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@#AIM: To explore the value of corneal epithelial thickness parameters in the diagnosis of early keratoconus by Fourier domain optical coherence tomography(FD-OCT).<p>METHODS: Retrospective control study. Patients with early keratoconus who were admitted to the Department of Ophthalmology of the First Affiliated Hospital of Soochow University from January 2015 to October 2020 and patients who received laser refractive surgery for myopia during the same period were included in this study. Using FD-OCT to measure the cornea in circle centralized by the pupil and with diameter of 9mm in the early-keratoconus group and the control group. This was to obtain the thickness parameter of corneal epithelium with diameter of 7mm, the respective averaged thickness value of corneal epithelium and the respective averaged thickness value of the full corneal layer on each of the 25 divisions. The parameter value differences between the early-keratoconus group and the control group were compared, and the diagnosis value of parameters that hold difference was analyzed. <p>RESULTS: The Min-e value in early-keratoconus group was significantly lower than that of the control group. On contrary, the value of Std.Dev, Max-Min-e, and Max-e were significantly higher in early-keratoconus group than that in latter one(all <i>P</i><0.001). The value of Std.Dev and Max-Min-e hold a greater diagnostic efficiency on diagnosis of early keratoconus(AUC=0.937, 0.928), while Max -e value and Min-e value performed a medium diagnostic efficiency(AUC=0.871, 0.797). Analysis on thickness of corneal epithelium on the 25 divisions found that the thickness of corneal epithelium at infratemporal region of inner ring(EIT1)became thinner most obviously in early-keratoconus group, with greatest diagnostic efficiency(AUC=0.827). The average corneal thickness of the 25 zones of the early keratoconus group was significantly thinner than that in the normal control group. Averaged corneal thickness at infratemporal region of inner ring(CIT1)hold a relatively high diagnostic efficiency among the 25 divisions(AUC=0.903).<p>CONCLUSION: The parameter values of corneal epithelium thickness including Std.Dev, Max-Min-e, Max-e, Min-e, the averaged thickness value of corneal epithelium at infratemporal region of inner ring, and the thickness value of full corneal layer at infratemporal region of inner ring can all be used for diagnosis of early keratoconus.
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AIM: To report the long- term clinical outcomes of accelerated trans-epithelial corneal cross-linking ( CXL ) protocols using KXL System ( Avedro, USA ) in the treatment of progressive keratoconus. · METHODS: Totally 52 patients ( 102 eyes ) with progressive keratoconus between December 2014 and February 2017 [ maximum keratometry values ( Kmax) ≤60.0D, minimum corneal thickness(Thk) ≥400m] were treated with an accelerate trans-epithelial CXL protocol (UV-A irradiation intensity 45mW/cm2 with a total fluence of 7. 2J/cm2 ) using KXL system ( Avedro, USA ) in Southwest Hospital. The average follow-up time was 11. 65mo (range: 9-26mo). Uncorrected distance visual acuity ( UDVA) , corrected distance visual acuity ( CDVA) , intra- ocular pressure ( IOP ) , slit-lamp microscope examination, Kmax and average keratometry values ( AveK ) , corneal stromal demarcation line depth and endothelial cell density ( ECD) were evaluated. ·RESULTS:The 52 patients (102 eyes) were included in this research, male 36 (70 eyes) and female 16 (32 eyes), average age was 19. 5±4. 6 years. Preoperative CDVA was 0. 84±0. 89 (LogMAR), postoperative CDVA was 0. 69±0. 72 ( P = 0. 398 ). Preoperative UDVA was 1. 02 ± 0. 62 (LogMAR), postoperative UDVA was 0. 85 ± 0. 59 ( P =0. 154 ). Preoperative IOP was 12. 95 ± 4. 40mmHg, postoperative IOP was 11.92±3. 66mmHg (P=0. 272). No statistical difference (P=0. 552) has been found between preoperative and postoperative ECD. Nevertheless, on the Sirius anterior system ( Sirius, CSO, Itlay) , significant statistical difference (P=0. 017) was confirmed between preoperative Kmax ( 50. 83 ± 3. 48D ) and postoperative Kmax (52. 05±3. 63D). Meanwhile, the postoperative Avek (47.74±2. 51D) was significantly lower (P=0. 041) than the preoperative Avek ( 48. 73 ± 4. 33D ). The average corneal stromal demarcation line depth ( 192 ± 23. 6μm ) was detected by the anterior segment OCT. No statistical difference ( P = 0. 816 ) has been found between preoperative and postoperative Thk. No severe complication was observed in all cases. ·CONCLUSION: Accelerated trans-epithelial CXL was effective in decreasing keratometry values for progressive keratoconus in this research, and the outcomes remained stable during the follow-up time. No endothelium damage or other severe complications were observed in this clinical research. The accelerated trans-epithelial CXL is as effective as the standard CXL.
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Context: Analysis of diagnostic ability of macular ganglionic cell complex and retinal nerve fiber layer (RNFL) in glaucoma. Aim: To correlate functional and structural parameters and comparing predictive value of each of the structural parameters using Fourier‑domain (FD) optical coherence tomography (OCT) among primary open angle glaucoma (POAG) and ocular hypertension (OHT) versus normal population. Setting and Design: Single centric, cross‑sectional study done in 234 eyes. Materials and Methods: Patients were enrolled in three groups: POAG, ocular hypertensive and normal (40 patients in each group). After comprehensive ophthalmological examination, patients underwent standard automated perimetry and FD‑OCT scan in optic nerve head and ganglion cell mode. The relationship was assessed by correlating ganglion cell complex (GCC) parameters with mean deviation. Results were compared with RNFL parameters. Statistical Analysis: Data were analyzed with SPSS, analysis of variance, t‑test, Pearson’s coefficient, and receiver operating curve. Results: All parameters showed strong correlation with visual field (P < 0.001). Inferior GCC had highest area under curve (AUC) for detecting glaucoma (0.827) in POAG from normal population. However, the difference was not statistically significant (P > 0.5) when compared with other parameters. None of the parameters showed significant diagnostic capability to detect OHT from normal population. In diagnosing early glaucoma from OHT and normal population, only inferior GCC had statistically significant AUC value (0.715). Conclusion: In this study, GCC and RNFL parameters showed equal predictive capability in perimetric versus normal group. In early stage, inferior GCC was the best parameter. In OHT population, single day cross‑sectional imaging was not valuable.
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AIM: To dynamically observe the feeling change of the photorecrptor layer in the eyes with acute central serous chorioretinopathy ( CSCR ) krypton laser treatment by fourier - domain optical coherence tomography ( FD - OCT), and to study their correlation with the chang of vision. METHODS: This is a retrospective case series study. The clinical diagnosis of 52 patients with monocular initial onset of central serous chorioretinopathy, krypton laser photocoagulation before treatment, after 1, 2, 4, 6, 8wk, 6mo, FD - OCT were performed to observe the morphological changes characteristic of photoreceptor layer and changes in vision. RESULTS: After 1wk treatment, all cases were improved; 2wk, 6 cases were cured; 4wk, 38 cases were cured; 6wk, 41 cases were cured; 8wk, 45 cases were cured, the OCT showed macular retinal neuroepithelial layer ( RNL ) from fully absorbed; 6mo with the same 8wk. Before and after treatment in patients with best corrected visual acuity and from the height difference between the macular region of RNL was statistically significant (P CONCLUSION: FD-OCT can dynamicaly observed acute central serous chorioretinopathy krypton laser treatment of photoreceptor ultrastruture changes. Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant (P<0. 01).
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Background Lasein situ keratomileusi(LASIK) imainstream surgery forefractive correction,and femtosecond laseimuch often used to create thin corneal flap.The measuremenof OPTOVUE RTVue-100 OCto flap and stromal bed thicknesseofferuseful basifoLASIK.Ican be used in measuring the thicknesand shape of the corneal flap.Buthe study on the comparison of flap thicknesbetween WavelighFS200 femtosecond laseand MoriM2 microkeratome 90 μm-knife (Mori90 microkeratome) LASIK by OCilack.Objective The aim of thitrial wato compare the featureof corneal flapcreated by the WavelighFS200 femtosecond laseand Mori90 microkeratome.Methodpiloand prospective study wadesigned.Written informed consenwaobtained from each patienprioto LASIK.Sixty righeyeof 60 patientwith myopiomyopiastigmatism were enrolled in thiclinical trial.The patientwere randomized into the FS200 femtosecond lasegroup and Mori90 microkeratome group with matching demography.RTVue OCwaused to measure flap thicknesusing 10 settingon the 60 eye1 month afteoperation.The featureof the LASIK flapwere analyzed based on the measuring outcomes.ResultThe central flap thickneswa(112±3) μm and the mean flap thickneswa(112 ±3) μm in the FS200 femtosecond lasegroup,which wasignificanlowethan the central flap thicknesa(121±7) μm and the mean flap thicknesa(128±11) μm in the Mori90 microkeratome group respectively (P=0.031,0.030).Corneal flapin the FS200 femtosecond lasegroup showed flashape and thain the Mori90 microkeratome group wameniscushape.The central flap thickneswanoevidently differenfrom thaof peripheral thicknesin the FS200 femtosecond lasegroup (P =0.320).However,in the Mori90 microkeratome group,the central flap thickneswaobviously thinnethan thain the peripheral thicknes(P=0.038).The mean deviation between the actual and predicted flap thicknes(110 μm) wa(3±4)μm in the FS200 femtosecond lasegroup and (17±10) μm in the Mori90 microkeratome group,showing significandifference between them (P =0.009).ConclusionRTVue OCdeterminethathe shape of flapcreated by the FS200 femtosecond laseimore uniform and closeto the expected thicknesof 110 μm than the onecreated by the Mori90 microkeratome.OPTOVUE RTVue-100 OCiuseful tool to evaluate the flap shape and thicknesafteLASIK.
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BackgroundFlap creation is one of the most important steps during laser in situ keratomileusis (LASIK). As the microkeratome blade technology is developing, the accuracy, uniformity and reproducibility of corneal flaps created by the microkeratome blade are of high clinical concern. ObjectiveThe aim of this trial was to compare the features of corneal flaps created using the Moria M2 microkeratome 110 μm-knife with regular blade versus the Med-Logics O blade. MethodsA pilot and prospective study was designed. Two hundred and four eyes of one hundred and two patients were enrolled in this clinical trial. The patients were divided into the Moria M2 microkeratome 110 μm-knife with Med-Logics 0 blade group ( 110-0 group) ( 102 eyes) and Moria M2 microkeratome with 110 μm-knife with regular blade group (110 group) (102 eyes),with the matched demography. Fourier-domain optical coherence tomography ( RTVue OCT) was used to measure flap thickness using 28 settings on the 204 corneas at one week postoperatively. The features of the LASIK flaps were analyzed on the basis of the outcomes. Written informed consent was obtained from each patient prior to LASIK. Results There was no statistically significant difference in uncorrected visual acuity and the mean spherical equivalent between the 110-0 group and 110 group ( Z =-0. 375,P =0. 708 ; u =0. 056, P =0. 956 ) one week after LASIK. The mean flap thickness of the 110-0 group was considerably thinner than that of the 110 group ( 133.28+15.41μ m versus 142.81 ±10. 07μm) ( u =-5. 227,P＜0. 001 ). The corneal flaps in both the 110-0 group and in 110 group showed a meniscus shape. The nasal flap thickness of the right eyes was not evidently different from that of temporal ( P＞0. 05 ) , but in the left eyes, nasal flap thickness was obviously thicker than the temporal flap thickness (P＜0. 05) in both groups. The mean deviation between the achieved and attempted flap thickness ( 130 μm) were (17.46±2.28) μm in the 110-0 group and ( 16. 82±6. 12) μm in the 110 group, showing a significant difference between them ( u ==0. 517, P=0. 608 ).ConclusionsThe shape of flaps created using the Moria M2 110-0 is more uniform and closer to the expected thickness of 130 μm than the ones created using the Moria M2 110 microkeratome.