Reply

Abstract

We thank Lakhani et al for their interest in our study.1Baskaran M. Iyer J.V. Narayanaswamy A.K. et al.Anterior segment imaging predicts incident gonioscopic angle closure.Ophthalmology. 2015; 122: 2380-2382Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar We agree that blunt trauma should have been one of the exclusion criteria. However, none of the subjects included had a history of blunt trauma in the past or during the interim period of follow-up, nor had angle recession on gonioscopy. We agree with the authors regarding the importance of intertest reliability for grading gonioscopic angle closure by different observers. We have mentioned this point as a limitation of the study in the discussion. We have documented the agreement for documenting gonioscopic angle closure between the study gonioscopist and a senior ophthalmologist in the original study. A weighted kappa of 0.82 was achieved for this assessment.2Lavanya R. Foster P.J. Sakata L.M. et al.Screening for narrow angles in the Singapore population: evaluation of new noncontact screening methods.Ophthalmology. 2008; 115: 1720-1722Abstract Full Text Full Text PDF PubMed Scopus (87) Google Scholar We also agree with the authors' comments regarding the disadvantages of static point analysis compared to 360° assessment for grading angle closure with anterior segment optical coherence tomography. However, because our original study was based on cross-sectional anterior segment optical coherence tomography scans, we decided to follow the same imaging protocol. Although we agree that scleral spur visibility may be an issue when acquiring anterior segment optical coherence tomography scans, our cohort was preselected for having good scleral spur visibility at baseline and, thus, they had minimal artifacts affecting image acquisition and quality.3Sakata L.M. Lavanya R. Friedman D.S. et al.Assessment of the scleral spur in anterior segment optical coherence tomography images.Arch Ophthalmol. 2008; 126: 181-184Crossref PubMed Scopus (183) Google Scholar Furthermore, multiple scans were carefully acquired during the follow up study, such that the scleral spur was identified by the experienced operator handling the device (as detailed in the Methods).1Baskaran M. Iyer J.V. Narayanaswamy A.K. et al.Anterior segment imaging predicts incident gonioscopic angle closure.Ophthalmology. 2015; 122: 2380-2382Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar Re: Baskaran et al.: Anterior segment imaging predicts incident gonioscopic angle closure (Ophthalmology 2015;122:2380-2)OphthalmologyVol. 123Issue 9PreviewWe read with interest the article by Baskaran et al,1 in which the authors found that angle closure on anterior segment (AS) optical coherence tomography (OCT) predicts gonioscopic angle closure in patients with gonioscopically open angles at baseline. However, we raise the following questions with regard to their methodology. Full-Text PDF