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Wan T, Chen H, Wu S, Jin H. Analysis of surgically induced astigmatism of the anterior, posterior, and total cornea after implantable collamer lens implantation: a comparative study between temporal and superior clear corneal incisions. BMC Ophthalmol 2024; 24:252. [PMID: 38867207 PMCID: PMC11170833 DOI: 10.1186/s12886-024-03501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND To comparatively analyze the surgically induced astigmatism (SIA) of the anterior, posterior, and total corneas of eyes undertaking implantable collamer lens (ICL) implantation with temporal or superior corneal incisions. METHODS One hundred and nine eyes of 109 patients who received ICL implantation were recruited: 40 eyes had temporal incisions and 69 eyes had superior incisions. Total corneal refractive power (TCRP); simulated keratometry of the anterior (Sim-KAnt) and posterior (Sim-KPost) corneal curvature; and astigmatism of the anterior (CAAnt), posterior (CAPost), and total (CATCRP) cornea were recorded through a Pentacam preoperatively and 3 months postoperatively. The SIA of the anterior, posterior, and total cornea were also compared between the two groups. RESULTS There were no significant intergroup differences for TCRP, Sim-KAnt, Sim-KPost, CAAnt, CAPost, or CATCRP, preoperatively. However, values of CAAnt, CAPost, and CATCRP with temporal incision were significantly higher than those parameters with superior incision postoperatively. All of the SIA of the anterior, posterior, and total cornea were significantly lower for temporal incision than those with a superior incision (p < 0.001, p = 0.006 and p = 0.001 respectively). Meanwhile, the superior incisions created against-the-rule (ATR) astigmatism, and temporal incisions always induce with-the-rule (WTR) astigmatism in total cornea. CONCLUSIONS A superior incision may be suitable for correcting WTR astigmatism, while a temporal incision for correcting ATR astigmatism when using a non-toric ICL. Meanwhile, temporal incision could be a better choice with little preoperative astigmatism or that preoperative astigmatism would be corrected with toric ICLs. TRIAL REGISTRATION Registration number: ChiCTR2100051739. Prospectively registered: 01 October 2021.
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Affiliation(s)
- Ting Wan
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China
| | - Huaicheng Chen
- Department of Ophthalmology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Shirou Wu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China
| | - Hongying Jin
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
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Weller JM, Hübner L, Kruse FE, Tourtas T. Characterisation of ectasia after penetrating keratoplasty in keratoconus eyes using anterior segment optical coherence tomography. Br J Ophthalmol 2024; 108:506-512. [PMID: 36941032 PMCID: PMC10958274 DOI: 10.1136/bjo-2022-322859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/02/2023] [Indexed: 03/22/2023]
Abstract
BACKGROUND/AIMS Ectasia of the cornea can occur decades after penetrating keratoplasty (PK), especially in keratoconus eyes. The purpose of this study was to characterise ectasia after PK by morphological findings in anterior segment optical coherence tomography (AS-OCT). METHODS In this retrospective, single-centre case series, 50 eyes of 32 patients with a history of PK at an average of 25±10 years earlier were included. The eyes were classified either as ectatic (n=35) or as non-ectatic (n=15). The main parameters included central corneal thickness (CCT), lowest corneal thickness at the interface (LCTI), anterior chamber depth, graft-host interface angle at the thinnest point and host cornea-iris angle. Furthermore, steep and flat keratometry readings obtained by AS-OCT (CASIA-2, Tomey) and Scheimpflug tomography (Pentacam, Oculus) were assessed. OCT findings were correlated with clinical grading of ectasia. RESULTS There was a highly significant difference in LCTI, graft-host interface angle and anterior chamber depth (in pseudophakic eyes) between the groups. The ratio calculated by the quotient of LCTI divided by CCT was significantly lower in ectatic than non-ectatic eyes (p<0.001). In eyes with an LCTI/CCT ratio of ≤0.7, the OR for the occurrence of a clinical detectable ectasia was 2.4 (CI 1.5 to 3.7). Steep keratometry values were significantly higher in ectatic eyes. CONCLUSION AS-OCT is a helpful tool to recognise and quantify ectasia in post-PK eyes objectively.
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Affiliation(s)
- Julia M Weller
- Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Lisa Hübner
- Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Friedrich E Kruse
- Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Theofilos Tourtas
- Department of Ophthalmology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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3
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Bograd A, Himmel I, Pfister IB, Seiler TG, Frueh BE, Tappeiner C. Comparison of corneal measurements in keratoconus eyes with two swept-source-optical coherence tomography devices and a Scheimpflug device. Graefes Arch Clin Exp Ophthalmol 2024; 262:891-901. [PMID: 37688609 DOI: 10.1007/s00417-023-06219-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/25/2023] [Accepted: 08/26/2023] [Indexed: 09/11/2023] Open
Abstract
PURPOSE To assess the feasibility and reliability of biometric measurements taken with the Eyestar 900 device in keratoconus eyes in comparison with those taken with the Pentacam HR and IOLMaster 700. METHODS Seventy-five eyes of 75 patients with keratoconus were included. The central corneal thickness (CCT), thinnest point of corneal thickness (TCT), axial length (AL), flat (K1) and steep (K2) anterior and posterior (Kp1, Kp2) keratometry, maximal keratometry (KMax) and anterior chamber depth (ACD) were compared between the Eyestar 900, Pentacam HR and IOLMaster 700. Reliability parameters such as the coefficient of variation (CoV) and intraclass correlation coefficient (ICC) were calculated. Pearson's r was determined to assess the correlation between devices. RESULTS A high repeatability (CoV < 1%) and intraclass correlation (ICC > 0.9) was found for all devices, led by AL, TCT, K1 and K2 (CoV 0.01-0.36%; ICC 0.994-1.00). The largest correlation between devices was found for AL (Eyestar vs. IOLMaster, r = 1.0), K1 (Eyestar vs. IOLMaster, r = 0.997) and ACD (Eyestar vs. IOLMaster, r = 0.995; Pentacam vs. IOLMaster, r = 0.987; Eyestar vs. Pentacam, r = 0.983), but there were significant differences in measured values between devices (p < 0.001), whereas the correlation was only slightly lower (r = 0.947 to 0.994) for KMax, CCT, TCT, K2, Kp1 and Kp2. CONCLUSION Keratometric and axial length measurements with the Eyestar 900 were feasible and revealed a high repeatability and a good correlation to the other devices in eyes with keratoconus.
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Affiliation(s)
- Alexandra Bograd
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
- Berner Augenklinik, Bern, Switzerland.
- Department of Ophthalmology, Pallas Klinik, Olten, Switzerland.
| | - Isabelle Himmel
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | | | - Theo G Seiler
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
- Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zurich, Switzerland
- Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Beatrice E Frueh
- Department of Ophthalmology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Christoph Tappeiner
- Department of Ophthalmology, Pallas Klinik, Olten, Switzerland
- Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Department of Ophthalmology, San Raffaele Scientific Institute, University Vita-Salute, Milan, Italy
- Medical Faculty, University of Bern, Bern, Switzerland
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Owusu S, Zaabaar E, Kwarteng MA, Ankamah S, Abowine JBV, Kyei S. Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis. Clin Ophthalmol 2023; 17:3941-3964. [PMID: 38143558 PMCID: PMC10749111 DOI: 10.2147/opth.s436492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/07/2023] [Indexed: 12/26/2023] Open
Abstract
Scheimpflug Pentacam Tomography is becoming crucial in the diagnosis and monitoring of keratoconus, as well as in pre- and post-corneal refractive care, but there are still some inconsistencies surrounding its evidence base diagnostic outcome. Therefore, this study aimed at employing meta-analysis to systematically evaluate the keratometric, pachymetric, and pachymetric progression indices used in the diagnosis of Keratoconus. The review protocol was registered with PROSPERO (Identifier: CRD4202310058) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, MEDLINE, Web of Science, and EMBASE were used for data search, followed by a quality appraisal of the included studies using the revised tool for the quality assessment of diagnostic accuracy studies (QUADAS-2). Meta-analysis was conducted using the meta (6.5.0) and metafor (4.2.0) packages in R version 4.3.0, as well as Stata. A total of 32 studies were included in the analysis. All keratometry (K) readings (flattest meridian, K1; steepest meridian, K2, maximum, Kmax) were significantly steeper in keratoconic compared to normal eyes: [MD (95% CI)], K1 [2.67 (1.81; 3.52)], K1-back [-0.71 (-1.03; -0.39)], K1-front [4.06 (2.48; 5.63)], K2 [4.32 (2.89; 5.75)], K2-back [-1.25 (-1.68; -0.82)], K2-front [4.82 (1.88; 7.76)], Kmax [7.57 (4.80; 10.34)], and Kmean [2.80 (1.13; 4.47)]. Additionally, corneal thickness at the center, CCT [-61.19 (-73.79; -48.60)] and apex, pachy-apex [-41.86 (-72.64; -11.08)] were significantly thinner in keratoconic eyes compared to normal eyes. The pooled estimates for pachymetric progression index (PPI): PPImin [0.66 (0.43; 0.90)], PPImax [1.26 (0.87; 1.64)], PPIavg [0.90 (0.68; 1.12)], and Ambrosio relational thickness (ART): ARTmax [-242.77 (-288.86; -196.69)], and ARTavg [-251.08 (-308.76; -195.39)] revealed significantly more rapid pachymetric progression in keratoconic eyes than in normal eyes. The Pentacam Scheimpflug-derived keratometric, pachymetric, and pachymetric progression indices are good predictors in discriminating KC from normal eyes.
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Affiliation(s)
- Sandra Owusu
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer Zaabaar
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Michael Agyemang Kwarteng
- Department of Optometry, Bindura University of Science Education, Bindura, Zimbabwe
- Discipline of Optometry, University of Kwazulu-Natal, Durban, South Africa
| | - Samuel Ankamah
- University of Ghana Library System, University of Ghana, Accra, Ghana
| | | | - Samuel Kyei
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
- Biomedical and Clinical Research Center, University of Cape Coast, Cape Coast, Ghana
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Hayashi K, Uno K, Manabe SI, Yoshimura K. Age-Related Changes in Total Corneal Astigmatism in Eyes With High Myopia. Cornea 2023:00003226-990000000-00432. [PMID: 38049154 DOI: 10.1097/ico.0000000000003447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/26/2023] [Indexed: 12/06/2023]
Abstract
PURPOSE The purpose of this study was to compare age-related changes in corneal astigmatism in eyes with and without high myopia. METHODS Eight-hundred eyes with high myopia (axial length ≥26.0 mm) and 800 eyes without high myopia (200 eyes each from patients in their 40s, 50s, 60s, and ≥70s) underwent videokeratographic examination. The amounts of vertical/horizontal (Rx) and oblique astigmatism (Ry) components, irregular astigmatism, and corneal shape were compared between eyes with and without high myopia and among age categories. RESULTS In both groups, the mean Rx significantly changed to more positive with age (P < 0.001), whereas the Ry did not change significantly. The Rx was significantly more negative in the high myopia group than in the control group in all age categories (P ≤ 0.003), whereas the Ry did not differ significantly. The mean changes in the Rx and Ry during each 2 consecutive decades did not differ significantly between groups. The asymmetry and higher-order irregularity components increased with age (P ≤ 0.001) but did not differ significantly between groups, except for the higher-order irregularity in patients in their 60s (P = 0.018). In the averaged map, the corneal shape changed from with-the-rule to against-the-rule astigmatism with age in both groups, but the changes occurred later in the high myopia group. CONCLUSIONS Age-related changes from with-the-rule to against-the-rule astigmatism occurred later in eyes with high myopia compared with eyes without high myopia in middle or older aged patients, but this change in each age decade was comparable between eyes with and without high myopia.
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Hayashi K, Uno K, Manabe SI, Hirata A. Prevalence and characteristics of oblique astigmatism. Eye (Lond) 2023; 37:3174-3179. [PMID: 36928225 PMCID: PMC10564798 DOI: 10.1038/s41433-023-02470-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/02/2023] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE To examine the incidence and characteristics of eyes with oblique astigmatism stratified by meridian, age, sex, and eye side (left to right). METHODS One thousand eyes of 1000 patients with oblique corneal astigmatism underwent videokeratographic examination and was classified into 4 meridian categories: (1) 31°-45°, (2) 46°-59°, (3) 121°-135°, and (4) 136°-149°. Amounts of regular and irregular astigmatism, and the vertical/horizontal (Rx) and oblique astigmatism components (Ry) decomposed using vector analysis were compared among the 4 categories and age groups, and between sexes and eye sides. RESULTS Incidences of the 4 meridian categories were similar and did not differ significantly among age groups or between sexes. The incidence was significantly greater in eyes in meridian categories 1 and 2 in the left eye and categories 3 and 4 in the right eye, and significantly greater in men in their 40 s and 50 s and in women in their 70 s and 80 s (P < 0.0001). The mean regular astigmatism, asymmetry and higher-order irregularity components, and Rx and absolute Ry significantly increased with age (P ≤ 0.0372). The mean regular and irregular astigmatism, and absolute Rx and Ry did not differ significantly among the 4 categories, or between sexes or left and right eyes. CONCLUSIONS The incidence of oblique astigmatism was significantly greater in the temporal side meridians, and the incidence in women increased with age. The degree of oblique astigmatism increased with age, with an increase in irregular astigmatism.
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Wen Y, Jiang D, Tang K, Chen W. Current clinical applications of anterior segment optical coherence tomography angiography: a review. Graefes Arch Clin Exp Ophthalmol 2023; 261:2729-2741. [PMID: 36862203 DOI: 10.1007/s00417-023-05997-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 03/03/2023] Open
Abstract
Optical coherence tomography (OCT) is a revolutionary in vivo imaging technology that presents real-time information on ocular structures. Angiography based on OCT, known as optical coherence tomography angiography (OCTA), is a noninvasive and time-saving technique originally utilized for visualizing retinal vasculature. As devices and built-in systems have evolved, high-resolution images with depth-resolved analysis have assisted ophthalmologists in accurately localizing pathology and monitoring disease progression. With the aforementioned advantages, application of OCTA has extended from the posterior to anterior segment. This nascent adaptation showed good delineation of the vasculature in the cornea, conjunctiva, sclera, and iris. Thus, neovascularization of the avascular cornea and hyperemia or ischemic changes involving the conjunctiva, sclera, and iris has become prospective applications for AS-OCTA. Although traditional dye-based angiography is regarded as the gold standard in demonstrating vasculature in the anterior segment, AS-OCTA is expected to be a comparable but more patient-friendly alternative. In its initial stage, AS-OCTA has exhibited great potential in pathology diagnosis, therapeutic evaluation, presurgical planning, and prognosis assessments in anterior segment disorders. In this review of AS-OCTA, we aim to summarize scanning protocols, relevant parameters, and clinical applications as well as limitations and future directions. We are sanguine about its wide application in the future with the development of technology and refinement in built-in systems.
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Affiliation(s)
- Yajing Wen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Dan Jiang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kexin Tang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Wei Chen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Yoon SH, Song JR, Lee SH, Eom Y, Hyon JY, Jeon HS. Actual anterior-posterior corneal radius ratio in eyes with prior myopic laser vision correction according to axial length. Sci Rep 2023; 13:14267. [PMID: 37652933 PMCID: PMC10471610 DOI: 10.1038/s41598-023-41062-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
We retrospectively evaluate the actual anterior-posterior (AP) corneal radius ratio in eyes with previous laser correction for myopia (M-LVC) according to axial length (AL) using biometry data exported from swept-source optical coherence tomography between January 2018 and October 2021 in a tertiary hospital (1018 eyes with a history of M-LVC and 19,841 control eyes). The AP ratio was significantly higher in the LVC group than in the control group. Further, it was significantly positively correlated with AL in the LVC group. We also investigated the impact of the AP ratio, AL and keratometry (K) on the absolute prediction error (APE) in 39 eyes that underwent cataract surgery after M-LVC. In linear regression analyses, there were significant correlations between APE and AL/TK, while APE and AP ratio had no correlation. The APE was significantly lower in the Barrett True-K with total keratometry (Barrett True-TK) than in the Haigis-L formula on eyes with AL above 26 mm and K between 38 and 40 D. In conclusion, in eyes with previous M-LVC, AP ratio increases with AL. The Barrett True-K or Barrett True-TK formulas are recommended rather than Haigis-L formula in M-LVC eyes with AL above 26 mm and K between 38 and 40D.
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Affiliation(s)
- Seung Hee Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Ryong Song
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea
| | - Seung Hyen Lee
- Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Republic of Korea
| | - Youngsub Eom
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea
| | - Hyun Sun Jeon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.
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Said OM, Kamal M, Tawfik S, Saif ATS. Comparison of corneal measurements in normal and keratoconus eyes using Anterior Segment Optical Coherence Tomography (AS-OCT) and Pentacam HR topographer. BMC Ophthalmol 2023; 23:194. [PMID: 37138239 PMCID: PMC10155327 DOI: 10.1186/s12886-023-02946-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Keratoconus (KC) is easily recognized by its unique topographic pattern, but it can be difficult to distinguish subclinical form of the disease from the normal cornea. Optovue anterior segment optical coherence tomography (AS-OCT) helps diagnose KC. AIM OF THE WORK To assess and the level of agreement of Keratometry-readings (K), Central Corneal Thickness (CCT) and Thinnest Corneal Thickness (TCT) measurements obtained by Optovue AS-OCT and Wavelight Oculyzer Pentacam HR in two groups: KC eyes and normal eyes. PATIENTS AND METHODS This is a prospective clinical observational study. The study included 110 eyes divided into two groups. The study group included 62 eyes with topographic evidence of KC. The control group included 48 eyes of normal subjects with no topographic evidence of KC. All of the participants underwent full cycloplegic refraction, spectacle best-corrected distance visual acuity, comprehensive slit-lamp biomicroscopy and fundoscopy. All participants underwent corneal topography by Pentacam HR and AS-OCT. RESULTS There were highly significant differences between the studied groups as regarding BCVA, intraocular pressure and CCT measurements which were found to be lower among KC group compared to the control one. There were highly significant differences between the studied groups regarding TCT measurement detected by Pentacam HR and AS-OCT which was found to be lower among the keratoconus group compared to the control one (470.9, 455.7 versus 541.9 and 518.7 respectively). CONCLUSION Both Scheimpflug-based imaging and AS-OCT provide comparable readings with a good agreement regarding corneal pachymetry in keratoconus group with accurate identification of KC eyes and healthy ones. However, there was a significant difference in K readings between both devices in Keratoconus and control group.
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Affiliation(s)
- Omar M Said
- Department of Ophthalmology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
| | - Mahmoud Kamal
- Department of Ophthalmology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Sara Tawfik
- Department of Ophthalmology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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Mirzayev I, Gündüz AK, Aydın Ellialtıoğlu P, Gündüz ÖÖ. Clinical applications of anterior segment swept-source optical coherence tomography: A systematic review. Photodiagnosis Photodyn Ther 2023; 42:103334. [PMID: 36764640 DOI: 10.1016/j.pdpdt.2023.103334] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/25/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Optical coherence tomography (OCT) is a non-invasive method that provides the opportunity to examine tissues by taking cross-sectional images. OCT is increasingly being used to evaluate anterior segment (AS) pathologies. Swept-source (SS) OCT allows greater penetration and achieves better visualization of the internal configuration of AS tissues due to the longer wavelength employed and high scan speeds. We reviewed the utilization of AS SS-OCT in various conditions including glaucoma, ocular surface pathologies, iris tumors, refractive surgery, cataract surgery, and scleral diseases. A systematic literature search was carried out on PubMed, Scopus, and Web of Science databases between January 1, 2008, and September 1, 2022 using the following keywords: AS SS-OCT; dry eye and SS-OCT; ocular surface and SS-OCT; cornea and SS-OCT; dystrophy and SS-OCT; glaucoma and SS-OCT; ocular surface tumors and SS-OCT; conjunctival tumors and SS-OCT; refractive surgery and SS-OCT; cataract and SS-OCT; biometry and SS-OCT; sclera and SS-OCT; iris and SS-OCT; ciliary body and SS-OCT; artificial intelligence and SS-OCT. A total of 221 studies were included in this review. Review of the existing literature shows that SS-OCT offers several advantages in the diagnosis of AS diseases. Exclusive features of SS-OCT including rapid scanning, deeper tissue penetration, and better image quality help improve our understanding of various AS pathologies.
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Affiliation(s)
- Ibadulla Mirzayev
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; Halil Şıvgın Çubuk State Hospital, Ophthalmology Clinic, Ankara, Turkey
| | - Ahmet Kaan Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; Private Eye Clinic, Ankara, Turkey.
| | | | - Ömür Özlenen Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
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11
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Mazur R, Wylęgała A, Wylęgała E, Dobrowolski D. Comparative Analysis of Corneal Parameters Performed with GalileiG6 and OCT Casia 2. Diagnostics (Basel) 2023; 13:diagnostics13020267. [PMID: 36673077 PMCID: PMC9857403 DOI: 10.3390/diagnostics13020267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUNDS To compare keratometry (Ks and Kf), astigmatism (Ast.), and the astigmatism axes (Ax.) of the posterior surface of the cornea; the total, central cornea thickness (CCT); and the thinnest corneal thickness (TCT) measured using two different measurement methods. METHODS Patients qualified for cataract surgery at the Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, Katowice, Poland, were included in the study and monitored with the following two devices: OCT-CASIA2 and Dual Scheimpflug Analyzer GalileiG6. Our work was a randomized, prospective study in which compliance with the agreement of measurements between the devices was evaluated using the Bland-Altman method. RESULTS A total of 110 patients (62 females and 48 males) were examined. Overall, 100 eyes of patients that qualified for cataract surgery were enrolled in the study. No statistically significant difference was observed for Total-Ks and Total-Kf. A significant difference was observable for the following parameters: total Ks-ax, total Kf-ax, the total power of astigmatism, and in all parameters of the part of the cornea and corneal thickness (CCT and TCT). CONCLUSIONS The measurements obtained using Casia2 and the Dual Scheimpflug Analyzer GalileiG6 were significantly different and not interchangeable except for total Ks and Kf.
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Affiliation(s)
- Robert Mazur
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence:
| | - Adam Wylęgała
- Pathophysiology Department, School of Medicine, Medical University of Silesia, 40-055 Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Dariusz Dobrowolski
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Ramm L, Herber R, Lorenz G, Jasper CS, Pillunat LE, Pillunat KR. Evaluation of corneal biomechanical properties using the ocular response analyzer and the dynamic Scheimpflug-Analyzer Corvis ST in high pressure and normal pressure open-angle glaucoma patients. PLoS One 2023; 18:e0281017. [PMID: 36701409 PMCID: PMC9879466 DOI: 10.1371/journal.pone.0281017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To characterize differences in corneal biomechanics in high (HPG) and normal pressure (NPG) primary open-angle glaucoma, and its association to disease severity. METHODS Corneal biomechanical properties were measured using the Ocular Response Analyzer (ORA) and the dynamic Scheimpflug-Analyzer Corvis ST (CST). Disease severity was functionally assessed by automated perimetry (Humphrey field analyzer) and structurally with the Heidelberg Retina Tomograph. To avoid a possible falsification by intraocular pressure, central corneal thickness and age, which strongly influence ORA and CST measurements, group matching was performed. Linear mixed models and generalized estimating equations were used to consider inter-eye correlation. RESULTS Following group matching, 60 eyes of 38 HPG and 103 eyes of 60 NPG patients were included. ORA measurement revealed a higher CRF in HPG than in NPG (P < 0.001). Additionally, the CST parameter integrated radius (P < 0.001) was significantly different between HPG and NPG. The parameter SSI (P < 0.001) representing corneal stiffness was higher in HPG than in NPG. Furthermore, regression analysis revealed associations between biomechanical parameters and indicators of disease severity. In HPG, SSI correlated to RNFL thickness. In NPG, dependencies between biomechanical readings and rim area, MD, and PSD were shown. CONCLUSION Significant differences in corneal biomechanical properties were detectable between HPG and NPG patients which might indicate different pathophysiological mechanisms underlying in both entities. Moreover, biomechanical parameters correlated to functional and structural indices of diseases severity. A reduced corneal deformation measured by dynamic methods was associated to advanced glaucomatous damage.
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Affiliation(s)
- Lisa Ramm
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Robert Herber
- Faculty of Medicine Carl Gustav Carus, Department of Ophthalmology, TU Dresden, Dresden, Germany
- * E-mail:
| | - Georg Lorenz
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Carolin S. Jasper
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Lutz E. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Karin R. Pillunat
- Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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Herber R, Lenk J, Pillunat LE, Raiskup F. Comparison of corneal tomography using a novel swept-source optical coherence tomographer and rotating Scheimpflug system in normal and keratoconus eyes: repeatability and agreement analysis. EYE AND VISION 2022; 9:19. [PMID: 35606839 PMCID: PMC9128256 DOI: 10.1186/s40662-022-00290-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To determine the repeatability and agreement using corneal tomography of a swept-source optical coherence tomographer (SS-OCT) compared to a rotating Scheimpflug camera (RSC) in normal eyes and keratoconus (KC) eyes.
Methods
This prospective repeatability analysis was performed at the Department of Ophthalmology of University Hospital Carl Gustav Carus, Dresden, Germany. Forty-three normal and 57 KC eyes were enrolled in the study. Three consecutive measurements were performed by the same operator on each device. Corneal parameters of anterior and posterior corneal surface, such as simulated keratometry (SimK), as well as central and thinnest corneal thickness were evaluated. Repeatability and agreement were assessed by using the coefficient of repeatability and Bland-Altman analysis.
Results
The repeatability of anterior corneal parameters was comparable between RSC and SS-OCT in normal eyes (repeatability < 0.5 D). Repeatability was increased in mild and moderate KC for all parameters using both devices. In moderate KC, repeatability of Kmax was 1.33 D and 0.78 D for RSC and SS-OCT, respectively. Repeatability of posterior corneal parameters was consistently better for SS-OCT. Significant offsets and wide ranges of limits of agreement were found between the devices for SimK and corneal thickness values.
Conclusions
SS-OCT showed highly repeatable measurements of anterior and posterior corneal parameters in normal and KC eyes. Compared to RSC, the SS-OCT had a better repeatability of anterior corneal parameters in mild and moderate KC as well as posterior corneal parameters in all groups. Both devices should not be used interchangeably in the diagnostic process of patients.
Trial registration NCT04251143 at Clinicaltrials.gov, registered on 12 March 2018, https://clinicaltrials.gov/ct2/show/NCT04251143?cond=Keratoconus&cntry=DE&city=Dresden&draw=2&rank=1
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Itoi M, Itoi M, Harigaya A, Ishigaki K, Satou R, Ueda E. Corneal RGP Contact Lens Fitting Software for Keratoconus Built-In Anterior Segment Optical Coherence Tomography. Eye Contact Lens 2022; 48:503-508. [PMID: 36223291 DOI: 10.1097/icl.0000000000000940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the performance of the contact lens fitting software built into anterior segment optical coherence tomography (AS-OCT). METHODS This retrospective study enrolled patients with keratoconus prescribed with spherical corneal rigid gas-permeable contact lenses based on a contact lens fitting software. Subjects were classified into four subgroups based on corneal morphology: nipple, oval, globus, and marginal type. Software performance was evaluated according to the correlation between the back optical zone radius (BOZR) calculated by the contact lens fitting program and the BOZR of the lens prescribed, and the number of trial lens replacements required.Results:A total of 340 eyes of 254 patients with a mean age of 40.4 ± 13.6 years were included. The oval type was the most common (61.8%), followed by the nipple type (26.2%). Linear regression analysis revealed a significant correlation between the prescribed and the calculated BOZR in all subgroups (R 2 = 0.92, P < 0.01 for the nipple type; R 2 = 0.76, P < 0.01 for the oval type; R 2 = 0.93, P < 0.01 for the globus type; and R 2 = 0.79, P < 0.01 for the marginal type). Furthermore, the globus type had the highest proportion of cases requiring at least one trial lens replacement (36.3%), followed by the nipple group (27.0%). There were no significant differences among the subgroups ( P = 0.14). CONCLUSIONS In conclusion, our findings reveal that the contact lens fitting software built into AS-OCT may be useful for accurate contact lens prescription for any corneal shape.
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Affiliation(s)
- Motohiro Itoi
- Department of Ophthalmology (M.I.), Kyoto Prefectural University of Medicine, Kyoto, Japan; and Dougenzaka Itoi Eye Clinic (M.I., A.H., K.I., R.S., E.U.), Itoi Building 1-10-19 Dougenzaka Shibuya-ku, Tokyo, Japan
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Mounir A, Abdellah MM, Zidan OF, Mostafa EM. Inter-changeability Between Anterior Segment Optical Coherence Tomography and Scheimpflug Imaging in the Evaluation of Corneal Opacity. Open Ophthalmol J 2022. [DOI: 10.2174/18743641-v16-e2207051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose
To compare the results of corneal evaluation, either the total corneal thickness and corneal opacity depth by both technologies AS- OCT and Scheimpflug imaging by Sirius Scheimpflug placido topography.
Methods
sixty-eight eyes of sixty- eight consecutive patients with corneal opacities were examined by both AS-OCT and Sirius Scheimpflug imaging. Corneal thickness and corneal opacity depth were measured and compared determining the interchangeability using Bland–Altman plotting.
Results
Total corneal thickness was (470.32±62.10) and (463.47±56.47) by AS. OCT and Sirius Scheimpflug imaging, respectively (P value = 0.8).
While the actual measurement of corneal opacity, corneal opacity depth was (135.39±119) and (85.45±128) by AS-OCT and Siris Scheimpflug imaging respectively with P value (0.004).
Conclusion
AS-OCT and Scheimpflug imaging Sirius may be used interchangeably for measuring both total corneal thickness, while in the determination of corneal opacity depth. the AS-OCT is superior to Scheimpflug imaging in the accuracy of determination of actual boundaries of the corneal opacity.
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Watanabe A, Ninomiya W, Mizobuchi K, Watanabe T, Nakano T. Corneal shape changes after vitreoretinal surgery with fluid-gas exchange. Medicine (Baltimore) 2022; 101:e29205. [PMID: 35550470 PMCID: PMC9276418 DOI: 10.1097/md.0000000000029205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
To investigate changes in the corneal shape caused by fluid-gas exchange after vitrectomy.This retrospective case-control study included 43 eyes that underwent a combination of cataract surgery and vitrectomy. The corneal shape was measured using anterior segment optical coherence tomography CASIA2. The corneal shape measurements were performed preoperatively, 1 day, 1 week, 1 month, and 3 months after surgery. After calculating the real K value from the actual measured values of the posterior shape of the corneal refracting power and the single posterior corneal refracting power value, Fourier analysis values were examined. Fluid-gas exchange was performed in 23 eyes (gas group), while it was not performed in 20 eyes (nongas group).There was a significant increase in the real K value in the regular and asymmetry components (0.61 ± 0.36, 0.82 ± 0.64) in the gas group only on the first day after surgery (Steel-Dwass test; P < .05). There was also a significant increase in the real K value in the higher-order irregular astigmatism components (Steel-Dwass test; P < .05) for longer periods in the gas versus the nongas group. The shape of the posterior cornea increased in all components in the gas group on the first day after surgery (spherical power -6.35 ± 0.20, regular astigmatism 0.32 ± 0.12, asymmetry 0.22 ± 0.13, and higher-order irregular astigmatism 0.12 ± 0.05, Steel-Dwass test; P < .05).Postoperative changes caused by surgical invasion in the corneal shape appeared to be greater in the gas versus the nongas group, in addition to affecting the time periods of the postoperative corneal shape changes.
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Kong AW, Ahmad TR, Turner ML, Barnett J, Kaur G, Pasricha ND, Indaram M. Trends in Corneal Topography and Tomography Imaging for Keratoconus Management. Clin Ophthalmol 2022; 16:1357-1363. [PMID: 35510272 PMCID: PMC9059983 DOI: 10.2147/opth.s361352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/31/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe trends in the use of corneal topography and tomography for the management of keratoconus patients at a single academic institution and to identify how these trends may be associated with different procedural interventions. Patients and Methods In this retrospective cohort study, keratoconus patients treated from 2012 to 2019 were identified. The electronic health record was reviewed for the presence of corneal topography or tomography imaging completed within seven days of the first visit and the highest level of intervention at the first and most recent visit. Patients were grouped as pediatric (<18 years) or adult (≥18 years). Chi-square tests and linear regressions were used to evaluate trends and to determine which factors were predictive for receiving corneal collagen cross-linking (CXL) versus other surgical interventions (intrastromal corneal ring segments, lamellar keratoplasty, or penetrating keratoplasty) by the most recent visit. Results A total of 873 keratoconus patients met inclusion criteria. The use of corneal topography at the first visit remained relatively consistent from 2012 to 2019, while corneal tomography usage at the first visit increased from 3.9% in 2015, when corneal tomography was introduced, to 52.8% in 2019. Each year was associated with an 11.2% ± 1.9% increase in the use of corneal tomography at the first visit in pediatric patients and 6.7% ± 0.5% in adult patients. Use of corneal tomography at the first visit was a significant predictor for receiving CXL procedures (P < 0.001) and a negative predictor for requiring other surgical interventions (P = 0.032) when controlling for the year of the first visit. Conclusion Obtaining corneal tomography at the first visit has become the standard of care in keratoconus, especially for pediatric patients. Moreover, the increase in corneal tomography imaging has coincided with an increase in CXL procedures and decrease in other surgical interventions.
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Affiliation(s)
- Alan W Kong
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Tessnim R Ahmad
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Marcus L Turner
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jackson Barnett
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Gurbani Kaur
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Neel D Pasricha
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA,Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA
| | - Maanasa Indaram
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA,Correspondence: Maanasa Indaram, Department of Ophthalmology, University of California San Francisco, 490 Illinois Street, San Francisco, CA, 94158, USA, Email
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Flockerzi E, Vinciguerra R, Belin MW, Vinciguerra P, Ambrósio R, Seitz B. Correlation of the Corvis Biomechanical Factor with tomographic parameters in keratoconus. J Cataract Refract Surg 2022; 48:215-221. [PMID: 34321407 DOI: 10.1097/j.jcrs.0000000000000740] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/27/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the relationship between corneal biomechanics and keratoconus (KC) severity as described by tomographic parameters. SETTING University-based German ophthalmology department. DESIGN Retrospective cross-sectional study. METHODS A total of 448 KC corneas of the Homburg Keratoconus Center and 112 healthy corneas (448+112 patients) were examined by Pentacam high-resolution and Corneal Visualization Scheimpflug Technology (Pentacam HR and Corvis ST). The KC population included a wide spectrum of disease severity based on Belin's ABCD classification. Linear regression analysis was performed between the linear term of the Corvis Biomechanical Index (CBI) (CBI beta) and the tomographic values anterior radius of curvature (ARC), posterior radius of curvature (PRC), and thinnest corneal thickness (TCT). A linear transformation of the CBI beta was performed to provide an intuitive scaling, which was referred to as the Corvis Biomechanical Factor (CBiF = -0.24294226 × CBI beta + 6.02). This scaling adjusted the CBI beta to the same scale as posterior corneal curvature (PRC). RESULTS There was a high correlation of the CBI beta and its modification, the CBiF, with TCT (Pearson, r = -0.775), ARC (r = -0.835), and PRC (r = -0.839) in the KC population (P < .001). In the control corneas, the correlation between the CBI beta and ARC was weak (r = -0.216, P = .022), not significant (PRC, r = -0.146, P = .125), or moderate (TCT, r = -0.628, P < .001). CONCLUSIONS The linear term of the CBI was highly associated with KC severity as defined by corneal tomography. The CBiF represents a new scale based on biomechanical characteristics in KC, which could serve as a basis for a biomechanical KC classification in the future.
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Affiliation(s)
- Elias Flockerzi
- From the Department of Ophthalmology, Saarland University Medical Center, Homburg, Germany (Flockerzi, Seitz); Humanitas San Pio X Hospital, Milan, Italy (Vinciguerra); School of Engineering, University of Liverpool, Liverpool, United Kingdom (Vinciguerra); Department of Ophthalmology & Vision Science, University of Arizona, Tucson, Arizona (Belin); Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (Vinciguerra); Humanitas Clinical and Research Center, IRCCS, Rozzano (Mi), Italy (Vinciguerra); Department of Ophthalmology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil (Ambrósio)
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Choe GS, Kim KY. Comparison of Anterior Segment Measurements between Scheimpflug-Placido Camera and New Swept-source Optical Coherence Tomography. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We compared anterior segment measurements obtained using a Scheimpflug-Placido topographer (SIRIUS®, Costruzione Strumenti Oftalmici, Florence, Italy) and a new anterior module for a swept-source optical coherence tomography system (ANTERION®, Heidelberg Engineering Inc., Heidelberg, Germany).Methods: Anterior segment measurements were evaluated in 74 eyes of 101 patients with the two devices. Central corneal thickness (CCT), anterior chamber depth (ACD), corneal refractive power (K), J0 (Jackson cross-cylinder with axes at 180° and 90°), J45 vector (Jackson cross-cylinder with axes at 45° and 135°), and white-to-white corneal diameter (WTW) measurements obtained using the SIRIUS® system and the new anterior segment module of ANTERION® were compared.Results: The mean CCTs measured by SIRIUS® and ANTERION® were 558.69 ± 44.65 and 540.26 ± 36.57 μm, respectively. The difference was statistically significant (p < 0.005), and there were high correlations between the two methods (r = 0.915, p < 0.001). The mean ACD measurements were 3.34 ± 0.53 and 3.34 ± 0.51 mm (p = 0.856), respectively, for SIRIUS® and ANTERION®. The measurements were strongly correlated (r = 0.966, p < 0.001). The measurements of WTW, total mean K, and J0 obtained with the two systems differed significantly (p < 0.005, p = 0.017, and p < 0.005, respectively), with high correlations between the two systems (r = 0.875, r = 0.967, and r = 0.933, respectively; all p < 0.001).Conclusions: There were significant differences in measurements of K, CCT, WTW, and J0 between the two devices. Agreement analysis suggests that SIRIUS® and ANTERION® should not be used interchangeably.
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Güçlü H, Akaray İ, Kaya S, Sattarpanah S, Çınar AC, Sakallıoğlu K, Korkmaz S, Gürlü V. Agreement of Anterior Segment Parameters Between Schiempflug Topography and Swept-Source Optic Coherence Based Optic Biometry in Keratoconus and Healthy Subjects. Eye Contact Lens 2021; 47:539-545. [PMID: 33813587 DOI: 10.1097/icl.0000000000000787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study is to compare anterior segment parameters, including corneal thickness (CCT), keratometry and anterior chamber depth (ACD), and white to white corneal diameter (WTW), obtained by Pentacam Schiempflug imaging and intraocular lens (IOL) Master 700 swept-source optic coherence tomography biometry in keratoconus patients and healthy subjects. METHODS This prospective cross-sectional instrument agreement analysis includes 88 eyes of 50 keratoconus patients and 87 eyes of 50 healthy subjects. Biometry was performed using IOL Master 700, and topography was performed using Pentacam. The keratometry values (Kf, Ks, Km, and Kmax), ACD, WTW, CCT, axial length (AL), anterior chamber angle (ACA), and lens thickness (LT) were evaluated. Levels of agreement between devices were evaluated by Bland-Altman plots with 95% limits of agreement. RESULTS Intraocular lens Master 700 showed higher WTW, ACD, pupil diameter, and CCT values than Pentacam in both the keratoconus and control groups. However, there were no statistically significant differences in flat keratometry (Kf) and steep keratometry (Ks) values between the groups. CONCLUSION Pentacam and IOL Master 700 may be used interchangeably in normal eyes and keratoconus eyes for the measurement of keratometry values and axis; however, these two devices should not be considered interchangeable for WTW, ACD, pupil diameter, and CCT measurements in both keratoconus patients and healthy subjects.
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Affiliation(s)
- Hande Güçlü
- Department of Ophthalmology (H.G., İ.A., S. Kaya, S.S., A.C.Ç., K.S., V.G.), Trakya University of Medicine, Edirne, Turkey; and Department of Biostatistics and Medical Informatics (S. Korkmaz), Trakya University of Medicine, Edirne, Turkey
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Kamiya K, Ayatsuka Y, Kato Y, Shoji N, Miyai T, Ishii H, Mori Y, Miyata K. Prediction of keratoconus progression using deep learning of anterior segment optical coherence tomography maps. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1287. [PMID: 34532424 PMCID: PMC8422102 DOI: 10.21037/atm-21-1772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 06/11/2021] [Indexed: 12/12/2022]
Abstract
Background To predict keratoconus progression using deep learning of the color-coded maps measured with a swept-source anterior segment optical coherence tomography (As-OCT) device. Methods We enrolled 218 keratoconic eyes with and without disease progression. Using deep learning of the 6 color-coded maps (anterior elevation, anterior curvature, posterior elevation, posterior curvature, total refractive power, and pachymetry map) obtained by the As-OCT (CASIA, Tomey), we assessed the accuracy, sensitivity, and specificity of prediction of keratoconus progression in such eyes. Results Deep learning of the 6 color-coded maps exhibited an accuracy of 0.794 in discriminating keratoconus with and without progression. For a single map analysis, posterior elevation map (0.798) showed the highest accuracy, followed by anterior curvature map (0.775), posterior corneal curvature map (0.757), anterior elevation map (0.752), total refractive power map (0.729), and pachymetry map (0.720), in distinguishing between progressive and non-progressive keratoconus. The use of the adjusted algorithm by age subgroups improved to an accuracy of 0.849. Conclusions Deep learning of the As-OCT color-coded maps effectively discriminates progressive keratoconus from non-progressive keratoconus with an accuracy of approximately 85% using the adjusted age algorithm, indicating that it will become an aid for predicting the progression of the disease, which is clinically beneficial for decision-making of the surgical indication of corneal cross-linking (CXL).
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Affiliation(s)
- Kazutaka Kamiya
- Visual Physiology, Kitasato University, School of Allied Health Sciences, Kanagawa, Japan
| | | | | | - Nobuyuki Shoji
- Department of Ophthalmology, Kitasato University, School of Medicine, Kanagawa, Japan
| | - Takashi Miyai
- Department of Ophthalmology, Tokyo University, School of Medicine, Tokyo, Japan
| | - Hitoha Ishii
- Department of Ophthalmology, Tokyo University, School of Medicine, Tokyo, Japan
| | - Yosai Mori
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Kazunori Miyata
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
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Shanthi S, Aruljyothi L, Balasundaram MB, Janakiraman A, Nirmaladevi K, Pyingkodi M. Artificial intelligence applications in different imaging modalities for corneal topography. Surv Ophthalmol 2021; 67:801-816. [PMID: 34450134 DOI: 10.1016/j.survophthal.2021.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 12/26/2022]
Abstract
Interpretation of topographical maps used to detect corneal ectasias requires a high level of expertise. Several artificial intelligence (AI) technologies have attempted to interpret topographic maps. The purpose of this study is to provide a review of AI algorithms in corneal topography from the perspectives of an eye care professional, a biomedical engineer, and a data scientist. A systematic literature review using Web of Science, Pubmed, and Google Scholar was performed from 2010 to 2020 on themes regarding imaging modalities, their parameters, purpose, and conclusions and their samples and performance related to AI in corneal topography. We provide a comprehensive summary of advances in corneal imaging and its applications in AI. Combined metrics from the Dual Scheimpflug and Placido device could be a good starting point to try AI models in corneal imaging systems. The range of area under the receiving operating curve for AI in keratoconus detection and classification was from 0.87 to 1, sensitivity was from 0.89 to 1, and specificity was from 0.82 to 1. A combination of different types of AI applications to corneal ectasia diagnosis is recommended.
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Affiliation(s)
- S Shanthi
- Kongu Engineering College, Erode, Tamil Nadu, India.
| | | | | | | | | | - M Pyingkodi
- Kongu Engineering College, Erode, Tamil Nadu, India
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Association between visual field damage and corneal structural parameters. Sci Rep 2021; 11:10732. [PMID: 34031496 PMCID: PMC8144395 DOI: 10.1038/s41598-021-90298-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/07/2021] [Indexed: 12/03/2022] Open
Abstract
The main goal of this study is to identify the association between corneal shape, elevation, and thickness parameters and visual field damage using machine learning. A total of 676 eyes from 568 patients from the Jichi Medical University in Japan were included in this study. Corneal topography, pachymetry, and elevation images were obtained using anterior segment optical coherence tomography (OCT) and visual field tests were collected using standard automated perimetry with 24-2 Swedish Interactive Threshold Algorithm. The association between corneal structural parameters and visual field damage was investigated using machine learning and evaluated through tenfold cross-validation of the area under the receiver operating characteristic curves (AUC). The average mean deviation was − 8.0 dB and the average central corneal thickness (CCT) was 513.1 µm. Using ensemble machine learning bagged trees classifiers, we detected visual field abnormality from corneal parameters with an AUC of 0.83. Using a tree-based machine learning classifier, we detected four visual field severity levels from corneal parameters with an AUC of 0.74. Although CCT and corneal hysteresis have long been accepted as predictors of glaucoma development and future visual field loss, corneal shape and elevation parameters may also predict glaucoma-induced visual functional loss.
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Li Y, Gokul A, McGhee C, Ziaei M. Repeatability and agreement of biometric measurements using spectral domain anterior segment optical coherence tomography and Scheimpflug tomography in keratoconus. PLoS One 2021; 16:e0248659. [PMID: 34019547 PMCID: PMC8139453 DOI: 10.1371/journal.pone.0248659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 04/30/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare the repeatability and agreement in biometric measurements using Spectral Domain Anterior Segment OCT (AS-OCT, REVO-NX, Optopol) and Scheimpflug tomography (Pentacam-AXL, Oculus) in keratoconus. Methods Prospective case series at a university hospital tertiary center. Axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), and thinnest corneal thickness (TCT) were measured using both devices in patients with keratoconus. Three groups were analyzed: eyes with no prior crosslinking or contact lens wear (Group A), eyes with prior crosslinking (Group B), and eyes with prior contact lens wear (Group C). Repeatability and agreement of measurements were analyzed. Results The study comprised of 214 eyes of 157 subjects. In Group A (n = 95 eyes), Group B (n = 86 eyes), and Group C (n = 33 eyes), intraclass correlation coefficient (ICC) was higher than 0.90 for all examined parameters, except for ACD readings in Group A with the REVO-NX (ICC = 0.83). Differences in ACD, TCT, and CCT were significantly different between the two devices for Groups A, B and C (p<0.05). AL measurements differed significantly in Groups A and B (p<0.05) but not in Group C (p = 0.18). Repeatability did not vary significantly between Groups A, B, or C in any parameter with both devices (p>0.05). There was poor agreement between the two devices across all parameters (p<0.05). Conclusions Both devices demonstrated good repeatability but poor agreement across AL, ACD, CCT and TCT measurements. There was no significant difference in repeatability in virgin eyes compared to eyes with prior crosslinking or contact lens wear, however, the interchangeable use of the two devices is not recommended.
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Affiliation(s)
- Ye Li
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Akilesh Gokul
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Charles McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Mohammed Ziaei
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- * E-mail:
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Pujari A, Agarwal D, Sharma N. Clinical role of swept source optical coherence tomography in anterior segment diseases: a review. Semin Ophthalmol 2021; 36:684-691. [PMID: 33689554 DOI: 10.1080/08820538.2021.1897854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To note the comprehensive role of swept source anterior segment optical coherence tomography (SS-ASOCT) in anterior segment diseases. METHODS A systematic literature search was carried out on various medical databases using the keywords, swept source anterior segment optical coherence tomography; SS-ASOCT; Cornea and SS-ASOCT; SS-ASOCT and glaucoma; SS-ASOCT and cataract; SS-ASOCT and biometer; SS-ASOCT and tear film and ocular surface.Original works and novel reports describing the potential role of SS-ASOCT in various anterior segment conditions were included. RESULTS After a thorough assessment of literature, it was clear that the SS-ASOCT did provide newer insights into many anterior eye conditions. The rapid scan acquisition, deeper tissue penetration, and higher magnification did enhance many of our understandings, which were previously not possible. In addition, lenticular assessment under complex clinical scenarios with automated values on objective scale has made it a worthy tool with immense future possibilities. CONCLUSIONS SS-ASOCT unveiled various anterior segment findings which were of clinical importance.
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Affiliation(s)
- Amar Pujari
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Agarwal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Tañá-Rivero P, Aguilar-Córcoles S, Ruiz-Mesa R, Montés-Micó R. Repeatability of whole-cornea measurements using a new swept-source optical coherence tomographer. Eur J Ophthalmol 2020; 31:1709-1719. [PMID: 32686488 DOI: 10.1177/1120672120944022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this study was to evaluate the repeatability of several corneal parameters provided by a high-resolution swept-source optical coherence tomographer (SS-OCT). METHODS One eye from each of 74 patients was measured five times consequently using the ANTERION SS-OCT. The following corneal parameters were analyzed: average, steep and flat keratometry (K), astigmatism for anterior, posterior and total at 3-mm, average K and astigmatism at 6-mm, anterior and posterior eccentricity, higher-order aberrations (HOA) and spherical aberration (Z40), and anterior and posterior best-fit sphere at 8-mm. The intrasubject standard deviation (Sw), coefficient of variation (CoV), coefficient of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated for each parameter to assess the repeatability. RESULTS We have not found statistically significant differences between repeated measurements (p > 0.05). Repeatability was good considering the different metrics used. Sw values were <0.09, varying from 0.035 (posterior average K at 6-mm) to 0.0878 (anterior flat K at 3-mm). CoV values were also low and similar among the different parameters (from 0.08% to 0.21%), except for anterior, posterior and total astigmatism (from 2.25% to 8.46%). Both anterior and posterior eccentricity, and corneal aberrations (HOA and Z40) CoV values were also high. The CoR values were low for all parameters showing those related to the posterior cornea the lowest values (about 0.01). ICC values were >0.98. CONCLUSIONS The ANTERION SS-OCT showed good repeatability when reconstructed different parameters for the whole cornea. This device produces measurements with high repeatability that could be useful for clinical research.
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Affiliation(s)
| | | | | | - Robert Montés-Micó
- Oftalvist Clinic, Alicante, Spain.,Optics and Optometry & Vision Sciences Department, University of Valencia, Valencia, Spain
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Zhang X, Munir SZ, Sami Karim SA, Munir WM. A review of imaging modalities for detecting early keratoconus. Eye (Lond) 2020; 35:173-187. [PMID: 32678352 DOI: 10.1038/s41433-020-1039-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/28/2020] [Accepted: 06/10/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Early identification of keratoconus is imperative for preventing iatrogenic corneal ectasia and allowing for early corneal collagen cross-linking treatments to potentially halt progression and decrease transplant burden. However, early diagnosis of keratoconus is currently a diagnostic challenge as there is no uniform screening criteria. We performed a review of the current literature to assess imaging modalities that can be used to help identify subclinical keratoconus. METHODS A Pubmed database search was conducted. We included primary and empirical studies for evaluating different modalities of screening for subclinical keratoconus. RESULTS A combination of multiple imaging tools, including corneal topography, tomography, Scheimpflug imaging, anterior segment optical coherence tomography, and in vivo confocal microscopy will allow for enhanced determination of subclinical keratoconus. In patients who are diagnostically borderline using a single screening criteria, use of additional imaging techniques can assist in diagnosis. Modalities that show promise but need further research include polarization-sensitive optical coherence tomography, Brillouin microscopy, and atomic force microscopy. CONCLUSIONS Recognition of early keratoconus can reduce risk of post-refractive ectasia and reduce transplantation burden. Though there are no current uniform screening criterion, multiple imaging modalities have shown promise in assisting with the early detection of keratoconus.
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Affiliation(s)
- Xuemin Zhang
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Saleha Z Munir
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Syed A Sami Karim
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Wuqaas M Munir
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.
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Zhao Y, Chen D, Savini G, Wang Q, Zhang H, Jin Y, Song B, Ning R, Huang J, Mei C. The precision and agreement of corneal thickness and keratometry measurements with SS-OCT versus Scheimpflug imaging. EYE AND VISION 2020; 7:32. [PMID: 32528997 PMCID: PMC7285531 DOI: 10.1186/s40662-020-00197-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/19/2020] [Indexed: 11/23/2022]
Abstract
Purpose To assess the repeatability and reproducibility of swept-source optical coherence tomography (SS-OCT) and Scheimpflug system and evaluate the agreement between the two systems in measuring multiple corneal regions in children. Methods Pachymetric and keratometric maps for both systems were evaluated. Central, midperipheral and peripheral corneal thickness (CT), keratometry and astigmatism power vectors were recorded. The three outcomes yielded by the same observer were used to assess intraobserver repeatability. The differences in the mean values provided by each observer were used to evaluate interobserver reproducibility. Within-subject standard deviation, test-retest repeatability (TRT) and coefficient of variation (CoV) were used to analyze the intraobserver repeatability and interobserver reproducibility. Paired T-test and Bland-Altman were used to appraise interdevice agreement. Results Seventy-eight eyes of 78 children were included. The CoV was ≤2.12 and 1.10%, respectively, for repeatability and reproducibility. TRT and CoV were lower for central and paracentral CT measurements than for peripheral measurements. The SS-OCT device generated higher precision when acquiring CT data, whereas Scheimpflug system showed higher reliability when measuring corneal keratometry. Although the CT readings measured using SS-OCT were significantly thinner than Scheimpflug device (P < 0.001), the central and thinnest CT values were still of high agreement. The interdevice agreement of keratometry measurement was high for the central corneal region and moderate for the paracentral and peripheral areas. Conclusions The precision of CT measurements by SS-OCT was higher, while the reliability of keratometry measurements by the Scheimpflug system was higher in children. Apart from the measured values in the central corneal region, the thickness and keratometry readings should not be considered interchangeable between the two systems.
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Affiliation(s)
- Yune Zhao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang China
| | - Ding Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | | | - Qing Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Hongfang Zhang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang China
| | - Yili Jin
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Benhao Song
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Rui Ning
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Jinhai Huang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang China.,Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Chenyang Mei
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang China.,Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027 Zhejiang China
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Abstract
PURPOSE OF REVIEW This article reviews emerging technologies in retinal imaging, including their scientific background, clinical implications and future directions. RECENT FINDINGS Fluorescence lifetime imaging ophthalmoscopy is a technology that will reveal biochemical and metabolic changes of the retina at the cellular level. Optical coherence tomography is evolving exponentially toward higher resolution, faster speed, increased portability and more cost effective. Adaptive optics scanning laser ophthalmoscopy fluorescein angiography will provide unprecedented detail of the retinal vasculature down to the level of capillaries, enabling earlier and more sensitive detection of retinal vascular diseases. SUMMARY Continued developments in retinal imaging focus on improved resolution, faster speed and noninvasiveness, while providing new information on the structure-function relationship of the retina inclusive of metabolic activity at the cellular level.
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Comparison of refractive outcomes using conventional keratometry or total keratometry for IOL power calculation in cataract surgery. Graefes Arch Clin Exp Ophthalmol 2019; 257:2677-2682. [PMID: 31486917 DOI: 10.1007/s00417-019-04443-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 08/10/2019] [Accepted: 08/15/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To compare the refractive outcomes following cataract surgery using conventional keratometry (K) and total keratometry (TK) for intraocular lens (IOL) calculation in the SRK/T, HofferQ, Haigis, and Holladay 1 and 2, as well as Barrett and Barrett TK Universal II formulas. METHODS Sixty eyes of 60 patients from Siriraj Hospital, Thailand, were prospectively enrolled in this comparative study. Eyes were assessed using a swept-source optical biometer (IOLMaster 700; Carl Zeiss Meditec, Jena, Germany). Posterior keratometry, K, TK, central corneal thickness, anterior chamber depth, lens thickness, axial length, and white-to-white corneal diameter were recorded. Emmetropic IOL power was calculated using K and TK in all formulas. Selected IOL power and predicted refractive outcomes were recorded. Postoperative manifest refraction was measured 3 months postoperatively. Mean absolute errors (MAEs), median absolute errors (MedAEs), and percentage of eyes within ± 0.25, ± 0.50, and ± 1.00 D of predicted refraction were calculated for all formulas in both groups. RESULTS Mean difference between K and TK was 0.03 D (44.56 ± 1.18 vs. 44.59 ± 1.22 D), showing excellent agreement (ICC = 0.99, all p < 0.001). Emmetropic IOL powers in all formulas for both groups were very similar, with a trend toward lower MAEs and MedAEs for TK when compared with K. The Barrett TK Universal II formula demonstrated the lowest MAEs. Proportion of eyes within ± 0.25, ± 0.50, and ± 1.00 D of predicted refraction were slightly higher in the TK group. CONCLUSIONS Conventional K and TK for IOL calculation showed strong agreement with a trend toward better refractive outcomes using TK. The same IOL constant can be used for both K and TK.
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Analysis of Intrasession Repeatability of Ocular Aberrometric Measurements and Validation of Keratometry Provided by a New Integrated System in Mild to Moderate Keratoconus. Cornea 2019; 38:1097-1104. [DOI: 10.1097/ico.0000000000002034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Fourier Analysis of Corneal Irregular Astigmatism Due to the Anterior Corneal Surface in Dry Eye. Eye Contact Lens 2019; 45:188-194. [PMID: 30550406 DOI: 10.1097/icl.0000000000000559] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate corneal irregular astigmatism due to the anterior corneal surface using Fourier harmonic analysis with a Placido ring-based corneal topographer (Placido-based topographer) and three-dimensional anterior segment optical coherence tomography (OCT) in dry eyes. METHODS Forty-four eyes of 44 subjects with dry eye and 20 eyes of 20 normal control subjects were enrolled. Corneal topographic data were obtained using a Placido-based topographer and OCT. Dioptric data from the central 3-mm zone of the anterior corneal surface were decomposed using Fourier harmonic analysis. Spherical, regular astigmatism, and irregular astigmatism (asymmetry and higher-order irregularity) refractive error components of the cornea from the two imaging modalities were compared. RESULTS Both asymmetry and higher-order irregularity values were significantly greater in dry eyes than in control eyes for both the Placido-based topographer and OCT measurements (all P<0.05). In dry eyes, measured values of asymmetry and higher-order irregularities were significantly smaller when obtained with OCT than with the Placido-based topographer (both P<0.001). By contrast, these parameters were not significantly different between the two devices in control eyes. In dry eyes, severity of superficial punctate keratopathy in the central corneal region was correlated with irregular astigmatism. CONCLUSIONS The amount of corneal irregular astigmatism, quantified using Fourier harmonic analysis, was significantly higher in dry eyes than in normal eyes. Measurements obtained with OCT and the Placido-based topographer differed in subjects with dry eyes. Therefore, caution should be practiced when trying to use these measurements interchangeably.
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Terrien marginal degeneration. Surv Ophthalmol 2019; 64:162-174. [DOI: 10.1016/j.survophthal.2018.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/29/2018] [Accepted: 09/17/2018] [Indexed: 11/19/2022]
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Measurement of Corneal Biomechanical Properties in Diabetes Mellitus Using the Ocular Response Analyzer and the Corvis ST. Cornea 2019; 38:595-599. [DOI: 10.1097/ico.0000000000001879] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Hayashi K, Sato T, Sasaki H, Hirata A, Yoshimura K. Sex-related differences in corneal astigmatism and shape with age. J Cataract Refract Surg 2018; 44:1130-1139. [DOI: 10.1016/j.jcrs.2018.06.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/23/2018] [Accepted: 06/09/2018] [Indexed: 11/26/2022]
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Ang M, Baskaran M, Werkmeister RM, Chua J, Schmidl D, Aranha dos Santos V, Garhöfer G, Mehta JS, Schmetterer L. Anterior segment optical coherence tomography. Prog Retin Eye Res 2018; 66:132-156. [DOI: 10.1016/j.preteyeres.2018.04.002] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/20/2018] [Accepted: 04/04/2018] [Indexed: 02/03/2023]
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Fan R, Chan TCY, Prakash G, Jhanji V. Applications of corneal topography and tomography: a review. Clin Exp Ophthalmol 2018; 46:133-146. [DOI: 10.1111/ceo.13136] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/10/2017] [Accepted: 12/14/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Rachel Fan
- Faculty of Medicine; The University of Hong Kong; Hong Kong
| | - Tommy CY Chan
- Department of Ophthalmology & Visual Sciences; The Chinese University of Hong Kong; Hong Kong
| | - Gaurav Prakash
- NMC Eye Care; NMC Specialty Hospital; Abu Dhabi United Arab Emirates
| | - Vishal Jhanji
- Department of Ophthalmology & Visual Sciences; The Chinese University of Hong Kong; Hong Kong
- Department of Ophthalmology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania USA
- Centre for Eye Research Australia; University of Melbourne; Melbourne Victoria Australia
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Hayashi K, Yoshida M, Hirata A, Yoshimura K. Changes in shape and astigmatism of total, anterior, and posterior cornea after long versus short clear corneal incision cataract surgery. J Cataract Refract Surg 2018; 44:39-49. [DOI: 10.1016/j.jcrs.2017.10.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/30/2017] [Accepted: 10/02/2017] [Indexed: 11/29/2022]
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Módis L, Németh G, Szalai E, Flaskó Z, Seitz B. Scanning-slit topography in patients with keratoconus. Int J Ophthalmol 2017; 10:1686-1692. [PMID: 29181311 DOI: 10.18240/ijo.2017.11.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/06/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the anterior and posterior corneal surfaces using scanning-slit topography and to determine the diagnostic ability of the measured corneal parameters in keratoconus. METHODS Orbscan II measurements were taken in 39 keratoconic corneas previously diagnosed by corneal topography and in 39 healthy eyes. The central minimum, maximum, and astigmatic simulated keratometry (K) and anterior axial power values were determined. Spherical and cylindrical mean power diopters were obtained at the central and at the steepest point of the cornea both on anterior and on posterior mean power maps. Pachymetry evaluations were taken at the center and paracentrally in the 3 mm zone from the center at a location of every 45 degrees. Receiver operating characteristic (ROC) analysis was used to determine the best cut-off values and to evaluate the utility of the measured parameters in identifying patients with keratoconus. RESULTS The minimum, maximum and astigmatic simulated K readings were 44.80±3.06 D, 47.17±3.67 D and 2.42±1.84 D respectively in keratoconus patients and these values differed significantly (P<0.0001 for all comparisons) from healthy subjects. For all pachymetry measurements and for anterior and posterior mean power values significant differences were found between the two groups. Moreover, anterior central cylindrical power had the best discrimination ability (area under the ROC curve=0.948). CONCLUSION The results suggest that scanning-slit topography and pachymetry are accurate methods both for keratoconus screening and for confirmation of the diagnosis.
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Affiliation(s)
- László Módis
- Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Debrecen 4032, Hungary
| | - Gábor Németh
- Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc 3526, Hungary
| | - Eszter Szalai
- Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Debrecen 4032, Hungary
| | - Zsuzsa Flaskó
- Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Debrecen 4032, Hungary
| | - Berthold Seitz
- Department of Ophthalmology, Homburg Keratoconus Center, University of Saarland, Homburg/Saar 66424, Germany
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