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Römkens HCS, Beckers HJM, Schouten JSAG, Berendschot TTJM, Webers CAB. Effect of combined water drinking test and dark room provocative testing in Caucasian eyes with narrow angles. Eye (Lond) 2022; 36:167-174. [PMID: 33654318 PMCID: PMC8727610 DOI: 10.1038/s41433-021-01398-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 12/30/2020] [Accepted: 01/08/2021] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To assess the usefulness of water drinking test and dark room provocative testing (WDT + DRPT) in current clinical practice by evaluating input parameters from Swept-source Optical Coherence Tomography (SS-OCT) images, and to determine if clinical factors like axial length, central endothelial cell count (CECC) and retinal nerve fibre layer thickness (RNFL) thickness are associated with a positive WDT + DRPT. METHODS SS-OCT examination was performed in consecutive subjects presenting as new patients in the outpatient clinic aged > 40 years. If at least one eye met the inclusion criteria (anterior chamber angles <20° and anterior chamber depth < 2.5 mm on SS-OCT), subjects were included in this study and WDT + DRPT was carried out. The eye with the smallest angle was analysed. The difference in parameters between eyes with a positive (≥8 mmHg) and negative (<8 mmHg) increase in intraocular pressure (IOP) after WDT + DRPT were statistically analysed. Second, the correlation between IOP increase after WDT + DRPT and anterior chamber angle parameters (RNFL thickness, CECC and axial length) was studied. RESULTS A total of 95 subjects with a mean age of 64 years were included. There was an association between IOP increase after WDT + DRPT and anterior chamber angle characteristics, however this was not of clinical significance. No positive results after WDT + DRPT were found in patients with anterior chamber angles ≥ 20°. CONCLUSIONS The present findings indicate that this combined provocative test has no definite correlative or predictive value in angle closure disease. Further, the test is not useful in predicting early diagnosis or possible CECC or RNFL loss.
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Affiliation(s)
- Hellen C. S. Römkens
- grid.412966.e0000 0004 0480 1382Maastricht University Medical Center, Maastricht, the Netherlands
| | - Henny J. M. Beckers
- grid.412966.e0000 0004 0480 1382Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jan S. A. G. Schouten
- grid.412966.e0000 0004 0480 1382Maastricht University Medical Center, Maastricht, the Netherlands ,Canisisus Wilhelmina Ziekenhuis, Nijmegen, the Netherlands
| | - Tos T. J. M. Berendschot
- grid.412966.e0000 0004 0480 1382Maastricht University Medical Center, Maastricht, the Netherlands
| | - Carroll A. B. Webers
- grid.412966.e0000 0004 0480 1382Maastricht University Medical Center, Maastricht, the Netherlands
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Li Z, Qu W, Huang J, Meng Z, Li X, Zou R, Zhao Y. Effect of age and cycloplegia on the morphology of the human crystalline lens: swept-source OCT study. J Cataract Refract Surg 2022; 48:8-15. [PMID: 34016824 PMCID: PMC8700289 DOI: 10.1097/j.jcrs.0000000000000693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/27/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the effect of age and cycloplegia on the morphology of the crystalline lens using a swept-source optical coherence tomography (SS-OCT) system. SETTING Hospital. DESIGN Prospective cross-sectional study. METHODS The parameters including anterior chamber depth (ACD), the radii of curvature of the anterior and posterior surface of the crystalline lens (ALR and PLR), lens thickness (LT), lens equatorial diameter (LED), and lens vault (LV) were quantified by the SS-OCT before and after cycloplegia. The paired t test was used to compare the parameters before and after cycloplegia. A multivariate linear regression model was built to analyze the association between the parameters/cycloplegia-induced changes and age, while adjusting for the effect of axial length, refractive status, and sex. RESULTS 76 individuals (age range, 18 to 86 years) were recruited. The ALR and ACD were negatively correlated with age (P ≤ .002), and the LT, LV, and LED were positively correlated with age (P ≤ .004). In participants younger than 60 years, the ALR and ACD significantly increased, whereas the LV and LT significantly decreased after cycloplegia (all P < .001). With aging, cycloplegia-induced differences of ALR (P = .001) and ACD (P = .014) significantly decreased, and of LT (P < .001), LT (P < .001), and LV (P = .001) significantly increased. CONCLUSIONS The crystalline lens morphology measured by the SS-OCT revealed steepening anterior surface and increasing equatorial diameter with age. Cycloplegia caused a significant change of anterior surface morphology in participants younger than 60 years, and this effect diminished with age.
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Zheng Q, Hu M, Li ZL, Chang PJ, Zhao YE. Assessment of anterior chamber angle changes after phacoemulsification with swept-source OCT. Int J Ophthalmol 2021; 14:1527-1532. [PMID: 34667728 DOI: 10.18240/ijo.2021.10.08] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/25/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens (IOL) implantation, based on anterior segment swept-source optical coherence tomography (AS-SS-OCT) measurements. METHODS This was a prospective case control study; sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure (IOP). Based on anterior chamber depth (ACD) and gonioscopy findings, the eyes were divided into two groups: group of shallow anterior chamber and narrow angle (SAC group, 30 eyes); and group of normal anterior chamber group with wide angle (NAC group, 30 eyes). Measurements of ACD, anterior chamber volume (ACV), iris volume (IV), lens vault (LV), angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), and trabecular iris angle (TIA) were conducted in each group before and 3mo after surgery. RESULTS There was no significant difference in age, axial length (AL), corneal curvature, corneal diameter, intraocular pressure, and IV between two groups before surgery, except for the LV (P=0.000). ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation (3.69±0.38 vs 3.85±0.39 mm, P=0.025; 161.37±19.47 vs 178.26±20.30 mm3, P=0.002). AOD750, ARA750 in nasal and inferior quadrants, TISA750 in all quadrants except temporal, and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation (all P<0.05). CONCLUSION Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects, but the angle related parameters including AOD750, ARA750, TISA750, TIA, TISA750, and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.
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Affiliation(s)
- Qian Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Man Hu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Zhang-Liang Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Ping-Jun Chang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
| | - Yun-E Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,National Clinical Research Center for Ocular Diseases, Wenzhou 325027, Zhejiang Province, China
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Montés-Micó R, Tañá-Rivero P, Aguilar-Córcoles S, Ruíz-Mesa R. Assessment of anterior segment measurements using a high-resolution imaging device. Expert Rev Med Devices 2020; 17:969-979. [PMID: 32847426 DOI: 10.1080/17434440.2020.1816463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the repeatability of several anterior segment parameters obtained with swept-source optical coherence tomography (SS-OCT). METHODS We measured 5-times consequently several parameters in 69 eyes using the ANTERION SS-OCT. White-to-white (WTW), angle-to-angle (ATA), spur-to-spur (STS), and lens vault distances were measured in the horizontal- and vertical-meridian. Anterior-chamber-angle (ACA), scleral-spur-angle (SSA), angle-opening-distance (AOD), and trabecular-iris-space-area (TISA) were measured at 500 and 750 μm for the superior-, nasal-,inferior-, and temporal-quadrants. Intrasubject standard deviation (Sw),coefficient of variation (CoV), coefficient of repeatability (CoR), and intraclass-correlation-coefficient (ICC) were calculated for each parameter. Bland-Altman analysis was done. RESULTS We have not found statistically significant differences between repeated measurements (p > 0.05). Repeatability was good for the different parameters evaluated. Sw values in distances and areas were low and ranged from 0.01 to 0.07. CoR values showed a similar pattern being larger for those metrics measuring angles. The same happened with CoV values, being very small for WTW,ATA, and STS distances (0.16-0.57%). ICC values for all parameters analyzed were > 0.97. Bland-Altman plots evidenced the narrow limits of agreement for all parameters. CONCLUSIONS The ANTERION SS-OCT demonstrated high repeatability measuring different distances, angles, and areas of the anterior segment of the eye.
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Affiliation(s)
- Robert Montés-Micó
- Oftalvist Clinic , Alicante, Spain.,Optics and Optometry & Vision Sciences Department, University of Valencia , Valencia, Spain
| | - Pedro Tañá-Rivero
- Optics and Optometry & Vision Sciences Department, University of Valencia , Valencia, Spain
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Heslinga FG, Alberti M, Pluim JPW, Cabrerizo J, Veta M. Quantifying Graft Detachment after Descemet's Membrane Endothelial Keratoplasty with Deep Convolutional Neural Networks. Transl Vis Sci Technol 2020; 9:48. [PMID: 32884855 PMCID: PMC7445365 DOI: 10.1167/tvst.9.2.48] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/22/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose We developed a method to automatically locate and quantify graft detachment after Descemet's membrane endothelial keratoplasty (DMEK) in anterior segment optical coherence tomography (AS-OCT) scans. Methods A total of 1280 AS-OCT B-scans were annotated by a DMEK expert. Using the annotations, a deep learning pipeline was developed to localize scleral spur, center the AS-OCT B-scans and segment the detached graft sections. Detachment segmentation model performance was evaluated per B-scan by comparing (1) length of detachment and (2) horizontal projection of the detached sections with the expert annotations. Horizontal projections were used to construct graft detachment maps. All final evaluations were done on a test set that was set apart during training of the models. A second DMEK expert annotated the test set to determine interrater performance. Results Mean scleral spur localization error was 0.155 mm, whereas the interrater difference was 0.090 mm. The estimated graft detachment lengths were in 69% of the cases within a 10-pixel (∼150 µm) difference from the ground truth (77% for the second DMEK expert). Dice scores for the horizontal projections of all B-scans with detachments were 0.896 and 0.880 for our model and the second DMEK expert, respectively. Conclusions Our deep learning model can be used to automatically and instantly localize graft detachment in AS-OCT B-scans. Horizontal detachment projections can be determined with the same accuracy as a human DMEK expert, allowing for the construction of accurate graft detachment maps. Translational Relevance Automated localization and quantification of graft detachment can support DMEK research and standardize clinical decision-making.
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Affiliation(s)
- Friso G Heslinga
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Mark Alberti
- Ophthalmology Department, Rigshospitalet - Glostrup, Copenhagen, Denmark
| | - Josien P W Pluim
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Javier Cabrerizo
- Ophthalmology Department, Rigshospitalet - Glostrup, Copenhagen, Denmark.,Copenhagen Eye Foundation, Copenhagen, Denmark
| | - Mitko Veta
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
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Chen W, Hu T, Xu Q, Chen Z, Zhang H, Wang J. Acute Effects of Intraocular Pressure-Induced Changes in Schlemm's Canal Morphology on Outflow Facility in Healthy Human Eyes. Invest Ophthalmol Vis Sci 2020; 61:36. [PMID: 32716504 PMCID: PMC7425758 DOI: 10.1167/iovs.61.8.36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To estimate the outflow facility coefficient (C) as a function of Schlemm's canal cross-sectional area (SCAR) in healthy subjects using noninvasive oculopression tonometry (OPT). Methods In 25 healthy volunteers, intraocular pressure (IOP) decay values were recorded by a ophthalmodynamometer, with a fixed external force (0.15 N) on the inferior-temporal eyelid, every 10 seconds, for four minutes, and again after a 30-minute rest. Schlemm's canal profile images and IOP were obtained pre-procedurally (baseline), immediately (T0), and at 1-minute intervals post-procedurally (T1, T2, T3, and T4). C was calculated for different IOPs. The SCAR, coronal, and the meridional diameter of Schlemm's canal were calculated. Results Mean C0 for the maximum IOP was 0.020 ± 0.017 µL/min/mm Hg; mean C was 0.018 ± 0.0071 and 0.058 ± 0.0146 µL/min/mm Hg at 40 and 20 mm Hg, respectively. C was nonlinearly dependent on the IOP (R2 = 0.945). The SCAR was 5440 ± 3140.82, 3947.6 ± 2246.8, and 5375.7 ± 2662.7 µm2 at baseline, T0, and T4, respectively. The coronal diameter of SC decreased significantly from the baseline (33.02 ± 11.3 µm) to T0 (26.6 ± 9.37 µm) and recovered at T4 (32.3 ± 9.53 µm). The SCAR and IOP correlated significantly throughout (R2 = 0.9944; P < 0.001). C0 significantly correlated with the SCAR at baseline and with changes in the SCAR and IOP from T0 to T4. Conclusions Schlemm's canal dimensions are responsible for the IOP-dependent mechanical forces, and these changes appear to directly affect outflow facility.
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