Accuracy of the indices of MS-39 anterior segment optical coherence tomography in the diagnosis of keratoconic corneas

2021 ◽  
pp. 112067212110637
Author(s):  
Rania S Elkitkat ◽  
Yasser Rifay ◽  
Hesham M Gharieb ◽  
Hossam Eldin A Ziada

Purpose To determine the normative and the cut-off values of various indices available in the MS 39 Anterior Segment Optical Coherence Tomography (MS-39 AS-OCT) for keratoconus (KC) diagnosis, and to detect the accuracy of the variable available parameters. Methods This cross sectional observational study was conducted at Dr Rifay Ophthalmology Center, Rabat, Morocco, on 172 eyes with KC (group 1) and 248 eyes of healthy controls (group 2). Participants were screened using MS-39 AS-OCT (CSO, Firenze, Italy). The investigated indices included: keratometric indices, pachymetric indices, elevation indices, Keratoconus Summary Indices (KSI), aberration indices, and epithelial mapping evaluation. Results Most of the studied indices were significantly different between both groups (P value <0.001). Twenty two indices had Area Under the Receiver Operating Curve (AUROC) values >0.950, eight of which were from the KSI. The indices with the highest AUROC values were: Root Mean Square (RMS) for the front corneal surface at 6 mm circle (AUROC = 0.996, and best cut-off >1.69 with sensitivity of 97.67% and specificity of 97.98%) and RMS per unit of area for the front surface at 6 mm circle (AUROC = 0.996, and best cut-off >0.06 with sensitivity of 97.67% and specificity of 97.98%). Epithelial thickness-derived metrics were not among the parameters with the highest accuracy. Conclusions This study presented the mean and the cut-off values for a plethora of parameters available in the MS-39 AS-OCT. The results of this study show that MS-39 AS-OCT is a valuable equipment for diagnosing keratoconic corneas, with a high accuracy detected for many parameters.

2020 ◽  
pp. bjophthalmol-2019-315445
Author(s):  
Alexei N Kulikov ◽  
Dmitrii S Maltsev ◽  
Alina A Kazak ◽  
Maria A Burnasheva

PurposeTo study the correlation between intraocular pressure (IOP) reduction and the number of hyper-reflective particles appearing in the anterior chamber following selective laser trabeculoplasty (SLT).Material and methodsIn this prospective interventional study, we included primary open-angle glaucoma patients. All participants received a standardised SLT session, which consisted of 100 pulses of 0.9 mJ over 360°. Anterior segment optical coherence tomography (4×4 mm volume scan, 101 horizontal cross-sectional scans) and applanation tonometry were performed before SLT and 15 min, 1 day, 1 week, 1 month and 3 months after. Particles were counted on cross-sectional scans using a standardised algorithm.ResultsIn this study, we included 25 patients (25 eyes), 14 males and 11 females, with a mean age of 68.9±10.5 and baseline IOP of 21.4±4.5 mm Hg. IOP at month 1 and month 3 after SLT was 18.0±4.0 and 17.4±3.3 mm Hg, respectively. The mean number of anterior chamber particles before and 15 min after SLT was 0.62±0.2 and 7.1±2.0 particles/mm2, respectively (p=0.036). There was a statistically significant correlation between the mean number of anterior chamber particles 15 min after SLT and IOP reduction at 1 month (r=0.62, p=0.03) and 3 months (r=0.71, p=0.01).ConclusionThe number of the anterior chamber particles graded using anterior segment optical coherence tomography after the procedure correlates with the IOP-lowering effect of SLT.


2021 ◽  
Vol 13 ◽  
pp. 251584142110201
Author(s):  
Anuradha Raj ◽  
Renu Dhasmana ◽  
Harsh Bahadur

Purpose: To evaluate the relationship between measurements and various morphometric parameters of primary pterygium on anterior segment optical coherence tomography(AS-OCT) and refractive and keratometric astigmatism. Methods: In this cross-sectional study, patients with primary pterygium were included. The AS-OCT parameters of pterygium consisting of epithelial thickness near apex(µm), apical or head thickness(µm), its thickness at limbus(µm), horizontal length of pterygium(mm), central corneal thickness (µm) and maximum pterygium thickness(mm) were evaluated. Results: Sixty three patients comprising of 63 eyes with a primary pterygium were studied. The mean keratometric and refractive astigmatism were 1.69 ± 3.15 Diopter(D) and0.5 ± 1.4D, respectively. There was a significant association between pterygium grade and stocker’s line with keratometric astigmatism ( p = 0.02, 0.00) respectively. Vertical and horizontal length on slit lamp and horizontal length on AS-OCT showed significant association with keratometric astigmatism ( p = 0.05, 0.00,0.00), respectively. Limbal thickness on AS-OCT showed significant positive correlation with refractive astigmatism ( r = 0.29, p = 0.02). Conclusion: The pterygium grade influences the keratometric astigmatism. Increased limbal thickness of pterygium on AS-OCT leads to more refractive astigmatism.


Author(s):  
Matthias Grimm ◽  
Hessam Roodaki ◽  
Abouzar Eslami ◽  
Nassir Navab

Abstract Purpose Intraoperative optical coherence tomography (iOCT) was recently introduced as a new modality for ophthalmic surgeries. It provides real-time cross-sectional information at a very high resolution. However, properly positioning the scan location during surgery is cumbersome and time-consuming, as a surgeon needs both his hands for surgery. The goal of the present study is to present a method to automatically position an iOCT scan on an anatomy of interest in the context of anterior segment surgeries. Methods First, a voice recognition algorithm using a context-free grammar is used to obtain the desired pose from the surgeon. Then, the limbus circle is detected in the microscope image and the iOCT scan is placed accordingly in the X–Y plane. Next, an iOCT sweep in Z direction is conducted and the scan is placed to centre the topmost structure. Finally, the position is fine-tuned using semantic segmentation and a rule-based system. Results The logic to position the scan location on various anatomies was evaluated on ex vivo porcine eyes (10 eyes for corneal apex and 7 eyes for cornea, sclera and iris). The mean euclidean distances (± standard deviation) was 76.7 (± 59.2) pixels and 0.298 (± 0.229) mm. The mean execution time (± standard deviation) in seconds for the four anatomies was 15 (± 1.2). The scans have a size of 1024 by 1024 pixels. The method was implemented on a Carl Zeiss OPMI LUMERA 700 with RESCAN 700. Conclusion The present study introduces a method to fully automatically position an iOCT scanner. Providing the possibility of changing the OCT scan location via voice commands removes the burden of manual device manipulation from surgeons. This in turn allows them to keep their focus on the surgical task at hand and therefore increase the acceptance of iOCT in the operating room.


2021 ◽  
Author(s):  
Mohamed Salah El-Din Mahmoud ◽  
Nosiba Essam ◽  
Layla Mohamed Hammouda ◽  
Ahmed Shawkat Mohamed

Abstract Purpose: The study aims is to detect primary angle-closure glaucoma (PACG) suspects using both anterior segment optical coherence tomography (AS-OCT) and Scheimpflug imaging. Methods: A prospective cross-sectional observational study on forty PACG suspect patients with a range of ages from 20 to 70 years. Angle imaging by AS-OCT (Optovue Inc., Fairmont, CA) with study parameters in the superior, inferior, nasal, and temporal quadrants were anterior chamber angle (ACA), angle opening distance at 750 µm (AOD750), and trabecular-iris space area at 750 μm (TISA). Also, angle imaging using Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) with study parameters were the anterior chamber angle (ACA), anterior chamber depth (ACD) and, anterior chamber volume (ACV). The angle evaluation was done before and after the mydriatic test.Results: As regarding AS-OCT, after the mydriatic test, we noticed a decrease in all parameters measured, some decreased significantly while others did not. A significant decrease was noticed in ACA (TIA750) in all quadrants (P value<0.001in nasal, 0.001in superior &temporal, 0.003 in inferior) and in TISA750 in the nasal quadrant only (P-value 0.004). AOD750 and TISA750 in the remaining quadrants also decreased but not significantly as ACA. As regarding Pentacam, all parameters decreased after the mydriatic test. ACA (P-value <0.001) and ACD (P-value 0.004) showed significant statistical decrease but ACV showed statistically non-significant decrease (P-value 0.558).Conclusions: AS-OCT and Pentacam are reliable investigations for the detection of PACG suspects which needs more close follow-up for a possible increase in IOP.


2018 ◽  
Vol 16 (2) ◽  
pp. 86-94
Author(s):  
Vijaya Anandan ◽  
Rekha Srinivasan ◽  
Rashima Asokan ◽  
Ronnie George

Aim: To compare the anterior chamber volume measurements obtained with Pentacam and derived from anterior segment optical coherence tomography. Design: Cross-sectional study. Methods: We included normal subjects who underwent a comprehensive eye examination including refraction, keratometry, Goldmann applanation tonometry, gonioscopy, anterior segment optical coherence tomography (AS-OCT) (Carl Zeiss Meditec Inc.; Dublin, CA, USA) and Pentacam (Oculus Inc.; Lynnwood, WA, USA). Fifty scans were selected for Pentacam and 12 images were selected for calculation of anterior chamber volume. Only the right eye was considered for analysis. Results: One-hundred and nineteen eyes of 119 subjects were included for analysis. The mean age of the subjects was 42.58 ± 13.15 years, of which 74 were female and 45 were male. The mean anterior chamber volume measured using AS-OCT was 119.17 ± 26.56 mm3 and with Pentacam was 131.29 ± 34.26 mm3. The comparison of means between the two modalities was statistically significant (t = -8.857, Mean Difference (MD) = 12.11, 95% CI: (4.29, 19.95), p = 0.003). Bland-Altman plot showed poor agreement between the chamber volume measurements obtained by Pentacam and AS-OCT with MD of 12.1 mm3 (95 % CI: 41.4 to -17.1) and intra-class correlation between the two instruments was 0.94 (95% CI: 0.91, 0.96) (p < 0.0001). Conclusion: The anterior chamber volume can be measured using Pentacam as well as AS-OCT since these measurements were reliable. However, these measurements were not interchangeable due to poor levels of agreement.


2021 ◽  
Author(s):  
Mohammad Reza Akhlaghi ◽  
Farzan Kianersi ◽  
Hamed Radmehr ◽  
Alireza Dehghani ◽  
Afsaneh Naderi Beni ◽  
...  

Abstract Background One of the major side effects of hydroxychloroquine is retinopathy. The aim of this study was to evaluate the Optical coherence tomography angiography (OCTA) parameters in a group of patients who have hydroxychloroquine-induced retinopathy based on Multifocal electroretinography (mfERG) with a group who do not have retinopathy.Method This is a Cross-Sectional Study. In this study, patients with RA or SLE who had been taking HCQ for at least 7 years were included. MfERG and OCTA imaging were performed for all patients. Patients were divided into Normal mfERG and Abnormal mfERG groups based on mfERG results. OCTA parameters were studied in these two groups.Result 61 patients (61 eyes) were included. 41 patients had SLE and 20 patients had RA. 40 patients (66.7%) had Abnormal mfERG. The mean VD in SCP layer was not significantly different between Normal mfERG and Abnormal mfERG groups (P-Value> 0.05). Mean VD in SCP layer was not significantly different between Normal mfERG and Abnormal mfERG groups (P-Value> 0.05). In RA subgroup, mean VD in SCP layer in PeriFovea region in Abnormal mfERG group was significantly lower than normal group (P-Value <0.05). Mean VD in DCP layer in Whole Image, Superior Hemi, Inferior Hemi, PeriFovea area in Abnormal mfERG group was significantly lower than normal group (P-Value <0.05). This discrepancy was also observed in the RA subgroup but not in the SLE subgroup. The mean of none of the parameters of FAZ (mm2), Flow Area of Outer Retina (mm2) and Flow Area of Choriocapillaris (mm2) were not statistically significant between the groups Abnormal mfERG and Normal mfERG. (p-value>0.05). Conclusion VD in the DCP layer decreased in abnormal mfERG patients compared to patients with normal mfERG. But it seems that VD in SCP layer, FAZ Area and Flow Area are similar in both groups. OCTA may be used as a non-invasive tool in the diagnosis of early stages of HCQ-induced retinopathy, especially in RA patients, but further studies are needed.


Author(s):  
Alireza Khodabande ◽  
Massood Mohammadi ◽  
Hamid Riazi-Esfahani ◽  
Shahab Karami ◽  
Massood Mirghorbani ◽  
...  

Abstract Background To evaluate changes in anterior segment morphology on anterior segment optical coherence tomography (AS-OCT) following pars plana vitrectomy (PPV) without tamponade. Methods Patients who underwent PPV without tamponade for epiretinal membrane were evaluated. Eligible patients underwent intraocular pressure (IOP) measurement and AS-OCT preoperatively as well as 1 month and 6 months post-operatively. Anterior chamber width (ACW), anterior chamber depth (ACD), trabecular iris angle (TIA), angle opening distance at 500 and 750 µm (AOD), and trabecular iris space area at 500 and 750 µm (TISA) at four quadrants were recorded and analyzed. Additionally, the mean values of TIA (MTIA), AOD (MAOD), and TISA (MTISA) for each eye (mean of four quadrants) were analyzed. Results 23 patients completed the study. The mean age of participants was 56.4 ± 3.6 years of age and 13/23 (56%) were female. Mean IOP of patients was 18.1 ± 1.1, 18.3 ± 1.1, and 18.1 ± 1.2 preoperatively,1 month post-operatively, and 6 months post-operatively, respectively. (p = 0.83). No difference was detected post-operatively in measurements of ACW, ACD, MTIA, MAOD500, MAOD750, MTISA500, and MTISA750. Conclusion Pars plana vitrectomy without tamponade was not associated with changes in anterior chamber morphology.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Riham S. H. M. Allam ◽  
Rania A. Ahmed

Purpose. To study features of the lower punctum in normal subjects using spectral domain anterior segment optical coherence tomography (SD AS-OCT).Methods. Observational cross-sectional study that included 147 punctae (76 subjects). Punctae were evaluated clinically for appearance, position, and size. AS-OCT was used to evaluate the punctal shape, contents, and junction with the vertical canaliculus. Inner and outer diameters as well as depth were measured.Results. 24 males and 52 females (mean age44±14.35 y) were included. Lower punctum was perceived by OCT to be an area with an outer diameter (mean412.16±163 μm), inner diameter (mean233.67±138.73 μm), and depth (mean251.7±126.58 μm). The OCT measured outer punctum diameter was significantly less than that measured clinically (P: 0.000). Seven major shapes were identified. The junction with the vertical canaliculus was detectable in 44%. Fluid was detected in 34%, one of which had an air bubble; however, 63% of punctae showed no contents and 4% had debris.Conclusions. AS-OCT can be a useful tool in understanding the anatomy of the punctum and distal lacrimal system as well as tear drainage physiology. Measuring the punctum size may play a role in plugs fitting.


Author(s):  
Sagili Chandrasekhara Reddy ◽  
Mohd Mansor Shariff ◽  
Aina Malindri Dasrilsyah

Purpose: To determine the central corneal thickness in myopic adult patients scheduled for laser corneal refractive surgery and to explore its correlation with degree of refractive error. Materials and Methods: The case records of 130 myopic patients who underwent laser corneal refractive surgery in a military hospital over a period of two years were reviewed to determine the central corneal thickness. All patients had 6/6 vision with best correction, and did not have any other anterior segment or fundus diseases in both eyes. The central corneal thickness was measured with Visante Carl Zeiss anterior segment optical coherence tomography instrument.                                                                                                                        Results: Out of 130 patients, males were more (73, 56.2%); mean age of patients was 33.8 years (range 18-60 years) and majority were Malays (110, 84.6%).  The spherical power of myopia ranged from – 0.5 to – 10.00 D, and the cylindrical power ranged from – 0.25 to – 3.25 D. The mean central corneal thickness of both eyes was 528.2 µm (range 331- 615 µm); in the mild degree of myopia (- 0.50 to - 2.00 D) 527.9 µm, moderate degree (- 2.25 to -5.00 D) 529.4 µm, and high degree (-5.25 to -11.00 D) 523.9 µm. Conclusion: The anterior segment optical coherence tomography provides noncontact, rapid, pachymetry mapping of the corneal thickness. In Malaysian patients, the mean central corneal thickness of both eyes in myopia was 528.1 µm (range 331- 615 µm). There was no correlation between the mean central corneal thickness and degree of myopia, different genders, age groups, ethnic groups and two eyes.


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