Automated 360-degree goniophotography with the NIDEK Gonioscope GS-1 for glaucoma

Purpose To evaluate the reliability of the NIDEK Gonioscope GS-1 when used to grade the iridocorneal angle in a clinical setting. Methods A total of 20 participants (37 eyes) who were 18 or older and had glaucoma or were glaucoma suspects were enrolled from the NYU Langone Eye Center and Bellevue Hospital. During their usual ophthalmology visit, they were consented for the study and underwent 360-degree goniophotography using the NIDEK Gonioscope GS-1. Afterwards, the three ophthalmologists separately examined the images obtained and determined the status of the iridocorneal angle in four quadrants using the Shaffer grading system. Physicians were masked to patient names and diagnoses. Inter-observer reproducibility was determined using Fleiss’ kappa statistics. Results The interobserver reliability using Fleiss’ statistics was shown to be significant between three glaucoma specialists with fair overall agreement (Fleiss’ kappa: 0.266, p<.0001) in the interpretation of 360-degree goniophotos. Automated 360-degree goniophotography using the NIDEK Gonioscope GS-1 have quality such that they are interpreted similarly by independent expert observers. This indicates that angle investigation may be performed using this automated device and that interpretation by expert observers is likely to be similar. Conclusion Images produced from automated 360-degree goniophotography using the NIDEK Gonioscope GS-1 are similarly interpreted amongst glaucoma specialists, thus supporting use of this technique to document and assess the anterior chamber angle in patients with, or suspected of, glaucoma and iridocorneal angle abnormalities. Précis Automated 360-degree goniophotography using the NIDEK Gonioscope GS-1 is a reasonable tool for anterior chamber angle assessment.