM检查结果房角关闭的阳性率分别为70%与100%;对Van Herick法与河南眼科研究所改进法进行一致性检验,在估测周边前房深度≤1/3CT且>1/4 CT时,Kappa值为0.85,一致性较好,在估测周边前房深度≤1/4 CT时,Kappa值为0.83,一致性较好;对房角镜检查结果及UBM检查结果进行一致性检验,在Van Herick法估测周边前房深度≤1/3 CT且>1/4 CT时,Kappa值为0.73,一致性一般,在Van Herick法估测周边前房深度≤1/4 CT时,Kappa值为0.40,一致性一般。对房角镜检查结果及UBM检查结果进行一致性检验,在河南眼科研究所改进法估测周边前房深度≤1/3 CT且>1/4 CT时,Kappa值为0.75,一致性较好,在河南眼科研究所改进法估测周边前房深度≤1/4 CT时,Kappa值为0,一致性较差。结论:Van Herick法及河南眼科研究所改进法前房深度检查在测量人群中房角关闭的具有一定的假阴性率,但准确性较高,仍适合作为估测房角关闭的初步检查方式。

Accuracy of estimating angle closure by slit-lamp anterior chamber depth examination

AIM:To verify the accuracy of Van Herick method and slit-lamp anterior chamber depth examination in estimating angle closure.METHODS:Totally 52 patients(100 eyes)over 40 years old were randomly selected from our outpatient department from June 2018 to January 2019.Their anterior chamber depth were examined by the methods of Van Herick method and the improved method to sort out peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT and peripheral anterior chamber depth are less than or equal to 1/4 CT.Van Herick's anterior chamber depth inspection method and improved anterior chamber depth inspection method were checked for consistency,and then gonioscopic inspection and UBM inspection under darkroom were performed to check whether the peripheral angle was closed.In order to know whether there was any difference between gonioscopic and UBM inspection for angle closure,the consistency of the two verification results was checked.RESULTS:Peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT by the methods of Van Herick,the positive incidence of angle closure in angioscopy and ultrasound biomicroscopy are 39% and 43% respectively,Peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT by the improved methods,the positive incidence of angle closure in angioscopy and ultrasound biomicroscopyare 46% and 42% respectively.In the patients whose peripheral anterior chamber depth checked by angioscopy and ultrasound biomicroscopy is less than or equal to 1/4 CT estimated by Van Herick method,the positive rate of angle closure was 67% and 89%,respectively.In the patients whose peripheral anterior chamber depth checked by angioscopy and ultrasound biomicroscopy is less than or equal to 1/4 CT estimated by the improved method,the positive rate of angle closure was 67% and 89%,respectively.The consistency test of the Van Herick method and the improved method showed good consistency(Kappa value:0.85),when peripheral anterior chamber depth are less than or equal to 1/3 CT and more than 1/4 CT.peripheral anterior chamber depth(>1/4 CT),and good consistency(Kappa value:0.83)when estimating peripheral anterior chamber depth≤1/4 CT.According to the consistency test of the results of angioscopy and ultrasound biomicroscopy,when the Van Herick method estimated the depth of peripheral anterior chamber are less than or equal to 1/3 CT and more than 1/4 CT,the consistency was general(Kappa value:0.73).When the Van Herick method estimated the depth of peripheral anterior chamber is less than or equal to 1/4 CT,the consistency was general(Kappa value:0.40).According to the consistency test of the results of angioscopy and ultrasound biomicroscopy,when the improved method estimated the depth of peripheral anterior chamber are less than or equal to 1/3 CT and more than 1/4 CT,the consistency was good(Kappa value:0.75).When the improved method estimated the depth of peripheral anterior chamber is less than or equal to 1/4 CT,the consistency was poor(Kappa value:0).CONCLUSION:The slit lamp anterior chamber depth examination has a certain false negative rate in estimating the angle closure in the population,but its accuracy is high,and it is still suitable for the preliminary examination of estimating the angle closure.