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Title: Aplicación de la teleoftalmologZapotitlána en la estimación de la profundidad de la cámara anterior
Author: Tabares, J.C.O.
Paczka, J.A.
Giorgi-Sandoval, L.A.
Topete-Jimenez, J.
Fonseca-Reyes, S.
Roig-Melo, E.
Issue Date: 2001
Abstract: Purpose: To investigate the performance of assessing anterior segment digitized images in a teleophthalmologic system, and compare it with conventional gonioscopy and anterior chamber depth determined clinically by biomicroscopy. Methods: Images from 770 eyes (385 subjects) were obtained with an analog camera coupled to a biomicroscope and sent through a local network to a computer. A 17' screen was used. Two experts determined the anterior chamber depth using Van Herick's technique. Strength of agreement in categorizing the anterior chamber depth was established (unweighted kappa statistics) among digitized images, gonioscopic appearance and clinical anterior chamber depth obtained in an eye disease screening campaign. Results: Agreement between image examiners and gonioscopy was very low (k < 0.204, P = 0.001); such agreement was greater between image examiners, especially when irido-corneal angle and anterior chamber depth scales were recorded (RE, k = 0.576; LE, k = 0.552; both eye, P = 0.0001). Sensitivities for image examiners to distinguish shallow angles were low (< 55%), although specificities were considerably higher (> 80%). Conclusions: Our findings suggest that Van Herick's technique might have a limited role to adequately describe anterior segment digitized images in a teleophthalmologic system due to a low agreement between examiners and with conventional gonioscopy.
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