Ultrasound biomicroscopic dark room provocative test.

PURPOSE: To compare the clinical application value of Ultrasound biomicrsocpic dark room provocative test with the traditional dark room test in screening primary angle closure glaucoma (PACG).

METHODS

22 eyes with PACG in prodromal stage and 30 eyes with deep anterior chamber and wide angle of 15 normal persons were observed in this trail. All 52 eyes were performed traditional dark room provocative test and ultrasound biomicorosopic darkroom test respectively. With different positive diagnostic criteria, the sensitivity of the two methods were compared using chi-squared analysis.

RESULTS

After staying in the dark room for 2 hours, In case group, IOP in 10 of 22 eyes rose more than 1.07 kPa (1kPa = 7.5 mmHg), in 12 eyes less than 1.07 kPa or had no changes; appositional angle closure were found by Goldmann gonioscopy in 8 eyes: 3 eyes in two quadrants, 5 eyes in more than two quadrants; the appositional angle closure was found by UBM in 15 eyes: 3 eyes in one quadrants, 5 eyes in two quadrants, 7 eyes in more than two quadrants. In the control group, IOP rose more than 1.07 kPa in 3 eyes. There were no appositional angle closure found in the control group. With the appositional angle closure as the positive diagnostic criteria, the sensitivity of the traditional darkroom test and UMB drak room test was 31.8% and 68.2% respectively. With chi-square test, there were statistically significant difference between the two methods (P < 0.05).

CONCLUSION

The sensitivity of UBM dark room provocative test is higher than the traditional method. Dark room provocative test with UBM prompts the sensitivity and specificity of dark room test, reduces the false negative rate and false positive rate in screening PACG. It may help to reduce chances of misdiagnosis and missed diagnosis caused by traditional dark room test.