1
|
Kim BZ, Lim JZ, McGhee CNJ. Cysts and tumours of the iris: Diagnostic tools and key management considerations-A review. Clin Exp Ophthalmol 2024; 52:665-683. [PMID: 38577954 DOI: 10.1111/ceo.14380] [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: 08/20/2023] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/06/2024]
Abstract
The iris is a unique structure, with exquisite variations in colour and form. Pathological changes, specifically including iris cysts and tumours are relatively uncommon, difficult to diagnose, and yet potentially blinding or life-threatening. Based on a comprehensive literature review, with highly illustrated key case examples, this report aims to guide the clinician in filtering the differential diagnoses of iris cysts and tumours. Evaluation is in the context of key diagnostic clinical tools and management considerations. Diagnostic imaging techniques include serial anterior segment photography, ultrasound, anterior segment optical coherence tomography, and iris fluorescein angiography, however, the roles of computerised topography and magnetic resonance imaging are also considered in this review. Management includes categorisation in terms of solid iris tumours (melanocytic vs. non-melanocytic), or iris cysts (primary vs. secondary) that may be usefully differentiated by clinical assessment, avoiding more invasive interventions. Cystic lesions are generally benign, although implantation cysts in particular cause significant complications and surgical challenges. Most solid tumours are melanocytic and also typically benign. However, in larger lesions, rapid growth, symptoms and complications more likely indicate malignancy, requiring further investigation.
Collapse
Affiliation(s)
- Bia Z Kim
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, Greenlane Eye Clinic, Health New Zealand (Te Whatu Ora) Auckland, Auckland, New Zealand
| | - Joevy Z Lim
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, Greenlane Eye Clinic, Health New Zealand (Te Whatu Ora) Auckland, Auckland, New Zealand
| | - Charles N J McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, Greenlane Eye Clinic, Health New Zealand (Te Whatu Ora) Auckland, Auckland, New Zealand
| |
Collapse
|
2
|
Minhaz AT, Orge FH, Wilson DL, Bayat M. Assessment of intraocular foreign body using high resolution 3D ultrasound imaging. Sci Rep 2024; 14:12011. [PMID: 38796466 PMCID: PMC11128014 DOI: 10.1038/s41598-024-62362-y] [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: 02/13/2024] [Accepted: 05/16/2024] [Indexed: 05/28/2024] Open
Abstract
Ocular trauma often involves intraocular foreign bodies (IOFBs) that pose challenges in accurate diagnosis due to their size, shape, and material composition. In this study, we proposed a novel whole-eye 3D ophthalmic ultrasound B-scan (3D-UBS) system for automating image acquisition and improved 3D visualization, thereby improving sensitivity for detecting IOFBs. 3D-UBS utilizes 14 MHz Clarius L20 probe, a motorized translation stage, and a surgical microscope for precise placement and movement. The system's 3D point spread function (PSF) is 0.377 × 0.550 × 0.894 mm3 characterized by the full-width at half-maximum intensity values in the axial, lateral and elevation directions. Digital phantom and ex vivo ocular models were prepared using four types of IOFBs (i.e., plastic, wood, metal, and glass). Ex vivo models were imaged with both 3D-UBS and clinical computed tomography (CT). Image preprocessing was performed on 3D-UBS images to remove uneven illumination and speckle noise. Multiplanar reformatting in 3D-UBS provides optimal plane selection after acquisition, reducing the need for a trained ultrasonographer. 3D-UBS outperforms CT in contrast for wood and plastic, with mean contrast improvement of 2.43 and 1.84 times, respectively. 3D-UBS was able to identify wood and plastic IOFBs larger than 250 µm and 300 in diameter, respectively. CT, with its wider PSF, was only able to detect wood and plastic IOFBs larger than 600 and 550 µm, respectively. Although contrast was higher in CT for metal and glass IOFBs, 3D-UBS provided sufficient contrast to identify those. 3D-UBS provides an easy-to-use, non-expert imaging approach for identifying small IOFBs of different materials and related ocular injuries at the point of care.
Collapse
Affiliation(s)
- Ahmed Tahseen Minhaz
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
| | - Faruk H Orge
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, USA
- Department of Pediatric Ophthalmology and Adult Strabismus, University Hospitals, Cleveland, OH, USA
| | - David L Wilson
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
| | - Mahdi Bayat
- Department of Electrical, Computer and Systems Engineering, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
3
|
Keiler J, Stahnke T, Guthoff RF, Wree A, Runge J. Ex Vivo Micro-CT in Ophthalmology: Preparation and Contrasting for Non-invasive 3D-Visualisation. Klin Monbl Augenheilkd 2023; 240:1359-1368. [PMID: 38092003 DOI: 10.1055/a-2111-8415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
X-ray-based micro-computed tomography (micro-CT) is a largely non-destructive imaging method for the visualisation and analysis of internal structures in the ex vivo eye and affords high resolution. In contrast to other high-resolution imaging methods, micro-CT enables spatial recording of larger and more complex tissue structures, such as the anterior chamber of the eye. Special contrasting methods help to enhance the absorption properties of soft tissue, that is otherwise only weakly radiopaque. Critical point drying (CPD), as primarily used in scanning electron microscopy, offers an additional tool for improving differential contrast properties in soft tissue. In the visualisation of intraosseous soft tissue, such as the efferent lacrimal ducts, sample treatment by decalcification with ethylenediaminetetraacetic acid and subsequent CPD provides good results for micro-CT. Micro-CT can be used for a wide range of questions in 1. basic research, 2. application-related studies in ophthalmology (e.g. evaluation of the preclinical application of microstents for glaucoma treatment or analysis of the positioning of intraocular lenses) but also 3. as a supplement to ophthalmological histopathology.
Collapse
Affiliation(s)
- Jonas Keiler
- Institut für Anatomie, Universitätsmedizin Rostock, Deutschland
| | - Thomas Stahnke
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland
- Institut für ImplantatTechnologie und Biomaterialien e. V., Warnemünde, Deutschland
| | - Rudolf F Guthoff
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland
| | - Andreas Wree
- Institut für Anatomie, Universitätsmedizin Rostock, Deutschland
| | - Jens Runge
- Institut für Anatomie, Universitätsmedizin Rostock, Deutschland
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Rostock, Deutschland
| |
Collapse
|
4
|
Tan W, Wang Z, Zeng Q, Lei X, Pan C, Shu B, Jin L, Chen Q. The influence of iris -ciliary angle (ICA) on the vault after implantation of V4c implantable collamer lens: a chain mediation model of ICL haptic related factors. BMC Ophthalmol 2023; 23:403. [PMID: 37803302 PMCID: PMC10559582 DOI: 10.1186/s12886-023-03122-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 09/01/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND This study aims to identify the relationship between iris -ciliary angle (ICA) and the vault. Additionally, we also seek to investigate the chain mediating effects of the ICL haptic related factors on this relationship. METHODS The participants were categorized into three groups according to the ICA value as follows: low ICA group (< 35°); moderate ICA group (35°-70°); high ICA group (> 70°). We compared the preoperative ocular characteristics and postoperative examinations among the three groups. Multiple variable stepwise regression was performed to establish the vault prediction formula. The Process V4.0 in SPSS and Hayes's PROCESS model 6 was conducted to further elucidate the mediating effects of the final tip point of ICL haptic and the ICL arc-lens arc on the relationship between the ICA and vault. RESULTS There was a significant difference in the positions of the ICL haptic among three ICA groups. The regression vault equation was Vault = 679.42-7.26*TCA + 192.30*ACD-196.37*CLR + 73.21* STS(horizontal).A significant negative correlation was found between the ICA and vault (P < 0.01).The chain mediation model revealed that the final tip point of ICL haptic and the ICL arc-Lens arc were sequential mediators between ICA and vault (effect = -1.63, 95% CI = -2.72--0.73). CONCLUSION The ICA was associated with vault via the mediation effect of the final tip point of the ICL haptic and the ICL arc -lens arc. Assessment of ICL haptic related parameters adds significant information to interpret the vault after surgery.
Collapse
Affiliation(s)
- Weina Tan
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Zheng Wang
- Aier Institute of Refractive Surgery, Guangzhou, Guangdong Province, People's Republic of China
| | - Qingyan Zeng
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Xiaohua Lei
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Chao Pan
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Bao Shu
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Lina Jin
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China
- Hankou Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China
| | - Qian Chen
- Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital), Wuhan, Hubei Province, People's Republic of China.
- Hongshan Aier Eye Hospital, Wuhan, Hubei Province, People's Republic of China.
| |
Collapse
|
5
|
Luo S, Holland G, Khazaeinezhad R, Bradford S, Joshi R, Juhasz T. Iridocorneal angle imaging of a human donor eye by spectral-domain optical coherence tomography. Sci Rep 2023; 13:13861. [PMID: 37620338 PMCID: PMC10449890 DOI: 10.1038/s41598-023-37248-0] [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: 10/21/2022] [Accepted: 06/19/2023] [Indexed: 08/26/2023] Open
Abstract
Iridocorneal angle (ICA) details particularly the trabecular meshwork (TM), Schlemm's canal (SC), and collector channels (CCs) play crucial roles in the regulation of the aqueous outflow in the eyes and are closely associated with glaucoma. Current clinical gonioscopy imaging provides no depth information, and studies of 3D high-resolution optical coherence tomography (OCT) imaging of these structures are limited. We developed a custom-built spectral-domain (SD-) OCT imaging system to fully characterize the angle details. Imaging of a human cadaver eye reveals the visibility of details in the TM/SC/CC region via a 'crossline' scanning and a series of image processing. This shows that ICA imaging can be used for preoperative glaucoma inspections in the clinical setting with the proposed prototype.
Collapse
Affiliation(s)
- Shangbang Luo
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, 92697, USA
- Department of Ophthalmology, University of California, Irvine, Irvine, CA, 92697, USA
| | | | | | - Samantha Bradford
- Department of Ophthalmology, University of California, Irvine, Irvine, CA, 92697, USA
| | - Rohan Joshi
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, 92697, USA
- Department of Ophthalmology, University of California, Irvine, Irvine, CA, 92697, USA
| | - Tibor Juhasz
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, 92697, USA.
- Department of Ophthalmology, University of California, Irvine, Irvine, CA, 92697, USA.
- ViaLase Inc., Aliso Viejo, CA, 92656, USA.
| |
Collapse
|
6
|
He L, Wang B, Wen Z, Li X, Wu D. 3-D High Frequency Ultrasound Imaging by Piezo-Driving a Single-Element Transducer. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:1932-1942. [PMID: 35050853 DOI: 10.1109/tuffc.2022.3145162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Electronic scanning of two-dimensional (2-D) arrays and mechanical or freehand scanning of one-dimensional (1-D) arrays have been mostly utilized for conventional three-dimensional (3-D) ultrasound (US) imaging. However, the development of 2-D arrays and the hardware systems are complicated and expensive, while freehand systems with positioning sensors and mechanical systems are mostly bulky. This article represents a novel scanning strategy for achieving high-quality 3-D US imaging with a high-frequency single-element transducer. A 42-MHz US transducer with a compact structure was designed and fabricated, which was excited in the 2-D vibration by a tubular piezoelectric actuator. A dedicated imaging system was set up and both B-mode and 3-D US imaging of a custom wire phantom have been carried out to evaluate the performance of the proposed transducer. Compared to the results obtained with the motorized linear translation stage, the reconstructed images obtained by the proposed resonance scanning method are accurate, demonstrating the feasibility of 3-D US imaging with a vibrating single-element US transducer.
Collapse
|