PSEUDOPHAKIC malignant glaucoma is diagnosedbased on the presence of a shallow or flat centraland peripheral anterior chamber in the presenceof patent iridectomy, with intraocular pressure(IOP) of 22 mm Hg or more a...PSEUDOPHAKIC malignant glaucoma is diagnosedbased on the presence of a shallow or flat centraland peripheral anterior chamber in the presenceof patent iridectomy, with intraocular pressure(IOP) of 22 mm Hg or more after lens extraction andintraocular lens implantation.1 Pseudophakic malignantglaucoma is one of the most challenging complicationsfaced by surgeons. Initial medication includes topicalcycloplegics, osmotic agents.展开更多
Purpose: To compare the repeatability and consistency of anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in measuring iris parameters in patients with primary angle closure gl...Purpose: To compare the repeatability and consistency of anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in measuring iris parameters in patients with primary angle closure glaucoma. Methods: Twenty-two patients (38 eyes) with primary angle closure glaucoma,including 5 eyes with acute angle closure glaucoma,10 fellow eyes of acute angle closure glaucoma, and 23 eyes with chronic angle closure glaucoma, were recruited consecutively in our hospital. All subjects underwent anterior scanning by AS-OCT and UBM. Peripheral iris thickness (PIT) and iris curvature (IC) in the anterior segment image obtained by AS-OCT and UBM were measured twice. The reproducibility of these two scans was evaluated by the intraclass correlation coefficient (ICC). A paired t-test was used to compare the difference between the two scans and the 95% limits of agreement (LoA) were calculated. Results:The ICCs of PIT and IC measured by UBM were 0.892 and 0.936 respectively, while for AS-OCT these values were 0.629 and 0.859, respectively. UBM had a higher reproducibility in both PIT and IC measurements as compared with AS-OCT.Differences in PIT measurement between AS-OCT and UBM(P=0.331).were not statistically significant, the 95% LoA (-0.178~0.156) mm was 36.1~41.2% of the mean. The IC was 0.053 mm smaller when measured by UBM than by AS-OCT (P=0.017), with the 95% LoA (-0.100~0.206) mm, or 36.2~74.6% of the mean.Conclusion:UBM had a higher reproducibility in measuring iris parameters than AS-OCT. The consistency between AS- OCT and UBM in measuring iris parameters was low in primary angle closure glaucoma patients. (Eye Science 2013; 28:1-6)展开更多
Anterior segment optical coherence tomography (AS-OCT) finds very few indications in the domain of strabismus surgery. Current applications remain restricted to determining limbus-muscle insertion distance and anter...Anterior segment optical coherence tomography (AS-OCT) finds very few indications in the domain of strabismus surgery. Current applications remain restricted to determining limbus-muscle insertion distance and anterior segment changes after strabismus surgery. We discuss two cases of operated strabismus surgery where AS-OCT imaging helped in identifying the operated eye and/or extra ocular muscles (EOM) and thus proved instrumental in planning and management.展开更多
AIMTo assess lens thickness measurements with anterior segment-optical coherence tomography (AS-OCT) in comparison with A-scan ultrasonography (A-scan US).METHODSThere were 218 adult subjects (218 eyes) aged 59.2&...AIMTo assess lens thickness measurements with anterior segment-optical coherence tomography (AS-OCT) in comparison with A-scan ultrasonography (A-scan US).METHODSThere were 218 adult subjects (218 eyes) aged 59.2±9.2y enrolled in this prospective cross-sectional study. Forty-three eyes had open angles and 175 eyes had narrow angles. Routine ophthalmic exam was performed and nuclear opacity was graded using the Lens Opacities Classification System III (LOCS III). Lens thickness was measured by AS-OCT (Visante OCT, Carl Zeiss Meditec, Dublin, CA, USA). The highest quality image was selected for each eye and lens thickness was calculated using ImageJ software. Lens thickness was also measured by A-scan US.RESULTSInterclass correlations showed a value of 99.7% for intra-visit measurements and 95.3% for inter-visit measurements. The mean lens thickness measured by AS-OCT was not significantly different from that of A-scan US (4.861±0.404 vs 4.866±0.351 mm, P=0.74). Lens thickness values obtained from the two instruments were highly correlated overall (Pearson correlation coefficient=0.81, P<0.001), and in all LOCS III specific subgroups except in grade 5 of nuclear opacity. Bland-Altman analysis revealed a 95% limit of agreement from -0.45 to 0.46 mm. Lens thickness difference between the two instruments became smaller as the lens thickness increased and AS-OCT yielded smaller values than A-scan US in thicker lens (β=-0.29, P<0.001)CONCLUSIONAS-OCT-derived lens thickness measurement is valid and comparable to the results obtained by A-scan US. It can be used as a reliable noncontact method for measuring lens thickness in adults with or without significant cataract.展开更多
Dry eye,one of the most frequent ocular surface diseases, is caused by complex ocular function and mechanism disorders. Currently, no uniform standard diagnosis of dry eye has been established. Traditional clinical ex...Dry eye,one of the most frequent ocular surface diseases, is caused by complex ocular function and mechanism disorders. Currently, no uniform standard diagnosis of dry eye has been established. Traditional clinical examinations provide inaccurate measurement and poor reproducibility due to various factors.Anterior segment optical coherence tomography (OCT) is applicable in the diagnosis of dry eye due to its high resolution, non-invasiveness, good accuracy, and repeatability.展开更多
Purpose:To compare the measurement of flap thickness using intraoperative ultrasound pachymetry and postoperative visante anterior segment optical coherence tomography (Visante-OCT) in eyes receiving laser in situ ker...Purpose:To compare the measurement of flap thickness using intraoperative ultrasound pachymetry and postoperative visante anterior segment optical coherence tomography (Visante-OCT) in eyes receiving laser in situ keratomileusis (LASIK). Methods: Seventeen patients (34 eyes) received LASIK using a Technolas-217Z100 laser and AMADEUSⅡ mechanical microkeratome(140 μm head). Flap thickness was assessed with an ultrasound pachymeter intraoperatively and a Visante-OCT postoperatively at 1 week and 1 month. Results: The intraoperative mean flap thickness by ultrasound pachymetry was (124±13.9) μm (range: 96.5 to 160 μm), and mean flap thickness by Visante-OCT was (145±7.13) μm (range: 130 to 158 μm) and (143±5.32) μm (range: 132 to 155 μm) postoperatively at 1 week and 1 month respectively (F=63.52,P<0.01). Intraoperative subtraction pachymetry underestimated flap thickness compared with postoperative Visante-OCT.(P<0.01)..There was no significant difference between postoperative Visante-OCT measurements at 1 week and 1 month after LASIK.(P=0.16). The 95% limit of agreement.(LoA).of flap thickness between ultrasound Visante-OCT and pachymetry was -5.40 to 42.10 μm. Conclusion: OCT overestimates flap thickness compared with intraoperative ultrasound pachymetry when using the AMADEUSⅡ mechanical microkeratome.展开更多
The changes in the iridocorneal angle structure during accommodation are assessed by means of anterior segment optical coherence tomography.Thirteen right eyes were included in the study.The device used for the measur...The changes in the iridocorneal angle structure during accommodation are assessed by means of anterior segment optical coherence tomography.Thirteen right eyes were included in the study.The device used for the measurement was the Visante?omni system.The stimuli were set up at different vergences(0.0 D,-1.5 D,and-3.0 D).The angle opening distance 500 and 750,the trabecular iris space area 500 and 750,and the scleral spur angle parameters were assessed at the nasal and temporal regions.The results in the iridotrabecular angle comparing the three accommodative states of the eye did not yield any statistically significant difference at nasal or temporal angle sections.In light of our results and in the conditions of our study,the structures of the iridocorneal angle are not significantly changed with accommodation.展开更多
Background:To measure the anterior and posterior segment structural features of acute primary angle-closure(APAC)eyes.Methods:A total of 36 subjects with unilateral APAC were recruited in this study.The ocular biometr...Background:To measure the anterior and posterior segment structural features of acute primary angle-closure(APAC)eyes.Methods:A total of 36 subjects with unilateral APAC were recruited in this study.The ocular biometric characteristics were measured by anterior segment optical coherence tomography(AS-OCT)and swept source optical coherence tomography(SS-OCT),respectively at baseline,2 weeks,and 1 month after surgical intervention.Results:At baseline,when compared with the fellow eyes,APAC-affected eyes showed significantly greater corneal thickness(P=0.004),shallower anterior chamber depth(ACD)(P<0.001),smaller anterior chamber area(ACA)(P=0.013),angle opening distance at 750μm from the scleral spur(AOD750)(P=0.002),trabecular-iris space area at 750μm from the scleral spur(TISA750)(P=0.033),angle recess area(ARA)(P=0.014),and iris area(IARE)(P=0.003),less iris curvature(ICURVE)(P=0.003),and larger lens vault(LV)(P=0.030).After intervention,the corneal thickness was significantly decreased at 1 month(P<0.001),while ACD,ACA,and AOD750 were significantly increased at 2 weeks and 1 month(all P<0.017).Changes in ACD were correlated with decreasing LV(P<0.05).The posterior segment parameters did not change over the 4-week period.Conclusions:When compared with the fellow eyes,APAC-affected eyes had greater corneal thickness,shallower anterior chamber,narrower angle,less ICURVE,and larger LV.After intervention,the corneal thickness was decreased,while the shallower anterior chamber was relieved to some extent.展开更多
Background Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamb...Background Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamber volume (ACV) measurements with rotating scheimpflug camera (RSC) and to examine agreement with anterior segment optical coherence tomography (AS-OCT). Methods Thirty nine healthy normal subjects were recruited from the Eye Center of Tongren Hospital. ACV was measured using RSC and AS-OCT in a randomly selected eye for each subject. For RSC measurements, both automatic and manual ACV measurements and 2 independent operators' ACV measurements were obtained. All subjects were invited for 3 visits within a week to evaluate repeatability and reproducibility of ACV measurement by RSC. Agreement was evaluated between RSC and AS-OCT. Results Good repeatability and reproducibility were found for both automatic and manual ACV measurements obtained by RSC. For intrasession repeatability, coefficient of variation (CVw) and intraclass correlation coefficient (ICC) values for automatic were 3.52% and 0.98; the values for manual were 3.44% and 0.97, respectively. For intersession reproducibility, the respective CVw and ICC values were 3.96% and 0.96. Good agreement was also found in 2 operators for both automatic and manual ACV measurements; nevertheless, poor agreement was found between RSC and AS-OCT (95% confidence interval (CO for agreement of automatic RSC measurement versus AS-OCT were -96.3 to 72.8 pl and 95% CI for agreement of manual RSC measurement versus AS-OCT were between 41.7 to 10.1 #1 ). Conclusions Both RSC automatic and manual ACV measurements showed good repeatability and reproducibility, and showed comparable agreement between 2 independent operators, but poor agreement was found between RSC and AS-OCT.展开更多
Optical coherence tomography angiography(OCTA)is a rapid and non-invasive technique for imaging vasculature in the eye.As OCTA can produce high-resolution cross-sectional images and allow depth-resolved analysis for a...Optical coherence tomography angiography(OCTA)is a rapid and non-invasive technique for imaging vasculature in the eye.As OCTA can produce high-resolution cross-sectional images and allow depth-resolved analysis for accurate localization of pathology of interest,it has become a promising method for anterior segment imaging.Furthermore,OCTA offers a more patient-friendly alternative to the conventional invasive dye-based fluorescent angiography.However,conventional OCTA systems are typically designed and optimized for the posterior segment of the eye,and thus using OCTA for anterior segment imaging can present several difficulties and limitations.In this review,we summarized the recent developments and clinical applications in anterior segment OCTA(AS-OCTA)imaging,such as for the cornea,iris,sclera and conjunctiva.We also compared commercially available OCTA systems,discussed the limitations of adapting current OCTA technology for the anterior segment imaging,and proposed possible future directions for AS-OCTA systems.AS-OCTA provides potential for future clinical applications such as diagnosis of corneal and iris pathologies,pre-operative surgical planning,assessment of new antiangiogenic therapeutics or evaluation of limbal stem cell deficiency.With further development,OCTA for anterior segment imaging in the clinics may become common in the near future.展开更多
Background:We aimed to evaluate dry eye diseases(DED)in patients with newly diagnosed depression and anxiety patients.Methods:Forty newly diagnosed depression,35 anxiety patients,and 37 controls without any history of...Background:We aimed to evaluate dry eye diseases(DED)in patients with newly diagnosed depression and anxiety patients.Methods:Forty newly diagnosed depression,35 anxiety patients,and 37 controls without any history of taking psychiatric drugs(or before the beginning of psychiatric medication)and topical ophthalmic drop use,were included in the study.All depression and anxiety diagnoses were performed by an experienced psychiatrist.Beck depression and anxiety tests were used to measure disease severity.Tear film break up time(TBUT),Schirmer’s test,Oxford scores and ocular surface disease index(OSDI)were admiinistered to participants.Anterior segment optical coherence tomography was used to measure tear meniscus heights(TMH),tear meniscus depths(TMD)and tear meniscus areas(TMA).Results:In anxiety and depression groups,Schirmer’s test(mm)(7.24±6.02,6.58±4.9 and 18.79±4.9 respectively,p<0.05)and TBUT(s)(5.62±3.1,5.6±3.5 and 13.37±1.7 respectively,p<0.05)were significantly lower than control group.In addition,OSDI and Oxford scores were significantly higher than controls.OSDI scores were 28.01±19,30.43±18.49,14.38±8.14 respectively(p=0.002)and Oxford scores were 1.9±0.7,2.1±0.6 and 0.7±0.4 respectively(p=0.001).TMD,TMH and TMA values were significantly lower in anxiety and depression groups compared with control groups.Correlations between disease inventory scores and dry eye tests were detected.Conclusions:This study showed a relation between DED and newly diagnosed anxiety and depression patients with no history of psychiatric drug use.The presence of correlation between dry eye tests and disease inventory scores strengthens this association.This is an important knowledge that need to be evaluated in these patients before starting psychiatric medication.展开更多
Background:Optical coherence tomography(OCT)is a non-invasive imaging system that can be used to obtain images of the anterior segment.Automatic segmentation of these images will enable them to be used to construct pa...Background:Optical coherence tomography(OCT)is a non-invasive imaging system that can be used to obtain images of the anterior segment.Automatic segmentation of these images will enable them to be used to construct patient specific biomechanical models of the human eye.These models could be used to help with treatment planning and diagnosis of patients.Methods:A novel graph cut technique using regional and shape terms was developed.It was evaluated by segmenting 39 OCT images of the anterior segment.The results of this were compared with manual segmentation and a previously reported level set segmentation technique.Three different comparison techniques were used:Dice’s similarity coefficient(DSC),mean unsigned surface positioning error(MSPE),and 95%Hausdorff distance(HD).A paired t-test was used to compare the results of different segmentation techniques.Results:When comparison with manual segmentation was performed,a mean DSC value of 0.943±0.020 was achieved,outperforming other previously published techniques.A substantial reduction in processing time was also achieved using this method.Conclusions:We have developed a new segmentation technique that is both fast and accurate.This has the potential to be used to aid diagnostics and treatment planning.展开更多
Background:Conjunctival lymphoma,conjunctival amyloidosis and benign reactive lymphoid hyperplasia(BRLH)are conditions that often have a similar appearance on the ocular surface.The use of high resolution anterior seg...Background:Conjunctival lymphoma,conjunctival amyloidosis and benign reactive lymphoid hyperplasia(BRLH)are conditions that often have a similar appearance on the ocular surface.The use of high resolution anterior segment optical coherence tomography(HR-OCT)enables clinicians to evaluate distinctive differences in tissue morphology and cellular patterns in various ocular surface conditions.In this study,we characterize the morphological differences seen in conjunctival lymphoma,conjunctival amyloidosis and BRLH on HR-OCT imaging.Methods:A retrospective chart review was performed of patients with biopsy proven conjunctival lymphoma,conjunctival amyloidosis and BRLH between 2012 and 2019 at the Bascom Palmer Eye Institute.Patients were excluded if HR-OCT imaging was not performed on initial presentation.Results:Thirty-four total eyes of 27 patients were identified.Twenty eyes had conjunctival lymphoma(16 patients),8 eyes had conjunctival amyloidosis(6 patients)and 6 eyes had BRLH(5 patients).All conditions appeared clinically as pink,red or yellow subepithelial lesions but had different features on HR-OCT.In lymphoma,HR-OCT images typically showed homogenous,dark subepithelial lesions with smooth borders,containing monomorphic dot-like infiltrates.HR-OCT images of amyloidosis typically showed heterogeneous,dark lesions with irregular borders,often containing hyperreflective linear infiltrates.HR-OCT images of BRLH showed variable infiltration of the subepithelial tissue,at times with homogenous lesions containing dot-like infiltrates like lymphoma and other times with more hyperreflective,subepithelial tissue.Flow cytometry and gene rearrangement was needed for final differentiation between BRLH and lymphoma lesions.Conclusions:Distinctive features on HR-OCT of conjunctival lymphoma,conjunctival amyloidosis and BRLH can help characterize these lesions beyond what is apparent with the clinical examination.Future studies can further validate this technology’s use with more subtle and challenging lesions.展开更多
Background:The fast development of swept-source optical coherence tomography(SS-OCT)and swept-source optical coherence tomography angiography(SS-OCTA)enables both anterior and posterior imaging of the eye.These techni...Background:The fast development of swept-source optical coherence tomography(SS-OCT)and swept-source optical coherence tomography angiography(SS-OCTA)enables both anterior and posterior imaging of the eye.These techniques have evolved from a research tool to an essential clinical imaging modality.Main text:The longer wavelength and faster speed of SS-OCT and SS-OCTA facilitate better visualization of structure and vasculature below pigmented tissue with a larger field of view of the posterior segment and 360-degree visualization of the anterior segment.In the past 10 years,algorithms dealing with OCT and OCTA data also vastly improved the image quality and enabled the automated quantification of OCT-and OCTA-derived metrics.This technology has enriched our current understanding of healthy and diseased eyes.Even though the high cost of the systems currently limited the widespread use of SS-OCT and SS-OCTA at the first beginning,the gap between research and clinic practice got obviously shortened in the past few years.Conclusions:SS-OCT and SS-OCTA will continue to evolve rapidly,contributing to a paradigm shift toward more widespread adoption of new imaging technology in clinical practice.展开更多
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 co...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.展开更多
文摘PSEUDOPHAKIC malignant glaucoma is diagnosedbased on the presence of a shallow or flat centraland peripheral anterior chamber in the presenceof patent iridectomy, with intraocular pressure(IOP) of 22 mm Hg or more after lens extraction andintraocular lens implantation.1 Pseudophakic malignantglaucoma is one of the most challenging complicationsfaced by surgeons. Initial medication includes topicalcycloplegics, osmotic agents.
基金Science and Technology Plan Program of Guangdong Province (2012A0802040022012B0318002942011B080701033)
文摘Purpose: To compare the repeatability and consistency of anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in measuring iris parameters in patients with primary angle closure glaucoma. Methods: Twenty-two patients (38 eyes) with primary angle closure glaucoma,including 5 eyes with acute angle closure glaucoma,10 fellow eyes of acute angle closure glaucoma, and 23 eyes with chronic angle closure glaucoma, were recruited consecutively in our hospital. All subjects underwent anterior scanning by AS-OCT and UBM. Peripheral iris thickness (PIT) and iris curvature (IC) in the anterior segment image obtained by AS-OCT and UBM were measured twice. The reproducibility of these two scans was evaluated by the intraclass correlation coefficient (ICC). A paired t-test was used to compare the difference between the two scans and the 95% limits of agreement (LoA) were calculated. Results:The ICCs of PIT and IC measured by UBM were 0.892 and 0.936 respectively, while for AS-OCT these values were 0.629 and 0.859, respectively. UBM had a higher reproducibility in both PIT and IC measurements as compared with AS-OCT.Differences in PIT measurement between AS-OCT and UBM(P=0.331).were not statistically significant, the 95% LoA (-0.178~0.156) mm was 36.1~41.2% of the mean. The IC was 0.053 mm smaller when measured by UBM than by AS-OCT (P=0.017), with the 95% LoA (-0.100~0.206) mm, or 36.2~74.6% of the mean.Conclusion:UBM had a higher reproducibility in measuring iris parameters than AS-OCT. The consistency between AS- OCT and UBM in measuring iris parameters was low in primary angle closure glaucoma patients. (Eye Science 2013; 28:1-6)
文摘Anterior segment optical coherence tomography (AS-OCT) finds very few indications in the domain of strabismus surgery. Current applications remain restricted to determining limbus-muscle insertion distance and anterior segment changes after strabismus surgery. We discuss two cases of operated strabismus surgery where AS-OCT imaging helped in identifying the operated eye and/or extra ocular muscles (EOM) and thus proved instrumental in planning and management.
文摘AIMTo assess lens thickness measurements with anterior segment-optical coherence tomography (AS-OCT) in comparison with A-scan ultrasonography (A-scan US).METHODSThere were 218 adult subjects (218 eyes) aged 59.2±9.2y enrolled in this prospective cross-sectional study. Forty-three eyes had open angles and 175 eyes had narrow angles. Routine ophthalmic exam was performed and nuclear opacity was graded using the Lens Opacities Classification System III (LOCS III). Lens thickness was measured by AS-OCT (Visante OCT, Carl Zeiss Meditec, Dublin, CA, USA). The highest quality image was selected for each eye and lens thickness was calculated using ImageJ software. Lens thickness was also measured by A-scan US.RESULTSInterclass correlations showed a value of 99.7% for intra-visit measurements and 95.3% for inter-visit measurements. The mean lens thickness measured by AS-OCT was not significantly different from that of A-scan US (4.861±0.404 vs 4.866±0.351 mm, P=0.74). Lens thickness values obtained from the two instruments were highly correlated overall (Pearson correlation coefficient=0.81, P<0.001), and in all LOCS III specific subgroups except in grade 5 of nuclear opacity. Bland-Altman analysis revealed a 95% limit of agreement from -0.45 to 0.46 mm. Lens thickness difference between the two instruments became smaller as the lens thickness increased and AS-OCT yielded smaller values than A-scan US in thicker lens (β=-0.29, P<0.001)CONCLUSIONAS-OCT-derived lens thickness measurement is valid and comparable to the results obtained by A-scan US. It can be used as a reliable noncontact method for measuring lens thickness in adults with or without significant cataract.
文摘Dry eye,one of the most frequent ocular surface diseases, is caused by complex ocular function and mechanism disorders. Currently, no uniform standard diagnosis of dry eye has been established. Traditional clinical examinations provide inaccurate measurement and poor reproducibility due to various factors.Anterior segment optical coherence tomography (OCT) is applicable in the diagnosis of dry eye due to its high resolution, non-invasiveness, good accuracy, and repeatability.
文摘Purpose:To compare the measurement of flap thickness using intraoperative ultrasound pachymetry and postoperative visante anterior segment optical coherence tomography (Visante-OCT) in eyes receiving laser in situ keratomileusis (LASIK). Methods: Seventeen patients (34 eyes) received LASIK using a Technolas-217Z100 laser and AMADEUSⅡ mechanical microkeratome(140 μm head). Flap thickness was assessed with an ultrasound pachymeter intraoperatively and a Visante-OCT postoperatively at 1 week and 1 month. Results: The intraoperative mean flap thickness by ultrasound pachymetry was (124±13.9) μm (range: 96.5 to 160 μm), and mean flap thickness by Visante-OCT was (145±7.13) μm (range: 130 to 158 μm) and (143±5.32) μm (range: 132 to 155 μm) postoperatively at 1 week and 1 month respectively (F=63.52,P<0.01). Intraoperative subtraction pachymetry underestimated flap thickness compared with postoperative Visante-OCT.(P<0.01)..There was no significant difference between postoperative Visante-OCT measurements at 1 week and 1 month after LASIK.(P=0.16). The 95% limit of agreement.(LoA).of flap thickness between ultrasound Visante-OCT and pachymetry was -5.40 to 42.10 μm. Conclusion: OCT overestimates flap thickness compared with intraoperative ultrasound pachymetry when using the AMADEUSⅡ mechanical microkeratome.
基金Support by the Ministerio de Economiay Competitivad[Research project SAF2013-44510-R with ERDF(European Regional Development Funds)from European Union]Daniel Monsálvez-Romín has a "Formación de Profesorado Universitario" Grant(FPU13/05332,Ministerio de Educación,Cultura y Deporte)Antonio Deláguila-Carrasco has an"Atraccióde talent"research scholarship(Universitat de València UV-INV-PREDOC14-179135)
文摘The changes in the iridocorneal angle structure during accommodation are assessed by means of anterior segment optical coherence tomography.Thirteen right eyes were included in the study.The device used for the measurement was the Visante?omni system.The stimuli were set up at different vergences(0.0 D,-1.5 D,and-3.0 D).The angle opening distance 500 and 750,the trabecular iris space area 500 and 750,and the scleral spur angle parameters were assessed at the nasal and temporal regions.The results in the iridotrabecular angle comparing the three accommodative states of the eye did not yield any statistically significant difference at nasal or temporal angle sections.In light of our results and in the conditions of our study,the structures of the iridocorneal angle are not significantly changed with accommodation.
基金The study was funded by Science and Technology Program of Guangzhou,China(201803010066)the National Natural Science Foundation of China(82000890)Young Talents’Science and Technology Innovation Project of Hainan Association for Science and Technology(QCXM202020).
文摘Background:To measure the anterior and posterior segment structural features of acute primary angle-closure(APAC)eyes.Methods:A total of 36 subjects with unilateral APAC were recruited in this study.The ocular biometric characteristics were measured by anterior segment optical coherence tomography(AS-OCT)and swept source optical coherence tomography(SS-OCT),respectively at baseline,2 weeks,and 1 month after surgical intervention.Results:At baseline,when compared with the fellow eyes,APAC-affected eyes showed significantly greater corneal thickness(P=0.004),shallower anterior chamber depth(ACD)(P<0.001),smaller anterior chamber area(ACA)(P=0.013),angle opening distance at 750μm from the scleral spur(AOD750)(P=0.002),trabecular-iris space area at 750μm from the scleral spur(TISA750)(P=0.033),angle recess area(ARA)(P=0.014),and iris area(IARE)(P=0.003),less iris curvature(ICURVE)(P=0.003),and larger lens vault(LV)(P=0.030).After intervention,the corneal thickness was significantly decreased at 1 month(P<0.001),while ACD,ACA,and AOD750 were significantly increased at 2 weeks and 1 month(all P<0.017).Changes in ACD were correlated with decreasing LV(P<0.05).The posterior segment parameters did not change over the 4-week period.Conclusions:When compared with the fellow eyes,APAC-affected eyes had greater corneal thickness,shallower anterior chamber,narrower angle,less ICURVE,and larger LV.After intervention,the corneal thickness was decreased,while the shallower anterior chamber was relieved to some extent.
文摘Background Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamber volume (ACV) measurements with rotating scheimpflug camera (RSC) and to examine agreement with anterior segment optical coherence tomography (AS-OCT). Methods Thirty nine healthy normal subjects were recruited from the Eye Center of Tongren Hospital. ACV was measured using RSC and AS-OCT in a randomly selected eye for each subject. For RSC measurements, both automatic and manual ACV measurements and 2 independent operators' ACV measurements were obtained. All subjects were invited for 3 visits within a week to evaluate repeatability and reproducibility of ACV measurement by RSC. Agreement was evaluated between RSC and AS-OCT. Results Good repeatability and reproducibility were found for both automatic and manual ACV measurements obtained by RSC. For intrasession repeatability, coefficient of variation (CVw) and intraclass correlation coefficient (ICC) values for automatic were 3.52% and 0.98; the values for manual were 3.44% and 0.97, respectively. For intersession reproducibility, the respective CVw and ICC values were 3.96% and 0.96. Good agreement was also found in 2 operators for both automatic and manual ACV measurements; nevertheless, poor agreement was found between RSC and AS-OCT (95% confidence interval (CO for agreement of automatic RSC measurement versus AS-OCT were -96.3 to 72.8 pl and 95% CI for agreement of manual RSC measurement versus AS-OCT were between 41.7 to 10.1 #1 ). Conclusions Both RSC automatic and manual ACV measurements showed good repeatability and reproducibility, and showed comparable agreement between 2 independent operators, but poor agreement was found between RSC and AS-OCT.
基金supported by the National Medical Research Council(NMRC)Centre Grant(CG)(NMRC/CG/C010A/2017).
文摘Optical coherence tomography angiography(OCTA)is a rapid and non-invasive technique for imaging vasculature in the eye.As OCTA can produce high-resolution cross-sectional images and allow depth-resolved analysis for accurate localization of pathology of interest,it has become a promising method for anterior segment imaging.Furthermore,OCTA offers a more patient-friendly alternative to the conventional invasive dye-based fluorescent angiography.However,conventional OCTA systems are typically designed and optimized for the posterior segment of the eye,and thus using OCTA for anterior segment imaging can present several difficulties and limitations.In this review,we summarized the recent developments and clinical applications in anterior segment OCTA(AS-OCTA)imaging,such as for the cornea,iris,sclera and conjunctiva.We also compared commercially available OCTA systems,discussed the limitations of adapting current OCTA technology for the anterior segment imaging,and proposed possible future directions for AS-OCTA systems.AS-OCTA provides potential for future clinical applications such as diagnosis of corneal and iris pathologies,pre-operative surgical planning,assessment of new antiangiogenic therapeutics or evaluation of limbal stem cell deficiency.With further development,OCTA for anterior segment imaging in the clinics may become common in the near future.
文摘Background:We aimed to evaluate dry eye diseases(DED)in patients with newly diagnosed depression and anxiety patients.Methods:Forty newly diagnosed depression,35 anxiety patients,and 37 controls without any history of taking psychiatric drugs(or before the beginning of psychiatric medication)and topical ophthalmic drop use,were included in the study.All depression and anxiety diagnoses were performed by an experienced psychiatrist.Beck depression and anxiety tests were used to measure disease severity.Tear film break up time(TBUT),Schirmer’s test,Oxford scores and ocular surface disease index(OSDI)were admiinistered to participants.Anterior segment optical coherence tomography was used to measure tear meniscus heights(TMH),tear meniscus depths(TMD)and tear meniscus areas(TMA).Results:In anxiety and depression groups,Schirmer’s test(mm)(7.24±6.02,6.58±4.9 and 18.79±4.9 respectively,p<0.05)and TBUT(s)(5.62±3.1,5.6±3.5 and 13.37±1.7 respectively,p<0.05)were significantly lower than control group.In addition,OSDI and Oxford scores were significantly higher than controls.OSDI scores were 28.01±19,30.43±18.49,14.38±8.14 respectively(p=0.002)and Oxford scores were 1.9±0.7,2.1±0.6 and 0.7±0.4 respectively(p=0.001).TMD,TMH and TMA values were significantly lower in anxiety and depression groups compared with control groups.Correlations between disease inventory scores and dry eye tests were detected.Conclusions:This study showed a relation between DED and newly diagnosed anxiety and depression patients with no history of psychiatric drug use.The presence of correlation between dry eye tests and disease inventory scores strengthens this association.This is an important knowledge that need to be evaluated in these patients before starting psychiatric medication.
文摘Background:Optical coherence tomography(OCT)is a non-invasive imaging system that can be used to obtain images of the anterior segment.Automatic segmentation of these images will enable them to be used to construct patient specific biomechanical models of the human eye.These models could be used to help with treatment planning and diagnosis of patients.Methods:A novel graph cut technique using regional and shape terms was developed.It was evaluated by segmenting 39 OCT images of the anterior segment.The results of this were compared with manual segmentation and a previously reported level set segmentation technique.Three different comparison techniques were used:Dice’s similarity coefficient(DSC),mean unsigned surface positioning error(MSPE),and 95%Hausdorff distance(HD).A paired t-test was used to compare the results of different segmentation techniques.Results:When comparison with manual segmentation was performed,a mean DSC value of 0.943±0.020 was achieved,outperforming other previously published techniques.A substantial reduction in processing time was also achieved using this method.Conclusions:We have developed a new segmentation technique that is both fast and accurate.This has the potential to be used to aid diagnostics and treatment planning.
基金Ronald and Alicia Lepke Grant,The Lee and Claire Hager Grant,The Jimmy and Gaye Bryan Grant,The H.Scott Huizenga Grant,The Grant and Diana Stanton-Thornbrough,The Robert Baer Family Grant,The Emilyn Page and Mark Feldberg Grant,The Gordon Charitable Foundation,The Jose Ferreira de Melo Grant,The Richard and Kathy Lesser Grant and The Richard Azar Family Grant(institutional grants),the Department of Veterans Affairs,Veterans Health Administration,Office of Research and Development,Clinical Sciences Research EPID-006-15S(Dr.Galor),R01EY026174(Dr.Galor)NIH Center Core Grant P30EY014801Research to Prevent Blindness Unrestricted Grant.
文摘Background:Conjunctival lymphoma,conjunctival amyloidosis and benign reactive lymphoid hyperplasia(BRLH)are conditions that often have a similar appearance on the ocular surface.The use of high resolution anterior segment optical coherence tomography(HR-OCT)enables clinicians to evaluate distinctive differences in tissue morphology and cellular patterns in various ocular surface conditions.In this study,we characterize the morphological differences seen in conjunctival lymphoma,conjunctival amyloidosis and BRLH on HR-OCT imaging.Methods:A retrospective chart review was performed of patients with biopsy proven conjunctival lymphoma,conjunctival amyloidosis and BRLH between 2012 and 2019 at the Bascom Palmer Eye Institute.Patients were excluded if HR-OCT imaging was not performed on initial presentation.Results:Thirty-four total eyes of 27 patients were identified.Twenty eyes had conjunctival lymphoma(16 patients),8 eyes had conjunctival amyloidosis(6 patients)and 6 eyes had BRLH(5 patients).All conditions appeared clinically as pink,red or yellow subepithelial lesions but had different features on HR-OCT.In lymphoma,HR-OCT images typically showed homogenous,dark subepithelial lesions with smooth borders,containing monomorphic dot-like infiltrates.HR-OCT images of amyloidosis typically showed heterogeneous,dark lesions with irregular borders,often containing hyperreflective linear infiltrates.HR-OCT images of BRLH showed variable infiltration of the subepithelial tissue,at times with homogenous lesions containing dot-like infiltrates like lymphoma and other times with more hyperreflective,subepithelial tissue.Flow cytometry and gene rearrangement was needed for final differentiation between BRLH and lymphoma lesions.Conclusions:Distinctive features on HR-OCT of conjunctival lymphoma,conjunctival amyloidosis and BRLH can help characterize these lesions beyond what is apparent with the clinical examination.Future studies can further validate this technology’s use with more subtle and challenging lesions.
基金supported by National Natural Youth Science Foundation Project of China(No.82201196).
文摘Background:The fast development of swept-source optical coherence tomography(SS-OCT)and swept-source optical coherence tomography angiography(SS-OCTA)enables both anterior and posterior imaging of the eye.These techniques have evolved from a research tool to an essential clinical imaging modality.Main text:The longer wavelength and faster speed of SS-OCT and SS-OCTA facilitate better visualization of structure and vasculature below pigmented tissue with a larger field of view of the posterior segment and 360-degree visualization of the anterior segment.In the past 10 years,algorithms dealing with OCT and OCTA data also vastly improved the image quality and enabled the automated quantification of OCT-and OCTA-derived metrics.This technology has enriched our current understanding of healthy and diseased eyes.Even though the high cost of the systems currently limited the widespread use of SS-OCT and SS-OCTA at the first beginning,the gap between research and clinic practice got obviously shortened in the past few years.Conclusions:SS-OCT and SS-OCTA will continue to evolve rapidly,contributing to a paradigm shift toward more widespread adoption of new imaging technology in clinical practice.
文摘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.