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Abtahi MA, Beheshtnejad AH, Latifi G, Akbari-Kamrani M, Ghafarian S, Masoomi A, Sonbolastan SA, Jahanbani-Ardakani H, Atighechian M, Banan L, Nouri H, Abtahi SH. Corneal Epithelial Thickness Mapping: A Major Review. J Ophthalmol 2024; 2024:6674747. [PMID: 38205099 PMCID: PMC10776199 DOI: 10.1155/2024/6674747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/27/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
The corneal epithelium (CE) is the outermost layer of the cornea with constant turnover, relative stability, remarkable plasticity, and compensatory properties to mask alterations in the underlying stroma. The advent of quantitative imaging modalities capable of producing epithelial thickness mapping (ETM) has made it possible to characterize better the different patterns of epithelial remodeling. In this comprehensive synthesis, we reviewed all available data on ETM with different methods, including very high-frequency ultrasound (VHF-US) and spectral-domain optical coherence tomography (SD-OCT) in normal individuals, corneal or systemic diseases, and corneal surgical scenarios. We excluded OCT studies that manually measured the corneal epithelial thickness (CET) (e.g., by digital calipers) or the CE (e.g., by confocal scanning or handheld pachymeters). A comparison of different CET measuring technologies and devices capable of producing thickness maps is provided. Normative data on CET and the possible effects of gender, aging, diurnal changes, refraction, and intraocular pressure are discussed. We also reviewed ETM data in several corneal disorders, including keratoconus, corneal dystrophies, recurrent epithelial erosion, herpes keratitis, keratoplasty, bullous keratopathy, carcinoma in situ, pterygium, and limbal stem cell deficiency. The available data on the potential role of ETM in indicating refractive surgeries, planning the procedure, and assessing postoperative changes are reviewed. Alterations in ETM in systemic and ocular conditions such as eyelid abnormalities and dry eye disease and the effects of contact lenses, topical medications, and cataract surgery on the ETM profile are discussed.
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Affiliation(s)
| | | | - Golshan Latifi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sadegh Ghafarian
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Masoomi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Laleh Banan
- Sunshine Coast University Hospital, Brisbane, Queensland, Australia
| | - Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ozalp O, Atalay E. Biometric Determinants of Epithelial Thickness Profile Across a Wide Range of Refractive Errors. Ophthalmol Ther 2022; 11:1089-1100. [PMID: 35286628 PMCID: PMC9114216 DOI: 10.1007/s40123-022-00489-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/17/2022] [Indexed: 10/27/2022] Open
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Hoshing A, Bhosale S, Samant M, Bamne A, Kalyankar H. A cross-sectional study to compare the normal corneal epithelial thickness in various age groups of Indian population using 9 mm wide optical coherence tomography scans. Indian J Ophthalmol 2022; 70:505-510. [PMID: 35086226 PMCID: PMC9023985 DOI: 10.4103/ijo.ijo_1621_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Purpose: To compare the corneal epithelial thickness among various age groups of normal Indians with 9-mm-wide optical coherence tomography scans. Methods: This cross sectional, observational study recruited patients in the age groups of 5–20 years (group 1), 21–35 years (group 2), 36–50 years (group 3), and more than 51 years (group 4). They underwent a detailed ophthalmic examination and were excluded if found to have any ocular surface or intraocular disease (except cataract and refractive error), undergone any ophthalmic surgery, corneal topography changes suggestive of corneal ectasias, or been continuously using any topical medication in either eye for a period of 3 months or more with the last instillation being within 1 month of inclusion in the study. Corneal epithelial thickness (CET) was measured using anterior segment optical coherence tomography (AS-OCT). The CET data from 25 sectors in each eye were analyzed for each age group. Results: There were 71 subjects in group 1, 76 subjects in group 2, 59 subjects in group 3, and 57 subjects in group 4. The mean (± standard deviation) ages in the groups 1, 2, 3, and 4 were 14.04 ± 5.10, 26.63 ± 4.71, 42.66 ± 3.92, and 61.65 ± 7.47 years, respectively. The central corneal thickness in all age groups was comparable. Maximum variance in CET parameters was seen in superior cornea. Conclusion: Central corneal thickness remains fairly stable over various age groups. The maximum variance in CET over age is seen in superior cornea. The findings from the Indian population correlate well with racially and geographically distinct subjects.
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Affiliation(s)
- Abhishek Hoshing
- Department of Cornea and Refractive Surgery, Laxmi Eye Institute, Panvela; Department of Ophthalmology, Apollo Hospitals, Navi Mumbai, Maharashtra, India
| | - Seema Bhosale
- Cataract Services, Laxmi Eye Institute, Panvel, Maharashtra, India
| | - Monica Samant
- Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Laxmi Eye Institute, Panvel, Maharashtra, India
| | - Aditya Bamne
- Clinical Optometry, Laxmi Eye Institute, Panvel, Maharashtra, India
| | - Huma Kalyankar
- Clinical Optometry, Laxmi Eye Institute, Panvel, Maharashtra, India
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Dong Y, Li D, Guo Z, Liu Y, Lin P, Lv B, Lv C, Xie G, Xie L. Dissecting the Profile of Corneal Thickness With Keratoconus Progression Based on Anterior Segment Optical Coherence Tomography. Front Neurosci 2022; 15:804273. [PMID: 35173574 PMCID: PMC8842478 DOI: 10.3389/fnins.2021.804273] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/23/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose To characterize the corneal and epithelial thickness at different stages of keratoconus (KC), using a deep learning based corneal segmentation algorithm for anterior segment optical coherence tomography (AS-OCT). Methods An AS-OCT dataset was constructed in this study with 1,430 images from 715 eyes, which included 118 normal eyes, 134 mild KC, 239 moderate KC, 153 severe KC, and 71 scarring KC. A deep learning based corneal segmentation algorithm was applied to isolate the epithelial and corneal tissues from the background. Based on the segmentation results, the thickness of epithelial and corneal tissues was automatically measured in the center 6 mm area. One-way ANOVA and linear regression were performed in 20 equally divided zones to explore the trend of the thickness changes at different locations with the KC progression. The 95% confidence intervals (CI) of epithelial thickness and corneal thickness in a specific zone were calculated to reveal the difference of thickness distribution among different groups. Results Our data showed that the deep learning based corneal segmentation algorithm can achieve accurate tissue segmentation and the error range of measured thickness was less than 4 μm between our method and the results from clinical experts, which is approximately one image pixel. Statistical analyses revealed significant corneal thickness differences in all the divided zones (P < 0.05). The entire corneal thickness grew gradually thinner with the progression of the KC, and their trends were more pronounced around the pupil center with a slight shift toward the temporal and inferior side. Especially the epithelial thicknesses were thinner gradually from a normal eye to severe KC. Due to the formation of the corneal scarring, epithelial thickness had irregular fluctuations in the scarring KC. Conclusion Our study demonstrates that our deep learning method based on AS-OCT images could accurately delineate the corneal tissues and further successfully characterize the epithelial and corneal thickness changes at different stages of the KC progression.
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Affiliation(s)
- Yanling Dong
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Dongfang Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Zhen Guo
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Yang Liu
- Ping An Technology (Shenzhen) Co. Ltd., Shenzhen, China
| | - Ping Lin
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Bin Lv
- Ping An Technology (Shenzhen) Co. Ltd., Shenzhen, China
| | - Chuanfeng Lv
- Ping An Technology (Shenzhen) Co. Ltd., Shenzhen, China
| | - Guotong Xie
- Ping An Technology (Shenzhen) Co. Ltd., Shenzhen, China
- Ping An Health Cloud Co. Ltd., Shenzhen, China
- Ping An International Smart City Technology Co. Ltd., Shenzhen, China
- *Correspondence: Guotong Xie,
| | - Lixin Xie
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
- *Correspondence: Guotong Xie,
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Ran Z, Moore J, Jiang F, Guo H, Eliasy A, Lopes BT, Bao F, Jiang J, Abass A, Elsheikh A. A new approach for quantifying epithelial and stromal thickness changes after orthokeratology contact lens wear. ROYAL SOCIETY OPEN SCIENCE 2021; 8:211108. [PMID: 34950488 PMCID: PMC8692962 DOI: 10.1098/rsos.211108] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/29/2021] [Indexed: 05/03/2023]
Abstract
The aim of the study was to develop an automatic segmentation approach to optical coherence tomography (OCT) images and to investigate the changes in epithelial and stromal thickness profile and radius of curvature after the use of orthokeratology (Ortho-K) contact lenses. A total of 45 right eyes from 52 participants were monitored before, and after one month of, uninterrupted overnight Ortho-K lens wear. The tomography of their right eyes was obtained using optical OCT and rotating Scheimpflug imaging (OCULUS Pentacam). A custom-built MATLAB code for automatic segmentation of corneal OCT images was created and used to assess changes in epithelial thickness, stromal thickness, corneal and stromal profiles and radii of curvature before, and after one month of, uninterrupted overnight wear of Ortho-K lenses. In the central area (0-2 mm diameter), the epithelium thinned by 12.8 ± 6.0 µm (23.8% on average, p < 0.01) after one month of Ortho-K lens wear. In the paracentral area (2-5 mm diameter), the epithelium thinned nasally and temporally (by 2.4 ± 5.9 µm, 4.5% on average, p = 0.031). The stroma thickness increased in the central area (by 4.8 ± 16.1 µm, p = 0.005). The radius of curvature of the central corneal anterior surface increased by 0.24 ± 0.26 mm (3.1%, p < 0.01) along the horizontal meridian and by 0.34 ± 0.18 mm (4.2%, p < 0.01) along the vertical meridian. There were no significant changes in the anterior and posterior stromal radius of curvature. This study introduced a new method to automatically detect the anterior corneal surface, the epithelial posterior surface and the posterior corneal surface in OCT scans. Overnight wear of Ortho-K lenses caused thinning of the central corneal epithelium. The anterior corneal surface became flattered while the anterior and posterior surfaces of the stroma did not undergo significant changes. The results are consistent with the changes reported in previous studies. The reduction in myopic refractive error caused by Ortho-K lens wear was mainly due to changes in corneal epithelium thickness profile.
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Affiliation(s)
- Ziying Ran
- School of Engineering, University of Liverpool, Liverpool, UK
| | - Joshua Moore
- School of Engineering, University of Liverpool, Liverpool, UK
- Department of Mathematical Sciences, School of Physical Sciences, University of Liverpool, Liverpool, UK
| | - Fan Jiang
- Eye Hospital, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Hongmei Guo
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan City, Shanxi Province, People's Republic of China
| | - Ashkan Eliasy
- School of Engineering, University of Liverpool, Liverpool, UK
| | - Bernardo T. Lopes
- School of Engineering, University of Liverpool, Liverpool, UK
- Federal University of São Paulo, 1500 Vila Clementino, São Paulo 04021-001, Brazil
| | - FangJun Bao
- Eye Hospital, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jun Jiang
- Eye Hospital, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Ahmed Abass
- School of Engineering, University of Liverpool, Liverpool, UK
- Department of Production Engineering and Mechanical Design, Faculty of Engineering, Port Said University, Port Fuad, Egypt
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, UK
- Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, People's Republic of China
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Hoshing AA, Bhosale S, Samant MP, Bamne A, Kalyankar H. A cross-sectional study to determine the normal corneal epithelial thickness in Indian population using 9-mm wide optical coherence tomography scans. Indian J Ophthalmol 2021; 69:2425-2429. [PMID: 34427236 PMCID: PMC8544085 DOI: 10.4103/ijo.ijo_244_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To study the corneal epithelial thickness with 9-mm scans of optical coherence tomography in normal Indians with appropriate representation of all age groups. Methods This was a cross-sectional observational study. 263 patients were divided into the age groups 5-20 years, 21-35 years, 36-50 years and more than 51 years were recruited for the study. All patients underwent a detailed ophthalmic examination. Patients found to have any ocular surface or intraocular disease condition (except cataract and refractive error), or who had undergone any ophthalmic surgery in the past, or had corneal topography changes suggestive of corneal ectasias (screened in patients with astigmatism more than 3 diopters) or had been continuously using any topical medication in either eye for a period of 3 months or more with the last instillation being within 1 month of inclusion in the study were excluded. All subjects underwent corneal epithelial thickness measurement with anterior segment optical coherence tomography (AS-OCT) on the Avanti OCT (Model RTVueXR1002, Optovue, USA). The corneal epithelial thickness (CET) data from 25 sectors in each eye were analyzed. Results 263 right and left eyes of 263 patients were analyzed in the study. Mean CETs in the central 2 mm zone were 54.13 ± 4.51 μm and 54.37 ± 3.75 μm for the right and left eyes, respectively. The superior peripheral sectors and inferior paracentral sectors were the thinnest and the thickest sectors, respectively, in both eyes. Conclusion CET parameters for Indian eyes are comparable to those reported from racially distinct and geographically distant study subjects.
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Affiliation(s)
- Abhishek A Hoshing
- Department of Cornea and Refractive Surgery, Strabismus and Neuro-Ophthalmology, Laxmi Eye Institute, Panvel; Department of Ophthalmology, Apollo Hospitals, Navi Mumbai, Maharashtra, India
| | - Seema Bhosale
- Department of Cataract Services, Strabismus and Neuro-Ophthalmology, Laxmi Eye Institute, Panvel, Maharashtra, India
| | - Monica P Samant
- Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Laxmi Eye Institute, Panvel, Maharashtra, India
| | - Aditya Bamne
- Department of Clinical Optometry, Laxmi Eye Institute, Panvel, Maharashtra, India
| | - Huma Kalyankar
- Department of Clinical Optometry, Laxmi Eye Institute, Panvel, Maharashtra, India
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Nam M, Kim SW. Changes in Corneal Epithelial Thickness Induced by Topical Antiglaucoma Medications. J Clin Med 2021; 10:jcm10163464. [PMID: 34441760 PMCID: PMC8397015 DOI: 10.3390/jcm10163464] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/20/2022] Open
Abstract
Corneal thickness measurement is important for assessing intraocular pressure in patients with glaucoma. This study investigated the changes in corneal epithelial thickness (CET) induced by antiglaucoma medications and explored the factors affecting CET measurement. CET was measured over a 9.0 mm diameter area by using Fourier domain optical coherence tomography in 125 patients with primary open-angle glaucoma and 125 age-matched controls without glaucoma. The influence of sex, age, benzalkonium chloride (BAK)-containing instillations, disease severity, and types and numbers of medications was analyzed using simple and multiple regression analyses. CET over 25 sectors was smaller in the glaucoma group than in the control group (mean difference of 4.2 µm in the central 2.0 mm zone; 52.8 ± 3.6 vs. 48.5 ± 3.9, p < 0.001). Simple regression analysis revealed age, use of β-blockers, prostaglandin, carbonic anhydrase inhibitors, total number of medications, and number of daily BAK-containing instillations were associated with a thinner epithelium. Multiple regression analysis revealed β-blockers, prostaglandin, and number of BAK-containing instillations were significant factors. Use of β-blockers and number of BAK-containing instillations were also associated with a thinner epithelium in the monotherapy subgroup analysis. CET was significantly smaller in patients with glaucoma receiving topical medications and was affected by the use of β-blockers, prostaglandin, and BAK.
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Dong Y, Li D, Guo Z, Liu Y, Lin P, Lv B, Lv C, Xie G, Xie L. Dissecting the Profile of Corneal Thickness With Keratoconus Progression Based on Anterior Segment Optical Coherence Tomography. Front Neurosci 2021; 15:804273. [PMID: 35173574 PMCID: PMC8842478 DOI: 10.3389/fnins.2021.804273 10.4103/joco.joco_147_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/23/2021] [Indexed: 05/21/2023] Open
Abstract
PURPOSE To characterize the corneal and epithelial thickness at different stages of keratoconus (KC), using a deep learning based corneal segmentation algorithm for anterior segment optical coherence tomography (AS-OCT). METHODS An AS-OCT dataset was constructed in this study with 1,430 images from 715 eyes, which included 118 normal eyes, 134 mild KC, 239 moderate KC, 153 severe KC, and 71 scarring KC. A deep learning based corneal segmentation algorithm was applied to isolate the epithelial and corneal tissues from the background. Based on the segmentation results, the thickness of epithelial and corneal tissues was automatically measured in the center 6 mm area. One-way ANOVA and linear regression were performed in 20 equally divided zones to explore the trend of the thickness changes at different locations with the KC progression. The 95% confidence intervals (CI) of epithelial thickness and corneal thickness in a specific zone were calculated to reveal the difference of thickness distribution among different groups. RESULTS Our data showed that the deep learning based corneal segmentation algorithm can achieve accurate tissue segmentation and the error range of measured thickness was less than 4 μm between our method and the results from clinical experts, which is approximately one image pixel. Statistical analyses revealed significant corneal thickness differences in all the divided zones (P < 0.05). The entire corneal thickness grew gradually thinner with the progression of the KC, and their trends were more pronounced around the pupil center with a slight shift toward the temporal and inferior side. Especially the epithelial thicknesses were thinner gradually from a normal eye to severe KC. Due to the formation of the corneal scarring, epithelial thickness had irregular fluctuations in the scarring KC. CONCLUSION Our study demonstrates that our deep learning method based on AS-OCT images could accurately delineate the corneal tissues and further successfully characterize the epithelial and corneal thickness changes at different stages of the KC progression.
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Affiliation(s)
- Yanling Dong
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Dongfang Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Zhen Guo
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Yang Liu
- Ping An Technology (Shenzhen) Co. Ltd., Shenzhen, China
| | - Ping Lin
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Bin Lv
- Ping An Technology (Shenzhen) Co. Ltd., Shenzhen, China
| | - Chuanfeng Lv
- Ping An Technology (Shenzhen) Co. Ltd., Shenzhen, China
| | - Guotong Xie
- Ping An Technology (Shenzhen) Co. Ltd., Shenzhen, China
- Ping An Health Cloud Co. Ltd., Shenzhen, China
- Ping An International Smart City Technology Co. Ltd., Shenzhen, China
- *Correspondence: Guotong Xie,
| | - Lixin Xie
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
- *Correspondence: Guotong Xie,
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Kim WK, Ryu IH, Yoo J, Kim SW. Effect of Gender, Age, and Ocular and Growth-Related Factors on Corneal Epithelial and Stromal Thickness in Children. J Clin Med 2020; 9:jcm9123849. [PMID: 33260816 PMCID: PMC7760657 DOI: 10.3390/jcm9123849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 01/01/2023] Open
Abstract
Data on corneal epithelial and stromal thickness in school-aged children in relation to gender, age, and ocular and growth parameters are limited. In this retrospective study, we analyzed corneal epithelial and stromal thickness measured with the RTVue system (Optovue, Inc., Fremont, CA, USA) in 122 male and 201 female Korean children (mean age 9.59 ± 2.18 years) with myopia. We used simple and multiple regression analysis to establish the relationships between gender, age, refractive status, axial length, anterior chamber depth (ACD), corneal refractive power, white-to-white corneal diameter (WTW), height, and body weight. Age, body weight, height, and central corneal thickness were positively associated with corneal epithelial thickness, whereas WTW was negatively associated. The multiple regression analysis showed corneal epithelial thickness was affected by sex, body weight, WTW, and central corneal thickness (CCT), while stromal thickness was influenced by age, sex, and WTW. Both corneal epithelial and stromal thickness were significantly greater in male than in female children and were affected by growth. Neither corneal epithelial nor stromal thickness were associated with the severity of myopia, corneal refractive power, or axial length.
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Affiliation(s)
- Wook Kyum Kim
- B & VIIT Eye Center, Seoul 06615, Korea; (W.K.K.); (I.H.R.)
| | - Ik Hee Ryu
- B & VIIT Eye Center, Seoul 06615, Korea; (W.K.K.); (I.H.R.)
| | - Jeongseo Yoo
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju 26426, Gangwon-do, Korea;
| | - Sun Woong Kim
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju 26426, Gangwon-do, Korea;
- Correspondence:
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Relationship Between Central Epithelial Thickness and Central Corneal Thickness in Healthy Eyes and Eyes After Laser In Situ Keratomileusis. Cornea 2018. [PMID: 29543664 DOI: 10.1097/ico.0000000000001568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To study the relationship between central epithelial thickness (CET) and central corneal thickness (CCT) in healthy individuals and to evaluate their changes after laser in situ keratomileusis (LASIK). METHODS In this study, we included 150 patients (150 eyes) who underwent LASIK and 83 healthy individuals (83 eyes). In all patients, CET and CCT were measured using anterior segment optical coherence tomography with Copernicus REVO on B-scans. Statistical analysis was performed using the Spearman rank test, t test, and receiver operating characteristic curve analysis. RESULTS In healthy individuals, CET positively correlated with CCT (r = 0.5, P < 0.001), the CET-to-CCT ratio being 0.100 ± 0.006. The CET-to-CCT ratio increased to 0.111 ± 0.009 (P < 0.001) and to 0.132 ± 0.021 (P < 0.001) at 1 day and 1 month postoperatively, respectively. The area under the curve for the CET-to-CCT ratio as a diagnostic criterion for previously performed myopic LASIK was 0.97 (sensitivity 93.5% and specificity 91.6%). CONCLUSIONS In healthy individuals, the corneal epithelium contributes a mean of 10.0% of corneal thickness. The CET-to-CCT ratio has a highly predictive value for indication of previously performed myopic LASIK. It seems that clinical application of epithelial thickness measurement can be improved by adjusting CET for CCT.
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