Table 2.
Summarised data of all included studies
| First author | Gonioscopy criteria | AS-OCT criteria | Threshold value | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|---|---|---|
| Porporato [34] | Posterior PTM not visible in ≥ 2 quadrants | ITC index | ≥ 35% | 82.1 (74.8–88.1) | 78.4 (76.4–80.4) | 23.6 (21.5–25.8) | 98.2 (97.4–98.7) |
| ≥ 50% | 75.7 (67.8–82.6) | 84.2 (82.4–85.9) | 28.0 (25.2–31.0) | 97.7 (97.0–98.3) | |||
| ≥ 75% | 60.7 (52.1–68.9) | 90.8 (89.3–92.1) | 34.8 (30.5–39.5) | 96.6 (95.9–97.2) | |||
| Li [35] | Posterior PTM not visible in > 180 degrees | AOD500 @ Temporal (mm) | 0.221 (0.215, 0.270) | 97.5 | 65.7 | ||
| AOD500 @ Nasal (mm) | 0.192 (0.184, 0.213) | 97.4 | 80.0 | ||||
| AOD500 @ Superior (mm) | 0.106 (0.085, 0.146) | 95.0 | 85.3 | ||||
| AOD500 @ Inferior (mm) | 0.150 (0.097, 0.186) | 97.4 | 74.3 | ||||
| AOD750 @ Temporal (mm) | 0.240 (0.232, 0.301) | 97.5 | 85.7 | ||||
| AOD750 @ Nasal (mm) | 0.231 (0.222, 0.300) | 95.0 | 77.1 | ||||
| AOD750 @ Superior (mm) | 0.106 (0.085, 0.146) | 92.5 | 88.2 | ||||
| AOD750 @ Inferior (mm) | 0.217 (0.196, 0.258) | 92.5 | 77.1 | ||||
| TISA500 @ Temporal (mm^2) | 0.077 (0.068, 0.080) | 87.5 | 80.0 | ||||
| TISA500 @ Nasal (mm^2) | 0.073 (0.039, 0.086) | 94.9 | 77.1 | ||||
| TISA500 @ Superior (mm^2) | 0.015 (0.002, 0.038) | 85.0 | 91.2 | ||||
| TISA500 @ Inferior (mm^2) | 0.050 (0.015, 0.067) | 100.0 | 80.0 | ||||
| TISA750 @ Temporal (mm^2) | 0.153 (0.134, 0.200) | 92.5 | 60.0 | ||||
| TISA750 @ Nasal (mm^2) | 0.123 (0.099, 0.128) | 95.0 | 77.1 | ||||
| TISA750 @ Superior (mm^2) | 0.065 (0.032, 0.117) | 95.0 | 85.3 | ||||
| TISA750 @ Inferior (mm^2) | 0.106 (0.054, 0.133) | 97.4 | 62.9 | ||||
| ACD (mm) | 2.28 (2.04, 2.37) | 92.5 | 88.6 | ||||
| ACV (mm^3) | 98.1 (89.2, 118.1) | 90.0 | 97.1 | ||||
| Porporato [33]a | Posterior PTM not visible in ≥ 3 quadrants | ITC index | ≥ 35% | 84.7 (76.0–91.2) | 77.0 (75.0–78.0) | 16.7 (15.1–18.4) | 98.9 (98.3–99.3) |
| ≥ 50% | 84.7 (76.0–91.2) | 77.1 (75.0–78.0) | 16.7 (15.1–18.4) | 98.9 (98.3–99.3) | |||
| ≥ 75% | 61.2 (50.8–70.7) | 89.7 (88.2–91.0) | 24.3 (19.2–30.2) | 97.7 (96.8–98.4) | |||
| Nongpiur [32] | Posterior TM not visible in ≥ 2 quadrants | LV | > 0.56 mm | 64.6 (49.5–77.8) | 78.3 (73.0–83.0) | ||
| AOD750 | ≤ 0.31 mm | 95.8 (85.7–99.5) | 60.1 (54.2–65.9) | ||||
| Stepwise logistic regression using LV and AOD750 | abs value > 1.99 | 91.7 (80.0–97.7) | 63.0 (57.1–68.6) | ||||
| Angle closure score as defined by Nongpiur et al | abs value > 3.11 | 79.2 (65.0–89.5) | 73.2 (67.6–78.3) | ||||
| Tun [36] | Posterior TM not visible in ≥ 2 quadrants | ≥ 2 quadrants with any irido-corneal contact anterior to scleral spur | 0.68 (0.53–0.80) | 0.86 (0.78–0.92) | 0.71 (0.59–0.80) | 0.85 (0.78–0.89) | |
| Melese [37]b | Spaeth grade A or B. Clinical judgement used for Spaeth grade C | (95% CI) | (min, max) | (min, max) | |||
| AOD500 @ Temporal (mm) | 0.28 (0.17–0.39) | 1.00 (1.00, 1.00) | 0.79 (0.58, 0.97) | ||||
| AOD500 @ Nasal (mm) | 0.23 (0.14–0.32) | 1.00 (1.00, 1.00) | 0.87 (0.69, 1.00) | ||||
| AOD500 @Superior (mm) | 0.15 (0.08–0.21) | 0.87 (0.61, 1.00) | 0.92 (0.71, 1.00) | ||||
| AOD500 @ Inferior (mm) | 0.24 (0.21–0.26) | 1.00 (1.00, 1.00) | 0.84 (0.65, 1.00) | ||||
| AOD750 @ Temporal (mm) | 0.37 (0.29–0.46) | 0.97 (0.82, 1.00) | 0.84 (0.66, 0.97) | ||||
| AOD750 @ Nasal (mm) | 0.39 (0.33–0.46) | 1.00 (1.00, 1.00) | 0.79 (0.58, 0.95) | ||||
| AOD750 @ Superior (mm) | 0.24 (0.19–0.29) | 0.97 (0.84,1.00) | 0.87 (0.66, 1.00) | ||||
| AOD750 @ Inferior (mm) | 0.31 (0.25–0.37) | 1.00 (1.00, 1.00) | 0.92 (0.76, 1.00) | ||||
| TISA500 @ Temporal (mm^2) | 0.079 (0.045–0.113) | 0.97 (0.85, 1.00) | 0.76 (0.58, 0.96) | ||||
| TISA500 @ Nasal (mm^2) | 0.070 (0.037–0.103) | 0.87 (0.59, 1.00) | 0.84 (0.68, 1.00) | ||||
| TISA500 @ Superior (mm^2) | 0.028 (0.012–0.043) | 0.87 (0.61, 1.00) | 0.87 (0.68, 1.00) | ||||
| TISA500 @ Inferior (mm^2) | 0.054 (0.045–0.064) | 1.00 (1.00,1.00) | 0.84 (0.65, 1.00) | ||||
| TISA750 @ Temporal (mm^2) | 0.162 (0.031–0.101) | 0.97 (0.85, 1.00) | 0.79 (0.58, 0.97) | ||||
| TISA750 @ Nasal (mm^2) | 0.134 (0.079–0.190) | 0.94 (0.70, 1.00) | 0.84 (0.66, 0.98) | ||||
| TISA750 @ Superior (mm^2) | 0.073 (0.042–0.103) | 0.87 (0.61, 1.00) | 0.89 (0.68, 1.00) | ||||
| TISA750 @ Inferior (mm^2) | 0.120 (0.098–0.142) | 1.00 (1.00, 1.00) | 0.84 (0.65, 1.00) | ||||
| TICV500 (microL) | 1.92 (1.26–2.57) | 1.00 (1.00, 1.00) | 0.87 (0.70, 1.00) | ||||
| TICV750 (microL) | 4.00 (2.95–5.06) | 1.00 (1.00, 1.00) | 0.87 (0.70, 1.00) | ||||
| ITC length @ Temporal (mm) | 0.030 (0.000–0.112) | 0.80 (0.56, 1.00) | 0.84 (0.66, 0.98) | ||||
| ITC length @ Nasal (mm) | 0.017 (0.000–0.089) | 0.61 (0.35, 0.90) | 0.94 (0.82, 1.00) | ||||
| ITC length @ Superior (mm) | 0.159 (0.067–0.250) | 0.80 (0.45, 1.00) | 0.79 (0.43, 0.95) | ||||
| ITC length @ Inferior (mm) | 0.054 (0.000–0.112) | 0.87 (0.58, 1.00) | 0.79 (0.56, 0.95) | ||||
| ITC index (%) | 36.9 (23.1–51.1) | 0.93 (0.73, 1.00) | 0.84 (0.63, 0.98) | ||||
| ITC area (mm^2) | 3.27 (1.40–5.15) | 0.93 (0.73, 1.00) | 0.87 (0.68, 1.00) | ||||
| Baskaran [31] | Posterior TM not visible in ≥ 2 quadrants | ≥ 1 quadrant with any iridotrabecular contact anterior to scleral spur | 100.0 (92.6–100.0) | 22.1 (17.4–27.4) | |||
| ≥ 2 quadrants with any iridotrabecular contact anterior to scleral spur | 75.0 (60.4–86.4) | 56.5 (50.5–62.3) | |||||
| ≥ 3 quadrants with any iridotrabecular contact anterior to scleral spur | 41.7 (27.6–56.8) | 89.1 (84.9–92.5) | |||||
| 4 quadrants with any iridotrabecular contact anterior to scleral spur | 16.7 (7.48–30.2) | 97.2 (94.5–98.8) | |||||
| Posterior TM not visible in ≥ 3 quadrants | ≥ 1 quadrants with any iridotrabecular contact anterior to scleral spur | 100.0 (87.7–100) | 20.7 (16.3–25.6) | ||||
| ≥ 2 quadrants with any iridotrabecular contact anterior to scleral spur | 82.1 (63.1–93.9) | 55.1 (49.3–60.8) | |||||
| ≥ 3 quadrants with any iridotrabecular contact anterior to scleral spur | 50.0 (30.7–69.4) | 87.9 (83.7–91.3) | |||||
| 4 quadrants with any iridotrabecular contact anterior to scleral spur | 25.0 (10.7–44.9) | 97.1 (94.5–98.6) | |||||
| Dabasia [38]c | Posterior TM not visible in ≥ 270 degrees | ACA (°) | ≤ 20.7 | 87.2 (72.6–95.7) | 86.8 (71.9–95.6) | ||
| Expert opinion after dynamic gonio assessment | ≤ 18.6 | 100 (80.5–100.0) | 66.7 (53.3–78.3) | ||||
| Posterior TM not visible in ≥ 270 degrees | ACD (mm) | ≤ 2.50 | 71.8 (55.1–85.0) | 84.6 (69.5–94.1) | |||
| Expert opinion after dynamic gonio assessment | ≤ 2.38 | 82.3 (56.6–96.2) | 83.6 (71.9–91.8) | ||||
| Campbell [39] | Posterior TM visible for less than 270 degrees | Iridotrabecular touch in nasal or temporal quadrant | Visit 1 | 46 (17—77) | 87 (76—94) | 36 | 90 |
| Visit 2 | 25 (6—57) | 89 (79—96) | 31 | 86 | |||
| Qin [40] | Modified Shaffer grade ≤ 1 in all quadrants | AOD-Schwalbe's Line @ Nasal (mm) | 0.29 | 80 | 87 | ||
| AOD-Schwalbe's Line @ Temporal (mm) | 0.29 | 85 | 77 | ||||
| Nongpiur [26] | Posterior PTM not visible in ≥ 180 degrees | Stepwise logistic regression model | 0.5 | 96 | 75 | 51 | 99 |
| 0.26 | 89 | 89 | 69 | 97 | |||
| Baskaran [41] | Posterior PTM not visible in ≥ 1 quadrants | ITC index | > 35% | 69.1 (52.9–82.4) | 88.8 (80.8–94.3) | 72.5 (55.9–85.5) | 87.0 (78.8–92.9) |
| ≥ 50% | 42.9 (27.7–59.0) | 94.9 (88.5–98.3) | 78.3 (55.7–92.8) | 79.5 (71.0–86.4) | |||
| > 70% | 21.4 (10.3–36.8) | 99.0 (94.4–100.0) | 90.0 (55.5–99.7) | 74.6 (66.2–81.8) | |||
| Posterior PTM not visible in ≥ 2 quadrants | > 35% | 71.9 (53.3–86.3) | 84.3 (76.0–90.6) | 57.5 (40.9–73.0) | 91.0 (83.6–95.8) | ||
| ≥ 50% | 43.8 (26.4–62.3) | 91.7 (84.8–96.1) | 60.9 (38.5–80.3) | 84.6 (76.7–90.6) | |||
| > 70% | 25.0 (11.5–43.4) | 98.1 (93.5–99.8) | 80.0 (42.2–97.9) | 81.5 (73.8–87.8) | |||
| Posterior PTM not visible in ≥ 3 quadrants | > 35% | 71.0 (52.0–85.8) | 83.5 (75.2–89.9) | 55.0 (38.5–70.7) | 91.0 (83.6–95.8) | ||
| ≥ 50% | 45.2 (27.3–64.0) | 91.7 (84.9–96.2) | 60.9 (38.0–80.7) | 85.5 (77.8–91.3) | |||
| > 70% | 25.8 (11.9–44.6) | 98.2 (93.5–99.8) | 80.0 (44.4–97.5) | 82.3 (74.6–88.4) | |||
| Posterior PTM not visible in 4 quadrants | > 35% | 92.3 (64.0–99.8) | 78.0 (69.7–84.8) | 30.0 (16.6–46.5) | 99.0 (94.5–100.0) | ||
| ≥ 50% | 76.9 (46.2–95.0) | 89.8 (83.1–94.4) | 43.5 (23.2–65.5) | 97.4 (92.7–99.5) | |||
| > 70% | 46.2 (19.2–74.9) | 96.9 (92.1–99.1) | 60.0 (26.2–87.8) | 94.6 (89.2–97.8) | |||
| Baskaran [42] | Posterior PTM not visible in ≥ 2 quadrants | Any iridotrabecular touch anterior to the SS in ≥ 1 quadrants | 95 | 61 | 61.7 | 94.9 | |
| Any iridotrabecular touch anterior to the SS in ≥ 2 quadrants | 92 | 65 | 63.5 | 92.5 | |||
| Any iridotrabecular touch anterior to the SS in ≥ 3 quadrants | 84 | 75 | 68.1 | 88.0 | |||
| Any iridotrabecular touch anterior to the SS in ≥ 4 quadrants | 77 | 76 | 68 | 83.3 | |||
| Tan [30] | Posterior TM not visible in ≥ 180 degrees | LV (mm) | ≥ 0.576 | 85.7 | 77.5 | 51 | 95.2 |
| Grewal [43] | Shaffer grade ≤ 1 in all quadrants | AOD500 @ Nasal (mm) | ≤ 0.34 | 78.6 (59.0–91.7) | 71.3 (65.1–77.0) | 19.5 (11.3–30.1) | 97.1 (93.4–99.0) |
| AOD500 @ Temporal (mm) | ≤ 0.32 | 67.9 (47.7–84.1) | 88.2 (83.4–92.0) | 33.3 (18.6–51.0) | 96.3 (92.8–98.4) | ||
| TISA500 @ Nasal (mm^2) | ≤ 0.20 | 64.3 (44.1–81.3) | 78.7 (72.8–83.8) | 18.3 (9.50–30.4) | 95.3 (91.2–97.8) | ||
| TISA500 @ Temporal (mm^2) | ≤ 0.21 | 71.4 (51.3–86.7) | 81.0 (75.4–85.8) | 22.8 (12.8–35.8) | 96.4 (92.7–98.5) | ||
| Chang [27] | Shaffer grade ≤ 1 in ≥ 2 quadrants | AOD750 if SS visible. If not, subjective assessment (mm) | ≤ 0.258 | 83.0 (78.9–86.5) | 78.2 (76.1–80.2) | 48.4 (44.6–52.3) | 94.9 (93.6–96.0) |
| Narayanaswamy [29]d | Posterior PTM not visible in ≥ 180 degrees | AOD250 @ Temporal (mm) | 0.144 | 77.1 (72.5–81.8) | 68.2 (65.6–70.9) | 37.7 (33.8–41.6) | 92.2 (90.4–94.0) |
| AOD250 @ Nasal (mm) | 0.138 | 75.6 (70.8–80.3) | 70.6 (68.0–73.2) | 39.1 (35.1–43.1) | 92.0 (90.2–93.8) | ||
| AOD500 @ Temporal (mm) | 0.191 | 88.9 (85.4–92.3) | 74.6 (72.1–77.1) | 46.6 (42.5–50.7) | 96.4 (95.1–97.6) | ||
| AOD500 @ Nasal (mm) | 0.177 | 85.1 (81.1–89.0) | 76.1 (73.7–78.6) | 47.1 (42.8–51.3) | 95.3 (93.9–96.6) | ||
| AOD750 @ Temporal (mm) | 0.258 | 90.2 (86.9–93.4) | 77.4 (74.9–79.8) | 49.9 (45.6–54.2) | 96.9 (95.8–98.0) | ||
| AOD750 @ Nasal (mm) | 0.225 | 82.5 (78.3–86.7) | 84.0 (81.9–86.2) | 56.3 (51.6–61.0) | 95.0 (93.7–96.3) | ||
| TISA500 @ Temporal (mm^2) | 0.103 | 88.2 (84.7–91.8) | 59.1 (56.3–62.0) | 35.0 (31.6–38.5) | 95.2 (93.6–96.7) | ||
| TISA500 @ Nasal (mm^2) | 0.076 | 73.3 (68.4–78.2) | 75.2 (72.7–77.7) | 42.4 (38.1–46.7) | 91.8 (90.0–93.5) | ||
| TISA750 @ Temporal (mm^2) | 0.151 | 83.5 (79.4–87.6) | 76.7 (74.3–79.2) | 47.3 (43.0–51.6) | 94.8 (93.4–96.2) | ||
| TISA750 @ Nasal (mm^2) | 0.134 | 80.3 (75.9–84.7) | 77.5 (75.1–79.9) | 47.2 (42.8–51.8) | 94.0 (92.5–95.5) | ||
| ARA750 @ Temporal (mm^2) | 0.191 | 84.1 (80.1–88.2) | 69.2 (66.5–71.9) | 40.6 (36.7–44.4) | 94.5 (93.0–96.0) | ||
| ARA750 @ Nasal (mm^2) | 0.154 | 74.0 (69.1–78.8) | 75.8 (73.3–78.3) | 43.2 (38.9–47.5) | 92.0 (90.3–93.7) | ||
| Khor [28] | Any iridotrabecular touch anterior to the SS in ≥ 1 quadrants of quadrants tested | ||||||
| Posterior TM not visible in ≥ 1 quadrants | Inferior only | 79.5 | 72.7 | 53.4 | 90.0 | ||
| Inferior, nasal and temporal | 82.2 | 68.3 | 50.5 | 90.7 | |||
| Nasal and temporal only | 40.8 | 89.0 | 59.3 | 79.3 | |||
| Posterior TM not visible in ≥ 2 quadrants | Inferior only | 83.9 | 68.8 | 41.0 | 94.3 | ||
| Inferior, nasal and temporal | 87.4 | 64.8 | 39.0 | 95.2 | |||
| Nasal and temporal only | 46.8 | 87.6 | 49.3 | 86.5 | |||
| Posterior TM not visible in ≥ 3 quadrants | Inferior only | 87.8 | 67.0 | 34.3 | 96.6 | ||
| Inferior, nasal and temporal | 90.8 | 62.8 | 32.4 | 97.2 | |||
| Nasal and temporal only | 49.2 | 86.4 | 41.5 | 89.7 | |||
| Hong [44] | TM visible in < 90 degrees | ACA (°) | 31.8 | 75.0 | 97.6 | ||
| ACD (mm) | 2.45 | 87.5 | 97.6 | ||||
| Sakata [45] | Posterior TM not visible in ≥ 1 quadrants | Any iridotrabecular touch anterior to the SS in ≥ 1 quadrants | |||||
| Visante data | 97 (83–100) | 51 (37–65) | 53 (46–60) | 96 (79–99) | |||
| SL-OCT data | 90 (73–98) | 64 (50–77) | 59 (49–68) | 92 (79–97) | |||
| Wong [46] | Posterior TM not visible in ≥ 1 quadrants | Any iridotrabecular touch anterior to the SS in ≥ 1 quadrants | 84 | 58 | 50 | 88 | |
| Any iridotrabecular touch anterior to the SS in ≥ 2 quadrants | 68 | 75 | 58 | 82 | |||
| Any iridotrabecular touch anterior to the SS in ≥ 3 quadrants | 43 | 86 | 61 | 75 | |||
| Posterior TM not visible in ≥ 2 quadrants | Any iridotrabecular touch anterior to the SS in ≥ 1 quadrants | 83 | 55 | 44 | 88 | ||
| Any iridotrabecular touch anterior to the SS in ≥ 2 quadrants | 65 | 72 | 50 | 83 | |||
| Any iridotrabecular touch anterior to the SS in ≥ 3 quadrants | 46 | 86 | 59 | 79 | |||
| Nolan [47]e | Spaeth 0° in ≥ 1 quadrants, assessing temporal, nasal and inferior quadrants only | Any iridotrabecular touch anterior to the SS in ≥ 1 quadrants out of the 3 temporal, nasal and inferior quadrants | 94.1 (88.7–97.1) | 55.3 (47.9–62.4) | 62.7 (58.8–66.4) | 92.1 (85.4–95.7) | |
| Radhakrishnan [48] | Shaffer grade ≤ 1 in 4 quadrants | AOD500 (mm) | 0.191 | 100.0 | 87.5 | ||
| ARA500 (mm^2) | 0.12 | 87.0 | 100 | ||||
| ARA750 (mm^2) | 0.17 | 91.3 | 87.5 | ||||
| TISA500 (mm^2) | 0.11 | 87.0 | 100 | ||||
| TISA750 (mm^2) | 0.17 | 91.3 | 87.5 |
95% Confidence intervals indicated in brackets
Parameter with the highest Youden-J value in bold
aExcluded duplicate data from Porporato (2019)
bData from validation set only
cExcluded per individual analysis
dPPV/NPV values given for 20% prevalence
eExcluded per individual analysis