Biomechanical and histological changes associated with riboflavin ultraviolet-A-induced CXL with different irradiances in young human corneal stroma.

Keratoconus (KC) is a degenerative condition affecting the cornea, characterized by progressive thinning and bulging, which can ultimately result in serious visual impairment. The onset and progression of KC are closely tied to the gradual weakening of the cornea's biomechanical properties. KC progression can be prevented with corneal cross-linking (CXL), but this treatment has shortcomings, and evaluating its tissue stiffening effect is important for determining its efficacy. In this field, the shortage of human corneas has made it necessary for most previous studies to rely on animal corneas, which have different microstructure and may be affected differently from human corneas. In this research, we have used the lenticules obtained through small incision lenticule extraction (SMILE) surgeries as a source of human tissue to assess CXL. And to further improve the results' reliability, we used inflation testing, personalized finite element modeling, numerical optimization and histology microstructure analysis. These methods enabled determining the biomechanical and histological effects of CXL protocols involving different irradiation intensities of 3, 9, 18, and 30 mW/cm2, all delivering the same total energy dose of 5.4 J/cm2. The results showed that the CXL effect did not vary significantly with protocols using 3-18 mW/cm2 irradiance, but there was a significant efficacy drop with 30 mW/cm2 irradiance. This study validated the updated algorithm and provided guidance for corneal lenticule reuse and the effects of different CXL protocols on the biomechanical properties of the human corneal stroma.

Spatial mapping of corneal biomechanical properties using wave-based optical coherence elastography.

Quantifying the mechanical properties of the cornea can provide valuable insights into the occurrence and progression of keratoconus, as well as the effectiveness of corneal crosslinking surgery. This study presents a non-contact and non-invasive wave-based optical coherence elastography system that utilizes air-pulse stimulation to create a two-dimensional map of corneal elasticity. Homogeneous and dual concentration phantoms were measured with the sampling of 25 × 25 points over a 6.6 × 6.6 mm2 area, to verify the measurement capability for elastic mapping and the spatial resolution (0.91 mm). The velocity of elastic waves distribution of porcine corneas before and after corneal crosslinking surgery were further mapped, showing a significant change in biomechanics in crosslinked region. This system features non-invasiveness and high resolution, holding great potential for application in ophthalmic clinics.

Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography.

Indentation gonioscopy is commonly used in the clinic to evaluate peripheral anterior synechia (PAS) of angle closure glaucoma (ACG). The examination requires contacting with the cornea, resulting in an uncomfortable feeling for patients, and it only provides qualitative outcomes which may be affected by subjective judgment of the clinicians. Previous studies had reported to identify the presence of PAS by measuring the changes of morphological parameters of the anterior chamber angle (ACA) under the pupillary light reflex, by anterior segment optical coherence tomography (AS-OCT). However, this method was invalid for some subjects who had low sensitiveness to light. This article describes an air-puff dynamic anterior segment optical coherence tomography (DAS-OCT) system that can evaluate the presence of PAS in a non-contact approach. The peripheral cornea is deformed by an air puff jetted from the DAS-OCT, causing a transfer of force to the ACA, just as how indentation gonioscopy works. The dynamic changes of the ACA before and after the air puff are recorded by OCT. Ten eyes of normal subjects were enrolled in this study to validate the repeatability and availability of the measurements. Then, ten samples of the ACA from five subjects with ACG were recruited and were assigned into two groups, the non PAS group (NPAS) and PAS group, according to the results of gonioscopy. The ACA structural parameters including the angle opening distance at 750 µm to the scleral spur (AOD750) and the trabecular-iris space area at 750 µm anterior to the scleral spur (TISA750) were then calculated automatically by a custom-written algorithm. The intraclass correlation coefficient (ICC) of measured parameters was all above 0.85 for normal subjects, exhibiting good repeatability. For patients, both parameters showed significant differences between the two groups after the air puff, while no differences were observed before the air puff. AOD750dif and TISA750dif between two groups showed more significant differences, indicating that they could be used as indicators to identify the presence of PAS. In conclusion, the DAS-OCT system proposed in this study is demonstrated effective to identify the presence of PAS by measuring the changes of the ACA via a noncontact approach. It shows great potential for applications in guidance for diagnosis of angle closure glaucoma.

In situ assessment of lens elasticity with noncontact optical coherence elastography.

Lens biomechanics has great potential for application in clinical diagnostics and treatment monitoring of presbyopia and cataracts. However, current approaches to lens elastography do not meet the desired safety or sensitivity for clinical application. In this regard, we propose a noncontact optical coherence elastography (OCE) method to facilitate quantitative in situ imaging of lens elasticity. Elastic waves induced by air-pulse stimulation on the limbus propagate to the lens and are then imaged using custom-built swept-source optical coherence tomography to obtain the elastic wave velocity and Young's modulus. The proposed OCE method was first validated by comparing the results of in situ and in vitro measurements of porcine lenses. The results demonstrate that the Young's modulus measured in situ was highly consistent with that measured in vitro and had an intraclass correlation coefficient of 0.988. We further investigated the elastic changes induced by cold storage and microwave heating. During 36-hour cold storage, the mean Young's modulus gradually increased (from 5.62 ± 1.24 kPa to 11.40 ± 2.68 kPa, P < 0.0001, n = 9) along with the formation of nuclear opacities. 15-second microwave heating caused a greater increase in the mean Young's modulus (from 6.86 ± 1.21 kPa to 25.96 ± 8.64 kPa, P < 0.0025, n = 6) without apparent cataract formation. Accordingly, this study reports the first air-pulse OCE measurements of in situ lenses, which quantified the loss of lens elasticity during simulated cataract development with good repeatability and sensitivity, thus enhancing the potential for adoption of lens biomechanics in the clinic.

In vivo non-contact measurement of human iris elasticity by optical coherence elastography.

Quantifying the mechanical properties of the iris can offer valuable insights into the pathophysiology of primary angle closure glaucoma. However, current techniques for iris elastography remain ex vivo with limited clinical applications. This article describes a proposition for a non-contact and non-invasive air-puff optical coherence elastography (OCE) system that can evaluate iris elasticity in vivo. Ten eyes recruited from seven subjects underwent OCE imaging acquisition under three different illumination conditions. The Young's modulus of each eye was detected and shown to be inversely proportional to the iris length, indicating a relationship between mechanical properties and morphology of the iris. With its noninvasive and high-resolution features, this air-puff system shows great potential for applications in clinical ophthalmology.

Identification of peripheral anterior synechia with anterior segment optical coherence tomography.

PURPOSE: To generate a model that evaluates the presence and extent of peripheral anterior synechia (PAS) based on anterior segment optical coherence tomography (AS-OCT). METHODS: The extent of PAS involvement in the eyes of patients with angle closure was assessed by indentation gonioscopy, and the part of non-PAS and PAS were assigned into two groups (NPAS and PAS). Anterior chamber angles were then imaged by AS-OCT with light-emitting diode (LED) irradiation directly into the pupils, leading to pupillary constriction and increasing anterior chamber angle width. Parameters including the angle opening distance at 750 µm anterior to the scleral spur (AOD750) and trabecular-iris space area at 750 µm anterior to the scleral spur (TISA750) were then obtained. The differences before and after LED irradiation of AOD750 and TISA750 were calculated and used to generate a PAS model based on binary logistic regression. Validation data were then tested. RESULTS: A total of 258 AS-OCT images in 14 eyes were assigned to the modeling data, and 120 were assigned to the validation data. There were no differences in AOD750 and TISA750 in the dark between NPAS and PAS (PAOD750 = 0.258, PTISA750 = 0.486), whereas after LED light exposure, TISA750light was larger in NPAS than in PAS (P = 0.047). The light-dark differences of both parameters showed significant differences between the two groups (PAOD750dif = 0.019, PTISA750dif < 0.001). The area under the curve of the model performance was 0.841, and the overall correct rate was 80.8% based on the validation data. CONCLUSIONS: The present study demonstrates that the AS-OCT-based PAS model could be useful in the identifying of the presence of synechial angle closure and evaluating the extent of PAS in a single eye.

Diurnal variation of corneal elasticity in healthy young human using air-puff optical coherence elastography.

Due to the disruption of intraocular pressure (IOP) and central corneal thickness (CCT), diurnal variation in normal young human corneal elasticity is not clear. Using the custom-built air-puff optical coherence elastography, one eye of 21 normal subjects is enrolled randomly to measure the central corneal elasticity, IOP, and CCT in different time points within a day. Based on the multi-level model, the corneal elastic modulus is found to have a linear positive relation with IOP (P < .01) but not CCT (P = .175) and time point (P = .174-.686). A new indicator, corneal elasticity change rate, is proposed to present the magnitude of corneal elasticity change caused by 1 mmHg IOP, which can correct the interference effect of IOP. The results show that the corneal elasticity in the normal young human does not have the characteristics of diurnal variation under IOP control. Furthermore, IOP plays an important role in the corneal elasticity, and corneal elasticity change rate can increase the comparability of results between individuals.

Modeling of gonioscopic anterior chamber angle grades based on anterior segment optical coherence tomography.

BACKGROUND: To quantitatively assess anterior chamber angle (ACA) structure by anterior segment optical coherence tomography (AS-OCT) and develop a model to evaluate angle width as defined by gonioscopy. METHODS: The ACAs of each quadrant were evaluated by gonioscopy, classified by the Scheie grading system, and assigned into one of the three grades: small angle (SA), moderate angle (MA), and large angle (LA). The eyes were imaged by AS-OCT, and ACA structural parameters including angle opening distance at the scleral spur (AODSS) and at 750 µm anterior to the scleral spur (AOD750), trabecular-iris space area at 750 µm anterior to the scleral spur (TISA750), and a newly defined parameter "light intersection distance" (LID), were measured. The ACA structural data were used to construct an ordered logistic regression model for assignment of ACAs to one of the three angle grades. The validity of the model was then tested. RESULTS: A total of 169 quadrants from 53 subjects were included in the analysis, of which 111 quadrants were included in the modeling data and 58 in the testing data. In pairwise comparisons of SA, MA, and LA by ANOVA, the measured parameters were as follows: AOD750 (0.174 ± 0.060 vs. 0.249 ± 0.068 vs. 0.376 ± 0.114 mm; P < 0.001), TISA750 (0.075 ± 0.035 vs. 0.117 ± 0.036 vs. 0.181 ± 0.062 mm2; P < 0.001), and LID (- 0.300 ± 0.187 vs. -0.085 ± 0.170 vs. 0.122 ± 0.156 mm; P < 0.001). The ACA grading model based on LID showed a relatively high correction rate of 72.4%, and the model efficiency, calculated using the receiver operating characteristic, showed an area under the curve of 0.740. Weighted kappa statistics showed a good agreement for multiple ACA grades (0.772). CONCLUSIONS: The AS-OCT-based multiple ACA grades model was demonstrated as a non-contact approach for ACA assessment with high speed and high spatial resolution, providing guidance for diagnosis of angle closure.

In vivo noninvasive measurement of spatially resolved corneal elasticity in human eyes using Lamb wave optical coherence elastography.

Current elastography techniques are limited in application to accurately assess spatially resolved corneal elasticity in vivo for human eyes. The air-puff optical coherence elastography (OCE) with an eye motion artifacts correction algorithm is developed to distinguish the in vivo cornea vibration from the eye motion and visualize the Lamb wave propagation clearly in healthy subjects. Based on the Lamb wave model, the phase velocity dispersion curve in the high-frequency is calculated to obtain spatially resolved corneal elasticity accurately with high repeatability. It is found that the corneal elasticity has regional variations and is correlated with intraocular pressure, which suggests that the method has the potential to provide noninvasive measurement of spatially resolved corneal elasticity in clinical practice.

Assessment of corneal viscoelasticity using elastic wave optical coherence elastography.

The corneal viscoelasticity have great clinical significance, such as the early diagnosis of keratoconus. In this work, an analysis method which utilized the elastic wave velocity, frequency and energy attenuation to assess the corneal viscoelasticity is presented. Using phase-resolved optical coherence tomography, the spatial-temporal displacement map is derived. The phase velocity dispersion curve and center frequency are obtained by transforming the displacement map into the wavenumber-frequency domain through the 2D fast Fourier transform (FFT). The shear modulus is calculated through Rayleigh wave equation using the phase velocity in the high frequency. The normalized energy distribution is plotted by transforming the displacement map into the spatial-frequency domain through the 1D FFT. The energy attenuation coefficient is derived by exponential fitting to calculate the viscous modulus. Different concentrations of tissue-mimicking phantoms and porcine corneas are imaged to validate this method, which demonstrates that the method has the capability to assess the corneal viscoelasticity.

In vivo evaluation of corneal biomechanical properties by optical coherence elastography at different cross-linking irradiances.

Corneal collagen cross-linking (CXL) strengthens the biomechanical properties of damaged corneas. Quantifying the changes of stiffness due to different CXL protocols is difficult, especially in vivo. A noninvasive elastic wave-based optical coherence elastography system was developed to construct in vivo corneal elasticity maps by excitation of air puff. Biomechanical differences were compared for rabbit corneas given three different CXL protocols while keeping the total energy delivered constant. The Young's modulus was weaker in corneas treated with higher irradiance levels over shorter durations, and a slight increase of Young's modulus was present in all groups one week after the recovery process. Due to the noninvasive nature and minimal force to generate corneal elastic waves, this technique has the potential for early detection and treatment of corneal diseases in clinic.

Long scan depth optical coherence tomography on imaging accommodation: impact of enhanced axial resolution, signal-to-noise ratio and speed.

BACKGROUND: Spectral domain optical coherence tomography (SD-OCT) was a useful tool to study accommodation in human eye, but the maximum image depth is limited due to the decreased signal-to-noise ratio (SNR). In this study, improving optical resolutions, speeds and the SNR were achieved by custom built SD-OCT, and the evaluation of the impact of the improvement during accommodation was investigated. METHODS: Three systems with different spectrometer designs, including two Charge Coupled Device (CCD) cameras and one Complementary Metal-Oxide-Semiconductor Transistor (CMOS) camera, were tested. We measured the point spread functions of a mirror at different positions to obtain the axial resolution and the SNR of three OCT systems powered with a light source with a 50 nm bandwidth, centered at a wavelength of 840 nm. Two normal subjects, aged 26 and 47, respectively, and one 75-year-old patient with an intraocular lens implanted were imaged. RESULTS: The results indicated that spectrometers using cameras with 4096 camera pixels optimized the axial resolutions, due to the use of the full spectrum provided by the light source. The CCD camera system with 4096 pixels had the highest SNR and the best image quality. The system with the CMOS camera with 4096 pixels had the highest speed but had a compromised SNR compared to the CCD camera with 4096 pixels. CONCLUSIONS: Using these three OCT systems, we imaged the anterior segment of the human eye before and after accommodation, which showed similar results among the different systems. The system using the CMOS camera with an ultra-long scan depth, high resolution and high scan speed exhibited the best overall performance and therefore was recommended for imaging real-time accommodation.

Axial elongation measured by long scan depth optical coherence tomography during pilocarpine-induced accommodation in intraocular lens-implanted eyes.

We used an ultra-long scan depth optical coherence tomography (UL-OCT) system to investigate changes in axial biometry of pseudophakic eyes during pilocarpine- induced accommodation. The right eyes from 25 healthy subjects (age range 49 to 84 years) with an intraocular lens (IOL) were imaged twice in the non-accommodative and the accommodative states. A custom-built UL-OCT instrument imaged the whole eye. Then accommodation was induced by two drops of 0.5% pilocarpine hydrochloride separated by a 5-minute interval. Following the same protocol, images were acquired again 30 minutes after the first drop. The central corneal thickness (CCT), anterior chamber depth (ACD), IOL thickness (IOLT), and vitreous length (VL) were obtained using custom automated software. The axial length (AL) was calculated by summing the CCT, ACD, IOLT, and VL. With accommodation, ACD increased by +0.08 ± 0.09 mm, while the VL decreased by -0.04 ± 0.09 mm (paired t-test each, P<0.05). CCT and IOLT remained constant during accommodation (P > 0.05). The non-accommodative AL was 23.47 ± 0.93 mm, and it increased by +0.04 ± 0.04 mm after accommodation (P<0.01). The AL increased and the IOL moved backward during pilocarpine-induced accommodation in pseudophakic eyes.

Anterior Segment Biometry of the Accommodating Intraocular Lens and its Relationship With the Amplitude of Accommodation.

OBJECTIVES: To evaluate the anterior segment biometry of the Tetraflex accommodating intraocular lens (AIOL) and the contribution of forward movement to the amplitude of accommodation (AMP). METHODS: Patients who underwent phacoemulsification with implantation of Tetraflex AIOLs and control nonaccommodating intraocular lenses were imaged by custom-built, long scan depth spectral-domain optical coherence tomography at relaxed and maximal accommodative states. Anterior segment biometry was performed and correlated with the clinical manifestation including AMP. RESULTS: Patients in the Tetraflex group showed better distance-corrected near visual acuity (logMAR 0.43±0.10 vs. logMAR 0.51±0.10, P<0.05) and greater AMP (1.99±0.58 diopters [D] vs. 1.59±0.45 D, P<0.05) compared with the control group. The measurement of the postoperative anterior chamber depth (ACD) during accommodation showed a forward movement of the AIOLs in 16 eyes (69.6%). Compared with the control group, a greater proportion of cases in the Tetraflex group experienced forward movement (χ test, P<0.001). The AMP in the AIOL group negatively correlated with changes in postoperative ACD during accommodation (r=-0.47, P<0.05), whereas AMP in the control group negatively correlated with postoperative pupil diameter (r=-0.57, P<0.05). CONCLUSIONS: The Tetraflex AIOLs seemed to have a tendency for forward movement; however, the slight forward axial shifts of the Tetraflex AIOL during natural accommodation may not produce a clinically relevant change in optical power.

In vivo imaging of retinal hemodynamics with OCT angiography and Doppler OCT.

Retinal hemodynamics is important for early diagnosis and precise monitoring in retinal vascular diseases. We propose a novel method for measuring absolute retinal blood flow in vivo using the combined techniques of optical coherence tomography (OCT) angiography and Doppler OCT. Doppler values can be corrected by Doppler angles extracted from OCT angiography images. A three-dimensional (3D) segmentation algorithm based on dynamic programming was developed to extract the 3D boundaries of optic disc vessels, and Doppler angles were calculated from 3D vessel geometry. The accuracy of blood flow from the Doppler OCT was validated using a flow phantom. The feasibility of the method was tested on a subject in vivo. The pulsatile retinal blood flow and the parameters for retinal hemodynamics were successfully obtained.

Real-Time Measurement of Dynamic Changes of Anterior Segment Biometry and Wavefront Aberrations During Accommodation.

OBJECTIVES: To analyze the dynamic relationship between ocular geometrical structure and high-order aberrations (HOAs) in teal-time during accommodation of human eye. METHODS: A custom-built spectral domain optical coherence tomography (OCT) system with high-speed and ultra-long scan depth was used to image the anterior segment, whereas a Shack-Hartmann wavefront sensor was used to detect the whole-eye aberration. A Badal optometer with switched visual targets was integrated with this system to induce 0 and 3.00 D accommodative stimuli. Three young adult subjects were measured and the structural parameters of anterior segment were measured from OCT images and accommodative response and HOAs were calculated and exponentially fitted in real time during the accommodation. RESULTS: The dynamic process from nonaccommodation to 3.00 D accommodation results in reduced pupil diameter, shallower anterior chamber depth, and increased crystalline lens thickness. After an accommodative active time, the RMS of the HOAs changes sharply when an accommodative stimulus is introduced and then tends to be stable. The accommodative response time and velocity are characterized by fitted parameters. The individual differences of changing in HOAs between subjects can be explained by the different sign and changing tendency of certain terms of aberration coefficients in form of Zernike polynomials during the accommodation. CONCLUSIONS: Based on the integrated ocular measurement platform including OCT system and wavefront sensor, our research demonstrated how the morphology of the human anterior segment affect the aberration in real time during accommodation. The dynamic relationship between them helps us to deeply understand the mechanism of accommodation.

Macular Thickness Profiles of Intraretinal Layers in Myopia Evaluated by Ultrahigh-Resolution Optical Coherence Tomography.

PURPOSE: To investigate the thickness and variation profiles of 8 intraretinal layers in myopia. DESIGN: Prospective cross-sectional study. METHODS: Young subjects with spherical equivalents ranging from +0.50 to -10.25 diopters and good corrected vision were divided into emmetropic (n = 20), low myopic (n = 50), and high myopic (n = 30) groups. Retinal images centered on the fovea along the horizontal and vertical meridians were obtained by ultrahigh-resolution optical coherence tomography (OCT). Macular images were segmented into 8 intraretinal layers by an automatic segmentation algorithm to yield thickness profiles within a 6-mm-diameter circle divided into central, pericentral, and peripheral regions. RESULTS: For intraretinal layers in the central region, the outer segment of receptors layer was thicker in the high myopic group and positively correlated with axial length. In the pericentral and peripheral regions, all layers except the ganglion cell and inner plexiform layer had thickness changes in high myopia. The total thickness of the peripheral region was less than in the emmetropic controls owing to thinner inner nuclear layer, combined Henle fiber and outer nuclear layer, and outer segment of receptors layer. Nevertheless, the thicknesses of the combined myoid and ellipsoid zone and the combined interdigitation zone and retinal pigment epithelium/Bruch complex in the peripheral region were greater than for the emmetropic controls. CONCLUSIONS: Intraretinal layer thicknesses in young high myopic eyes varied significantly from emmetropic controls, especially in the peripheral region. Ultrahigh-resolution OCT with automated segmentation can detect changes in retinal macular microstructure during the development of myopia.

Biometry of anterior segment of human eye on both horizontal and vertical meridians during accommodation imaged with extended scan depth optical coherence tomography.

PURPOSE: To determine the biometry of anterior segment dimensions of the human eye on both horizontal and vertical meridians with extended scan depth optical coherence tomography (OCT) during accommodation. METHODS: Twenty pre-presbyopic volunteers, aged between 24 and 30, were recruited. The ocular anterior segment of each subject was imaged using an extended scan depth OCT under non- and 3.0 diopters (D) of accommodative demands on both horizontal and vertical meridians. All the images were analyzed to yield the following parameters: pupil diameter (PD), anterior chamber depth (ACD), anterior and posterior surface curvatures of the crystalline lens (ASC and PSC) and the lens thickness (LT). Two consecutive measurements were performed to assess the repeatability and reproducibility of this OCT. They were evaluated by calculating the within-subject standard deviation (SD), a paired t-test, intra-class correlation coefficients (ICC) and the coefficient of repeatability/reproducibility (CoR). RESULTS: There were no significant differences between two consecutive measurements on either horizontal or vertical meridians under both two different accommodative statuses (P>0.05). The ICC for all parameters ranged from 0.775 to 0.998, except for the PSC (0.550) on the horizontal meridian under the non-accommodative status. In addition, the CoR for most of the parameters were excellent (0.004% to 4.89%). In all the parameters, only PD and PSC were found different between the horizontal and vertical meridians under both accommodative statuses (P<0.05). PD, ACD, ASC and PSC under accommodative status were significantly smaller than those under the non-accommodative status, except that the PSC at the vertical meridian did not change. In addition, LT was significantly increased when accommodation. CONCLUSION: The extended scan depth OCT successfully measured the dimensions of the anterior eye during accommodation with good repeatability and reproducibility on both horizontal and vertical meridians. The asymmetry of lens posterior surface and oval-shaped pupil were found during accommodation.

Automatic biometry of the anterior segment during accommodation imaged by optical coherence tomography.

OBJECTIVE: To test accuracy and repeatability of a software algorithm that performs automatic biometry of the anterior segment of the human eye imaged with long scan depth optical coherence tomography (OCT). METHODS: The ocular anterior segment imaging was performed with custom-built long scan depth OCT. An automatic software algorithm including boundary segmentation, image registration, and optical correction was developed for fast and reliable biometric measurements based on the OCT images. The boundary segmentation algorithm mainly used the gradient information of images and applied the shortest path search based on the dynamic programming to optimize the edge finding. The automatic algorithm was validated by comparison of the biometric dimensions between automatic and manual measurements and repeatability study. RESULTS: Biometric dimensions of the anterior segment, including central corneal thickness, anterior chamber depth, pupil diameter, crystalline lens thickness, and radii of curvature of the anterior and posterior surfaces of lens, were obtained by the automatic algorithm successfully. There were no significant differences between the automatic and manual measurements for all biometric dimensions. The intraclass correlation coefficients (ICC) of agreement between automatic and manual measurements ranged from 0.85 to 0.98. The coefficients of repeatability and ICC for all automatic dimensions were satisfactory (1.1%-6.1% and 0.663-0.990, respectively). CONCLUSIONS: The high accuracy, good repeatability, and fast execution speed for automatic measurement of the anterior segment dimensions on the OCT images were demonstrated. The application of this automatic biometry is promising for investigating dynamic changes of human anterior segment during accommodation in real time.

Corneal reshaping and wavefront aberrations during overnight orthokeratology.

PURPOSE: To investigate changes of corneal thickness at the vertical and horizontal meridians and of wavefront aberrations (WA) over a 30-day period of overnight myopia orthokeratology (OK) lens wear. METHODS: Sixteen subjects (11 women, 5 men, 26.3±3.2 years) were enrolled and fitted for OK lenses. Long scan depth optical coherence tomography was used to measure corneal thickness profiles at both horizontal and vertical meridians at baseline and on days 1, 7, and 30 days. Corneal and ocular WA of a 6-mm pupil were measured and the root-mean-square (RMS) of the astigmatism, coma, spherical aberration (SA), and total higher-order aberrations (HOAs) were determined. RESULTS: During the 30-day period, the central cornea thinned in the horizontal and vertical meridians, whereas corneal thickening occurred in the temporal, nasal, and inferior mid-peripheries. In contrast, the cornea thinned in the mid-peripheral superior. There were significant increases in RMS for astigmatism, SA, coma, and positive horizontal coma during the study period. After OK, there were significant positive correlations between the midperipheral-central thickness change difference and the changes in corneal and ocular RMS of total HOAs and SA (r range: 0.281 to 0.492, P<0.05). Only the change of corneal coma RMS was correlated with midperipheral-central thickness change difference (r=0.270, P<0.05). The change in corneal horizontal coma was correlated with the temporal-nasal thickness change difference (r=-0.289, P<0.05). CONCLUSIONS: Overnight OK caused unique changes in corneal thickness profiles at the vertical and horizontal meridians and increased corneal and ocular HOAs related to corneal reshaping.