Study: Slit lamp anterior chamber estimation technique an accurate option

A recent Optometry and Vision Science study shows that a new slit lamp-based technique is an effective, low-cost alternative to gonioscopy.

Gispets and colleagues designed and tested slit lamp anterior chamber estimation (SLACE) to overcome limitations in measuring the anterior chamber angle (ACA), according to the study.

The researchers estimated the ACA of 100 eyes with two slit lamp models and compared the results with gonioscopy.

Results showed that, using the Overall Spaeth gonioscopy criterion, the SL-D7 slit lamp demonstrated a sensitivity of 100% and specificity of 75% in diagnosing a narrow angle with SLACE. The BD 900 slit lamp demonstrated a sensitivity of 87.5% and specificity of 71.5%.

"Although further work is required to determine its reproducibility and actual superiority over the traditional van Herick technique, these findings support the SLACE technique as a good alternative for angle evaluation, particularly in the detection of narrow occludable angles, the authors concluded. “It may be useful for eye care clinicians without access to expensive alternative equipment or those who cannot perform gonioscopy because of legal constraints regarding the use of diagnostic drugs.

"Indeed, notwithstanding divergences in target area (central vs. peripheral anterior chamber), the SLACE technique may be considered as based on the same philosophical principle as that proposed by Smith in 1979 to estimate the depth of the anterior chamber: it is a noninvasive, user-friendly technique that requires only a slit lamp, whereby good results can be obtained with very little training," they continued. “Accordingly, the SLACE technique may contribute to detection of eyes at risk for ACG before the onset of the disease, and by providing a quantifiable method of ACA estimation, it may also be a useful tool in research."

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Source:

Optom Vis Sci. 2014; Epub ahead of print.