ABSTRACT
Purpose: To establish normative data on anterior scleral thickness using the spectral domain anterior segment optical coherence tomography (AS?OCT). Methods: In total, 200 eyes of 100 healthy subjects underwent AS?OCT scans in the temporal and nasal quadrants. The scleral + conjunctival complex thickness (SCT) was measured by a single examiner. Mean SCT was analyzed for differences across age groups, gender, and location (nasal versus temporal). Results: Mean age was 46.4 ± 18.3 (21–84) years; male to female ratio was 54:46. Mean SCT (nasal + temporal) of the right eye (RE) was 682.3 ± 64.2 ?m in males and 660.6 ± 57.1 ?m in females. In the left eye (LE), it was 684.6 ± 64.9 ?m in males and 661.8 ± 49.3 ?m in females. These differences between male and female for both eyes were statistically significant (P = 0.006 and P = 0.002). The mean SCT of temporal and nasal quadrants in the RE was 678.54 ± 57.50 and 666 ± 66.2 ?m, respectively. In the LE, the temporal mean SCT quadrant was 679.6 ± 55.8 ?m, and the nasal was 668.6 ± 63.6 ?m. Age had a negative correlation with SCT (?0.62 ?m/year; P = 0.03), and males had a higher temporal SCT than females (22 ?m higher; P = 0.03). After adjusting for age and gender in a multivariate analysis, temporal SCT was significantly (P < 0.001) higher than nasal SCT. Conclusion: In our study, mean SCT decreased with age and males had a higher temporal SCT. This is the first study to evaluate scleral thickness in the Indian population, and the data can be used as a baseline for comparing variations in scleral thickness in disease.
ABSTRACT
Purpose: To analyze the ocular biometric parameters of eyes with acute primary angle closure (APAC) as compared to fellow eyes. Methods: A cross?sectional study was conducted on 27 patients presenting with recent onset APAC to a tertiary eye institute in India. Anterior and posterior ocular biometric parameters were measured simultaneously by anterior segment optical coherence tomography (AS?OCT), A?scan, ultrasound biomicroscopy (UBM), and B?mode ultrasonogram (USG). The parameters measured were anterior chamber depth (ACD), anterior chamber angle (ACA), angle opening distance (AOD500, AOD750), lens vault (LV), axial length (AL), ciliary body thickness maximum (CBTmax) and at the point of scleral spur (CBT0), anterior placement of the ciliary body (APCB), and retinochoroidal thickness (RCS). Results: Mean age � SD of patients with APAC was 55.66 � 7.2 years with female preponderance (21:6 patients). Mean presenting IOP � SD of the affected eye and fellow eye were 54.74 � 11.67 mm Hg and 18.7 � 11.67 mm Hg, respectively. Eyes with APAC had statistically significant narrower anterior ocular biometric parameters, higher LV, decreased ciliary body thickness, more APCB, and longer AL than the fellow eyes. CBTmax is the only variable that had significance (? = ?0.421,95% CI: ?0.806 to ? 0.035, P = 0.034) in the univariate analysis with RCS thickness in APAC eyes. Further, there was a correlation between CBT0 and APCB with CBTmax both in univariate (? = 0.894, P < 0.0001 and ? = ?0.351, P = 0.039) and multivariable analysis (? = 0.911, P < 0.0001 and ? = ?0.416, P = 0.016). Conclusion: Compared to the fellow eyes, APAC eyes had different ocular biometric parameters. In addition to known biometric parameters associated with pupillary block (narrower anterior biometric parameters?ACA, ACD, and AOD), our study found multiple nonpupillary block factors such as higher lens vault and thinner and more anteriorly placed ciliary body to be associated with APAC.
ABSTRACT
@#AIM: To investigate the clinical application value of anterior segment OCT(AS-OCT)in diagnosis and treatment of descemet's membrane detachment(DMD)after intraocular surgery. <p>METHODS: Totally 23 eyes of 21 patients with corneal edema after intraocular surgery in our hospital from June 2016 to April 2019 were analyzed retrospectively. The degree of corneal edema and the descemet's membrane detachment(DMD)were observed by AS-OCT. The patients with mild or above descemet's membrane detachment were treated with anterior chamber gas tamponade, the patients with other corneal edema were treated with drug conservative treatment, and the corneal edema and adhesion of descemet's membrane were observed.<p>RESULTS: In this study, 21 patients(23 eyes)had corneal edema of different degrees, 14 eyes with descemet's membrane detachment,11 eyes with mild or above descemet's membrane detachment were re-examined by AS-OCT one day after anterior chamber gas tamponade. 10 eyes had good adhesion, 1 eye had poor adhesion, and the adhesion was good after anterior chamber gas tamponade again. After 1mo follow-up, the cornea of all the patients recovered to be transparent and their vision recovered well.<p>CONCLUSION:AS-OCT can timely and accurately diagnose and evaluate descemet's membrane detachment and its therapeutic effect.
ABSTRACT
@#AIM: To analyze the correlation and consistency of five corneal diameter measurements.<p>METHODS: Totally 25 cases(50 eyes)who underwent ICL implantation in West China Hospital. The preoperative horizontal corneal diameter was measured using measuring caliper, SIRIUS anterior eye assay system, IOL Master500, anterior segment OCT and UBM. <p>RESULTS: The mean WTW distances were 11.54±0.30 mm as obtained with measuring caliper, 11.77±0.33mm with SIRIUS anterior eye assay system, 11.98±0.33mm with IOL Master500, 11.63±0.35mm with anterior segment OCT and 11.53±0.34mm with UBM. No statistical difference was found between measuring caliper and UBM, measuring caliper and anterior segment OCT, UBM and anterior segment OCT. The linear correlation analysis found significant correlation between the measurements of the five measurements. The Bland-Altman analysis for the measuring caliper and SIRIUS, measuring caliper and UBM, measuring caliper and anterior segment OCT found that the absolute values of 95% LOA upper and lower limits were less than 0.5mm.<p>CONCLUSION: The results of the four kinds of corneal horizontal diameter measurements can be interchanged including SIRIUS, UBM, anterior segment OCT and measuring caliper. IOL Master500 results are the largest, that cannot be used as a diagnostic basis for measuring the size of corneal horizontal diameter. The results of other measurement equipment should be combined with clinical practice.
ABSTRACT
Objective Systemic lupus erythematosus (SLE) cause irreversible damage to multiple organs of the body.This article evaluates the changes in tear film quality and visual quality in patients with SLE.Methods In the study,we selected 66 patients with SLE (66 right eyes) for the study group and 59 healthy volunteers (59 right eyes) for the control group,The measurements of BUT,corneal fluorescein staining(FL) score and SIt were taken in turn for both two groups.Anterior segment OCT was used for measuring the CET,CCT,TMD,TMH and TMA.OQAS Ⅱ system was taken for MTFcutoff,SR,static OSI,OV (100％,20％,9％) and dynamic OSI.Differences of the parameters were compared between the two groups.The data correlation was assessed by Spearman rank correlation analysis.Results There were significant differences in SIt,BUT,FL score,CET,TMH,TMD and TMA between the two groups(P＜0.05),but no significant difference in CCT (P＞0.05).The differences of static OSI,MTFcutoff,SR,OV100％,OV20％,OV9％ between the two groups were statistically significant(P＜0.01).The △OSI(differences between dynamic and static OSI) had the difference between the two groups(t=4.615,P＜0.001).TMA was positively correlated with CET,SIt,and BUT (P＜0.05),and had no correlation with OSI,MTFcutoff,SR,OV100％,OV20％,OV9％ (P＞0.05).Anti-ds-DNA is positively correlated with SIt,TMA,MTFcutoff and SR (r =0.346,0.208,0.257,0.197,P＜0.05) and negatively correlated with OSI(r=-0.292,P＜0.05).There was no correlation between ANA,C3,C4 and the parameters of tear film and visual quality (P＞0.05).Conclusion SLE may affect the amount and stability of the patient's tears and affects the corneal epithelial thickness and visual quality.
ABSTRACT
PURPOSE: To report a case of double Descemet's membrane in a patient who had penetrating keratoplasty after rupture of Descemet's membrane during deep anterior lamellar keratoplasty (DALK). CASE SUMMARY: A 24-year-old female had keratoconus in her right eye and underwent DALK for treatment. Descemet's membrane was ruptured while separating the corneal stroma from Descemet's membrane with the big bubble technique. The operation method was changed from DALK to penetrating keratoplasty. Detached Descemet's membrane was observed in the anterior chamber after suturing. Sterile air was injected into the anterior chamber to attach the Descemet's membrane. Five days after the surgery, Descemet's membrane was detached and a second air injection was performed. Corneal edema was improved but Descemet's membrane was re-detached. Double Descemet's membrane was observed by anterior segment optical coherence tomography (OCT). The detached Descemet's membrane originated from the recipient's cornea and not from the donor's cornea. Detached Descemet's membrane was removed successfully. Patient's cornea was clear and best corrected visual acuity was 20/25. CONCLUSIONS: When penetrating keratoplasty is performed instead of DALK, the surgeon should completely remove the remnant corneal stroma and Descemet's membrane. Remnant Descemet's membrane can be disregarded as it comes from the donor cornea. Unnecessary anterior chamber air injection causes endothelial damage. Anterior segment OCT is a useful tool to identify anatomical structures of transplanted cornea.
Subject(s)
Female , Humans , Young Adult , Anterior Chamber , Cornea , Corneal Edema , Corneal Stroma , Corneal Transplantation , Descemet Membrane , Keratoconus , Keratoplasty, Penetrating , Rupture , Tissue Donors , Tomography, Optical Coherence , Visual AcuityABSTRACT
Laser peripheral iridotomy ( LPI) is one of the main therapy for glaucoma due to its reliable efficacy of widening peripheral angle and therefore decreasing intraocular pressure by partially relieving pupillary block. The parameters of the anterior chamber angle following the LPI are the main evaluation indexes. At present,the detecting and diagnosis technique for the anterior chamber angle is deeply advancing, including gonioscopy, ultrasound biomicroscopy, anterior segment optical coherence tomography and Pentacam. These methods offer some useful parameters and also present with some limits in the application respectively in the evaluation of anterior chamber and angle structure. This review focuses on the application of Methods mentioned above and morphologic changes of anterior chamber and angle structure following the LPI.
ABSTRACT
PURPOSE: To evaluate intrableb morphology and function after trabeculectomy using anterior segment optical coherence tomography (AS-OCT). METHODS: Twenty-eight post-trabeculectomy eyes from patients with primary open-angle glaucoma were examined using AS-OCT. Intrableb structures, including bleb wall thickness, subconjunctival fluid, suprascleral fluid and the route under the scleral flap, were measured at the center of the bleb using AS-OCT and were classified according to their slit-lamp appearance. Blebs were classified as successful (IOP18 mmHg or use of ocular hypertensive medication.) in order to compare parameters between the two groups. RESULTS: The blebs were classified as either diffuse filtering (n=17), cystic (n=5), encapsulated (n=3) or flattened (n=3) according to slit lamp appearance and were correlated with AS-OCT images. Blebs were classified as successful and failed in order to compare parameters between the two groups. Significant differences were observed between the two groups in regard to subconjunctival fluid space (p=0.0004). No significant differences were observed in bleb wall thickness (p=0.098), suprascleral fluid space (p=0.87) or the route under the scleral flap (p=0.196). CONCLUSIONS: AS-OCT images of the intrableb structures were correlated with the appearance of the slit lamp, and a large subconjunctival space was associated with good bleb function. AS-OCT is useful for evaluating blebs; further studies should be performed to verify these findings.