Corneal and corneal epithelial thickness distribution characteristics in healthy North Indian eyes using spectral domain optical coherence tomography

Purpose: To determine the pattern of corneal thickness and epithelial thickness distribution in healthy North Indian eyes by using spectral domain optical coherence tomography (SD?OCT). Methods: The observational study measured total corneal and epithelial thickness in the central 2 mm zone and eight sectors each in paracentral 2�mm (ring 1) and midperipheral 5�mm (ring 2) zones on SD?OCT. Results: The study included 67 eyes of 67 subjects with a male:female ratio of 32:35 and mean age of 25.04 � 4.54 years. The mean central corneal and epithelial thicknesses were 505.97 � 30.12 ?m and 60.48 � 8.37 ?m, respectively. The epithelium of inferior and infero?nasal sectors in ring 1 and inferior sector in ring 2 was significantly thicker than the radially opposite sectors of the respective rings (P = 0.001; P = 0.01 and P = 0.02, respectively). Sector?wise analysis did not reveal any significant correlation between the total corneal thickness and epithelial thickness (all P > 0.05) except in the outer superior sector where there was a weak positive correlation (r = 0.28, P = 0.02). Central epithelial thickness in males (60.59 � 9.28 ?m) and females (60.37 � 7.58 ?m) was comparable (P = 0.91). Pachymetry was thinnest in the inferior, inferonasal, and inferotemporal sectors in 44.79% of eyes (n = 30), while thinnest epithelium was seen in the superior, superonasal, and superotemporal quadrants in 50.75% of eyes (n = 34). Conclusion: The epithelial thickness distribution in this sample of topographically normal healthy North Indian eyes was nonuniform and independent of the underlying corneal thickness. Epithelium was thinner in the superior cornea, whereas total corneal thickness was minimum in the inferior part

Evaluation of peripapillary retinal nerve fiber layer thickness in myopic juveniles / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the influence of myopia on peripapillary retinal nerve fiber layer thickness(RNFLT)using Cirrus optical coherence tomography(OCT)in myopic juveniles aged 12-18 years.<p>METHODS: Cross-sectional observational study. High-definition(HD), spectral-domain Cirrus OCT(Cirrus HD-OCT; Carl Zeiss, Dublin, CA)was used to analyze RNFLT in 145 healthy juveniles(145 eyes). The data for left eye were selected for analysis. The magnification effect was adjusted by the modified axial length method. The subjects were divided into four groups by spherical equivalent(SE): normal group(52 eyes, -0.25-+0.25D), low myopia group(60 eyes, -0.5--3.0D), moderate myopia group(25 eyes, -3.25--6.0D)and high myopia group(8 eyes,-6.25--12.0D). The correlations between RNFLT and axial length(AL)or SE was tested with linear regression analysis.<p>RESULTS: The older the age, the longer the eye axis length, the higher the degree of myopia. Comparison of adjusted RNFLT among the four groups: after adjustment, the average RNFLT of the low myopia group and the moderate myopia group were thicker than those of the normal control group(<i>P</i><0.05). The adjusted RNFLT of temporal quadrant in the moderate myopia group and the high myopia group were significantly thicker than those in the normal group and the low myopia group, as well as the adjusted RNFLT of nasal quadrant in the low, moderate myopia group were significantly thicker compared with those in the normal group(<i>P</i><0.05). There were statistically significant difference of adjusted RNFLT at 1-4 o'clock, 6 o'clock, 7 o'clock and 9 o'clock among multiple groups(<i>P</i><0.05). The adjusted values of RNFLT at 1-4 o'clock all showed positively correlated with AL(<i>r</i>=0.220, 0.259, 0.356, 0.237, 0.335, all <i>P</i><0.01)and negatively correlated with SE(<i>r</i>=-0.386, -0.276,-0.307, -0.254, -0.260, all<i> P</i><0.01); The adjusted RNFLT at 6, 7 o'clock showed negatively correlated with AL(<i>r</i>=-0.296,-0.327, all<i> P</i><0.01)and positively correlated with SE(<i>r</i>=0.245,0.295, all<i> P</i><0.05).<p>CONCLUSION: Teenagers' eyeballs are still in the shaping stage. When judging RNFLT in myopic juveniles, effects of ocular magnification effect, AL and SE should be considered. When adjusted temporal RNFLT at 1-4 o'clock are thinner than normal, glaucoma should be considered.

Epiretinal membrane profile on spectral domain optical coherence tomography in patients with uveitis

Purpose: To study the epiretinal membrane (ERM) profile on the spectral-domain optical coherence tomography (SDOCT) in eyes with uveitis. Methods: In this prospective observational study, macula of uveitic eyes were evaluated by SDOCT (Cirrus, model 5000) for ERM. ERM was quantified (in microns) and were followed up along with the best-corrected visual acuity (BCVA) and treatment profile for 1 year. ERM morphology (focal, global, or mixed) and characteristics (thickness at fovea, maximum thickness, and location of maximum thickness in relation to fovea) were documented. Changes in altered foveal contour, cystoid macular edema (CME), and central foveal thickness were also noted. BCVA was noted when the inflammation subsided and it was correlated to specific ERM characteristics. SDOCT characteristics were compared in three treatment groups (no oral steroids, oral steroids with, and without immunomodulators). Results: Thirty-four eyes of 25 patients were evaluated. Mean logMAR BCVA decreased from 0.25 to 0.35 (P = 0.005). Foveal involvement with ERM (P = 0.011), lost foveal contour (P = 0.043), and ellipsoid layer disruption (P = 0.017) were associated significantly with reduced BCVA. Focal attachment of ERM was more commonly associated with CME (P = 0.03). Median ERM thickness showed significant increase (P < 0.001). Significant ERM progression from parafoveal to foveal (P = 0.02), significant progression of the thickest area of ERM closer to fovea (P = 0.0006) indicated a strong tendency of foveal involvement and this was correlated with worse BCVA (P = 0.009, r = ?0.44) Oral steroids/immunomodulators showed no significant benefit on ERM progression. Conclusion: ERM progression in uveitis has a tendency to involve the fovea and is associated with significant vision loss, particularly in foveal ERM, focal attachment, and IS-OS disruption. Oral steroids and immunomodulators have no role in halting progression.

Diagnostic Ability of Spectral Domain OCT: Comparision between Preperimetric Glaucoma and Large Physiologic Cupping

PURPOSE: To assess the distinction ability for differentiating glaucoma patients based on optic disc, retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) measured using spectral domain optical coherence tomography (SD-OCT). Additionally, the diagnostic ability of these parameters was evaluated by comparing preperimetic glaucoma patients who frequently visited the clinic and normal patients with and without a large physiologic cup/disc (C/D) ratio. METHODS: Using SD-OCT, the optic disc, RNFL and GCIPL of preperimetic glaucoma patients were compared with normal people with and without a large C/D ratio from March, 2011 to December, 2014 at Department of Ophthalmology, Inha University Hospital. Preperimetic glaucoma was defined using the normal standard automated perimetry for glaucomatous optic nerve changes such as asymmetry of vertical C/D ratio, rim thinning, notching, excavation and RNFL defect. RESULTS: When comparing preperimetic glaucoma patients to normal people without large disc cupping, the most reliable parameter for optic disc parameters, vertical C/D ratio (0.89), showed more reliable diagnostic ability than the most reliable parameter for retinal nerve fiber, inferior RNFL thickness (0.79) and superonasal and inferonasal GCIPL thickness were the most reliable GCIPL parameters (p = 0.005 and 0.002, respectively). When comparing preperimetic glaucoma patients to normal people having a large physiologic disc cupping, average C/D ratio among optic nerve parameters, inferior RNFL thickness among RNFL thickness parameters and inferior GCIPL thickness among GCIPL parameters showed highly reliable diagnostic abilities. These 3 parameters were not statistically different (all p > 0.05) and had lower distinction ability than reported in previous studies. CONCLUSIONS: Diagnostic abilities of SD-OCT for distinguishing preperimetric glaucoma from normal people having large physiologic disc cupping were similar for optic disc, RNFL and GCIPL and showed low diagnostic ability than compared to normal people without large disc cupping.

Comparison of OCT Parameters between the Dominant and Nondominant Eye

PURPOSE: To evaluate the anatomical difference between the dominant and nondominant eyes in healthy, young adults by measuring macular, peripapillary retinal nerve fiber layer (PRNFL), and macular ganglion cell layer (MGCL) thicknesses. METHODS: Two hundred healthy adults were recruited and assessed for ocular dominance using 'a hole in the card test'. PRNFL, macular and MGCL thicknesses of both eyes were measured using spectral domain optical coherence tomography (OCT). RESULTS: There were no statistically significant differences for average thicknesses of MGCL in each of the six areas between the dominant and nondominant eyes. No difference was observed between temporal, inferior, average PRNFL thickness and macular thickness in dominant and nondominant eyes. CONCLUSIONS: There was no intraocular anatomical difference between the dominant and nondominant eyes in healthy, young adults.

A Study of Foveal Shape in Emmetropia and Myopia Using Spectral Domain Optical Coherence Tomography

PURPOSE: To investigate the shape of normal fovea in Korean subjects in their 20's using spectral domain optical coherence tomography (SD-OCT). METHODS: One hundred-twelve emmetropic eyes of 60 subjects and 100 myopic eyes of 58 subjects between 20 and 29 years of age were included in this study. Central foveal thickness (CFT), regional maximal retinal thickness (MRT), pit diameter, pit depth, and slope were obtained using Spectralis OCT and analyzed according to spherical equivalent and gender. RESULTS: In emmetropic and myopic eyes, MRT was significantly thinner temporally (p < 0.001) than in other regions and pit diameter was wider horizontally than vertically (p < 0.001). The CFT was significantly thicker and all regional MRT was thinner in myopic eyes than in emmetropic eyes (p < 0.001). Foveal pits were narrower and shallower in myopic eyes (p < 0.001). In both groups, CFT and all regional MRT in males were significantly thicker than in females (p < 0.05); however, no difference between the genders in horizontal pit diameter, pit depth, and slope were found. CONCLUSIONS: In normal subjects, statistically significant differences were found in foveal shapes between subjects with different spherical equivalent and gender. These differences should be considered when interpreting a foveal shape. Knowledge of the normal foveal morphology is important when conducting further macular studies.

Morphological features of choroidal metastases: An OCT analysis.

The morphological characteristics and retinal changes of chroidal metastases using Spectral Domain OCT are described in a case with primary lung adenocarcinoma and secondary choroidal involvement.

Spectral domain oct patterns of macular edema associated with branch retinal vein occlusion in Indian Eyes.

Aim : To study the spectral domain optical coherence tomography (sd-oct) characteristics of macular edema in branch retinal vein occlusion. Methods : 39 patients with branch retinal vein occlusion were studied with sd-oct . Characteristics analyzed were - integrity of inner segment outer segment junction, integrity of external limiting membrane, central retinal thickness and presence or absence of serous macular detachment. Results : 30 patients had disrupted photoreceptor Inner Segment-Outer Segment integrity. ( 76.9 %). External Limiting Membrane was disrupted in 64.2 % patients ( n=25 ). Serous macular detachment was present in 20. 5% patients. Average central retinal thickness was 363.84 microns. Conclusions : Spectral domain oct characteristics can help to predict the visual outcome in patients with macular edema due to branch retinal vein occlusion.

Age-Related Changes in the Thickness of the Lamina Cribrosa Measured by Spectral Domain OCT

PURPOSE: To measure the lamina cribrosa thickness (LCT) in vivo of healthy people and to determine any association between the LCT and age or sex. METHODS: We evaluated 100 eyes of 100 healthy volunteers. Forty eyes were selected and divided into 2 specific age groups (38-49 and 78-89 years) and the differences were assessed with respect to age and sex. Each participant underwent a complete eye examination and the LCT was evaluated with spectral domain optical coherence tomography (OCT) using enhanced depth imaging (EDI) mode. RESULTS: Eighty-seven eyes were considered for the measurement and analysis of the LCT and 13 eyes were excluded because of an unclear image for identifying the LCT. The mean age was 55.0 +/- 19.5 years. The mean LCT in healthy volunteers was 231.3 +/- 41.6 microm (range, 152.5 - 327.5 microm) and a negative relationship was found between LCT and age (LCT = -1.614 x age + 320.191 microm, 95% CI for slope -1.91 to -1.32, r2 = 0.572, p < 0.001). Regarding differences related to sex, males had relatively thicker LCT than females, irrespective of age, although not statistically significant (p = 0.623). CONCLUSIONS: The present study results showed a decrease in human LCT with increasing age. Therefore, a decreasing LCT with an increasing age could be considered a strong risk factor for the development of glaucoma. In addition, measuring the LCT may help to understand the disease prognosis.

Choroidal Thickness Changes According to the Refractive Errors and Axial Length in Korean Myopia Patients

PURPOSE: To investigate the choroidal thickness changes with the Enhanced Depth Imaging (EDI) technique according to refractive errors and axial length in Korean myopia patients. METHODS: A total of 90 eyes from 90 patients with myopia (between the ages of 19 and 39 years) underwent spectral-domain optical coherence tomography (SD-OCT)-EDI evaluations. Spherical equivalent was measured by cycloplegic refraction and axial length was obtained by IOL master(R). The subfoveal choroidal thickness was analyzed according to age, sex, axial length and spherical equivalent by linear correlations. RESULTS: The average age of all subjects was 25.44 years, mean spherical equivalent was -5.06 diopter (D), mean axial length was 25.70 mm, and mean choroidal thickness was 281.47 microm. In a multiple regression model, the patients' age had no statistical effect on subfoveal choroidal thickness. Subfoveal choroidal thickness decreased by 13.58 microm per -1D increase in refractive errors and by 33.99 microm per 1 mm increase in axial length when adjusted for sex and age. In addition, subfoveal choroidal thickness was 59.82 microm thicker in men than in women when adjusted for axial length and spherical equivalent (p < 0.001). CONCLUSIONS: Among young Korean myopia patients, subfoveal choroidal thickness was significantly related with refractive errors and axial length. Moreover, choroidal thickness was thicker in men than women when adjusted for refractive errors and axial length.

Choroidal Thickness Changes According to the Refractive Errors and Axial Length in Korean Myopia Patients

PURPOSE: To investigate the choroidal thickness changes with the Enhanced Depth Imaging (EDI) technique according to refractive errors and axial length in Korean myopia patients. METHODS: A total of 90 eyes from 90 patients with myopia (between the ages of 19 and 39 years) underwent spectral-domain optical coherence tomography (SD-OCT)-EDI evaluations. Spherical equivalent was measured by cycloplegic refraction and axial length was obtained by IOL master(R). The subfoveal choroidal thickness was analyzed according to age, sex, axial length and spherical equivalent by linear correlations. RESULTS: The average age of all subjects was 25.44 years, mean spherical equivalent was -5.06 diopter (D), mean axial length was 25.70 mm, and mean choroidal thickness was 281.47 microm. In a multiple regression model, the patients' age had no statistical effect on subfoveal choroidal thickness. Subfoveal choroidal thickness decreased by 13.58 microm per -1D increase in refractive errors and by 33.99 microm per 1 mm increase in axial length when adjusted for sex and age. In addition, subfoveal choroidal thickness was 59.82 microm thicker in men than in women when adjusted for axial length and spherical equivalent (p < 0.001). CONCLUSIONS: Among young Korean myopia patients, subfoveal choroidal thickness was significantly related with refractive errors and axial length. Moreover, choroidal thickness was thicker in men than women when adjusted for refractive errors and axial length.

The Measurements of Macular Thickness and Volume with SD-OCT in Normal Eyes

PURPOSE: We investigated reproducibility and repeatability of average macular thickness and volume measurements in normal eyes with Cirrus HD OCT (optical coherence tomography). METHODS: Fifty normal eyes from twenty-five subjects without medical and ocular histories were included. Macular cube 512 x 128 combination scanning using the Cirrus HD OCT was performed for a total of three times on the same visit by an experienced technician. Then other two technicians performed one more macular scanning respectively. Within-results, the intraclass correlation coefficient (ICC) was calculated for each parameter studied to evaluate repeatability and reproducibility. The correlation between macular measurements and demographic variables (age, gender, and spherical equivalent) were also investigated. RESULTS: The ICCs for intraoperator reproducibility were 0.99 on the average macular thickness and 0.96 on the macular volume. And the ICCs for interoperator repeatability were found to be 0.98 and 0.96, respectively. The ICCs for measurements of nine regional retinal thickness also were higher than 0.90. The retinal thickness was correlated with age, gender and refractive error. However, neither age nor refractive error affected to reproducibility and repeatability. CONCLUSIONS: The retinal thickness and macular volume measurements using Cirrus HD OCT in healthy volunteers showed excellent reproducibility and repeatability. Therefore, Cirrus HD OCT has been recognized as an useful tool for diagnosis and mornitoring of variable maculopathies.

Repeatability of Spectral Domain OCT (3D-OCT 1000) in Normal Subjects and Various Macular Diseases

PURPOSE: To evaluate the repeatability of macular thickness and total macular volume measurements made using spectral domain optical coherence tomography (OCT) in normal subjects and subjects with macular disease. METHODS: Among a total of 108 subjects, there were 50 normal subjucts, 20 patients with diabetic macular edema, 10 patients with retinal vein occlusion, 15 patients with age-related macular degeneration, and 13 subjects with other conditions. Two serial macular measurements were obtained from each subject by a single experienced examiner using spectral domain OCT. The repeatability of the measurements was evaluated by comparing two consecutive foveal and perifoveal thickness measurements and total macular volume measurements. The intraclass correlation coefficient was also calculated to evaluate the repeatability of measurements made in normal and macular disease subjects. Result: Spectral domain OCT measurements of macular thickness and macular volume were found to be consistent. Measurements of normal subjects were the most consistent, followed by measurements of patients with age-related macular degeneration, retinal vein occlusion, and diabetic macular edema. CONCLUSIONS: Although measurements made using spectral domain OCT were repeatable across all subjects, they were more consistent in normal subjects than in patients with macular disease. The differences in repeatability should be considered in the context of diseased pathologic anatomy. Physicians should remain cautious when using these measurements for clinical evaluation.

Repeatability and Agreement of Macular Thickness Measurement Using Time and Spectral Domain OCT in Diabetic Macular Edema

PURPOSE: To evaluate the repeatability of macular thickness measurements using time domain (TD) OCT and spectral domain (SD) OCT in diabetic macular edema. METHODS: In 42 eyes of 42 patients with diabetic macular edema, three consecutive macular measurements were performed with TD OCT and SD OCT, and measurements for macular thickness and total macular volume obtained by the two OCTs were compared. The within-subject standard deviation (Sw), coefficient of variation (CVw), and intraclass correlation coefficient (ICC) were calculated to assess repeatability, with agreement between measurements assessed with Bland Altman plots. The correlations were also evaluated via the Pearson's correlation coefficient. RESULTS: The Sw of TD OCT and SD OCT for foveal thickness, total macular volume were 29.67 micrometer/16.44 micrometer, 1.26 mm3/0.23 mm3, respectively, and were significantly lower in SD OCT. The ranges of the respective CVw and ICC values were 1.10-2.78%, 0.78~0.96 for TD OCT, and 0.29~0.94%, 0.92~0.99 for SD OCT. The SD OCT showed better repeatability for macular thickness measurements (all p< or =0.001). The 95% limits of agreement for foveal and total macular volume were 88.9 micrometer, 2.4 mm3, respectively. The Pearson's correlation coefficients of macular thickness and total macular volume between the two OCT methods were statistically significant (p=0.88-0.99). CONCLUSIONS: Although both OCTs proved reliable for macular thickness measurements in diabetic macular edema, SD OCT shows better repeatability than TD OCT. Although macular thickness measurements obtained from the two OCTs cannot be used interchangeably, there were statistically significant correlations between measurements obtained using the two OCTs.

Repeatability and Agreement of Macular Thickness Measurement Using Time Domain OCT and Spectral Domain OCT in Normal Subjects

PURPOSE:To compare the repeatability and agreement of macular thickness measurements using time domain (TD) optical coherence tomography (OCT) and spectral domain (SD) OCT in normal subjects. METHODS: Thirty-four normal subjects were included. Three consecutive macular measurements were taken with TD OCT and SD OCT. Total and regional macular thickness and total macular volume obtained by the two OCTs were compared. Within-subject standard deviation (Sw), coefficient of variation (CVw), and the intraclass correlation coefficient (ICC) were calculated to evaluate repeatability. The agreement was examined with Bland Altman plots. The correlation was also evaluated with Pearson correlation coefficients and multiple regression analysis. RESULTS: Sw for foveal thickness, total macular thickness, and total macular volume were 11.53 microm, 7.58 microm, and 0.48 mm3 for TD OCT and 6.69 microm, 2.55 microm, and 0.09 mm3 for SD OCT, respectively. The values for SD OCT were consistently lower, and this result was statistically significant. The range of the respective CVw and ICC values were 1.10~2.78% and 0.78~0.96% for TD OCT, and 0.29~0.94% and 0.92~0.99% for SD OCT, respectively. The SD OCT showed better repeatability for macular thickness measurements(all with p< or =0.001). The spans of 95% limits of agreement for foveal thickness, total macular thickness, and total macular volume were 67.94 microm, 29.01 microm, and 0.98 mm3, respectively. The Pearson correlation coefficient of foveal thickness, total macular thickness, and total macular volume between the two OCT's was statistically significant. CONCLUSIONS: Although both OCTs are reliable for macular thickness measurements, SD OCT shows better repeatability compared with TD OCT. Although macular thickness measurements obtained from the two OCTs can not be used interchangeably due to low agreement by different standards of measurement, there was a statistically significant correlation between the two OCT's.

The Comparison of Macular Thickness Measurements and Repeatabilities Between Time Domain and Spectral Domain OCT

PURPOSE: To compare macular thickness measurements obtained from time domain optical coherence tomography (TD-OCT) and 2 spectral domain (SD) OCTs and to evaluate their repeatability and agreement in normal subjects and diabetic macular edema patients. METHODS: Fifty-four healthy, normal subjects and 26 diabetic macular edema patients were participated in this study. In a randomly selected eye from each subject, two serial macular measurements were obtained from TD-OCT (Stratus OCT) and SD-OCTs (Cirrus HD-OCT, Spectralis HRA+OCT) by an experienced technician in random order. Nine areas of macular thickness map and repeatabilities obtained by the 3 OCTs were compared. RESULTS: In relative repeatability, SD-OCT showed better results overall compared to TD-OCT. Macular thickness was greatest in the Spectralis HRA+OCT in both normal subjects and diabetic macular edema patients, followed by Cirrus HD-OCT and Stratus OCT. In normal subjects, regardless of the type of comparison between the machines there was a statistically significant difference in all 9 areas. CONCLUSIONS: While the TD-OCT and the 2 SD-OCTs are reliable for macular thickness measurement, SD-OCT has better measurement repeatability compared with TD-OCT. Because macular measurements obtained from the 3 OCT systems cannot be interchanged, an effort should be made to standardize the measurement of each system.