Wong 2009a.

Study characteristics
Patient Sampling	Cohort study. Participants recruited from a glaucoma clinic at a Singapore hospital from January 1 to July 31, 2007. Data from one eye were included in the analysis.
Patient characteristics and setting	Sample size: 188 eyes. Age: mean (SD), 63.3 ± 10.5, range 37‐99 years. Sex: 107 (57.0%) female. Setting: secondary care. Country: Singapore. Ethnicity: 162 (86.2%) Chinese, 8 (4.3% ) Malay, 12 (6.4%) Indian and other 6 (3.2%). Exclusions: participants who had undergone any prior intraocular procedures or had any penetrating eye injuries or corneal disorders, such as corneal endothelial dystrophy, pterygium, or a corneal scar, that may preclude satisfactory imaging.
Index tests	SPAC: categorical grades and inbuilt numerical scale ranged from 1 to 12, with 12 representing the deepest ACD. Cut‐off values used: optimal thresholds were derived from study data using either separate or combined categorical and numerical grading. AS‐OCT: slit‐lamp OCT (Heidelberg Engineering, Heidelberg, Germany), image acquisition required imaging of the entire cross‐section of the anterior segment in 1 single‐image frame. Subjective judgement cut‐off: the ACA was considered closed on SL‐OCT imaging if there was contact between the iris and angle wall anterior to the scleral spur in two quadrants or more.
Target condition and reference standard(s)	Gonioscopy, the eye was considered occludable if the posterior trabecular meshwork could not be seen in the primary position without indentation (Scheie grade 3 or 4) in 2 or more quadrants (≥ 180 degrees).
Flow and timing	188 participants recruited, 35 were excluded due to; failure in obtaining SL‐OCT images due to obstructions or motion artefacts (14), SL‐OCT images could not be graded owing to poor definition of the scleral spur (21), leaving 153 for the final analysis. The index test and reference standard were conducted on the same occasion
Comparative
Notes	Ethnicity reported on original participants entering the study and not the analysed participants. Defined ACA closure for AS‐OCT and gonioscopy was reported in one or more quadrants, data entry for this review was considered for only 2 quadrants identified as closed for both the reference and index test. Conflict of interest: Dr T. Aung has received grant funding as well as financial support and honoraria for travel to conferences from Carl Zeiss Meditec. Patients who had undergone laser iridotomy were not excluded.
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Yes
Was a case‐control design avoided?	Yes
Did the study avoid inappropriate exclusions?	Yes
Could the selection of patients have introduced bias?		Low risk
Are there concerns that the included patients and setting do not match the review question?			Low concern
DOMAIN 2: Index Test (LACD)
DOMAIN 2: Index Test (Scheimpflug photography)
DOMAIN 2: Index Test (AS‐OCT)
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
If a threshold was used, was it pre‐specified?	Yes
Could the conduct or interpretation of the index test have introduced bias?		Low risk
Are there concerns that the index test, its conduct, or interpretation differ from the review question?			Low concern
DOMAIN 2: Index Test (SPAC)
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
If a threshold was used, was it pre‐specified?	Yes
Could the conduct or interpretation of the index test have introduced bias?		Low risk
Are there concerns that the index test, its conduct, or interpretation differ from the review question?			Low concern
DOMAIN 2: Index Test (Flashlight)
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Yes
Were the reference standard results interpreted without knowledge of the results of the index tests?	Yes
Could the reference standard, its conduct, or its interpretation have introduced bias?		Low risk
Are there concerns that the target condition as defined by the reference standard does not match the question?			Low concern
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Yes
Were all patients included in the analysis?	Yes
Did all patients receive a reference standard	Yes
Could the patient flow have introduced bias?		Low risk