scholarly journals A multi-parameter grading system for optimal fitting of scleral contact lenses

F1000Research ◽  
2022 ◽  
Vol 11 ◽  
pp. 6
Author(s):  
Preetam Kumar ◽  
Karen G. Carrasquillo ◽  
Simmy Chaudhary ◽  
Sayan Basu
Keyword(s):  
Optical Coherence Tomography ◽  
Ocular Surface ◽  
Contact Lenses ◽  
Anterior Segment ◽  
Grading System ◽  
Prosthetic Replacement ◽  
Slit Lamp ◽  
Grading Scale ◽  
Fitting Parameters ◽  
Slit Lamp Biomicroscopy

Background: While scleral lens practise has improved over the years due to factors such as availability of lenses with better materials and designs as well as experience of practitioners, a lack of objectivity appears to remain in terms of assessment of scleral lens fitting. This prospective observational work aimed to achieve standardization on this front through proposing a grading system for scleral lens fitting. Methods: After application of prosthetic replacement of ocular surface ecosystem (PROSE) devices on the participants’ eyes, four fundamental components for understanding scleral lens fitting such as central and limbal corneal clearance, mid-haptic compression, and alignment of lens edge over anterior sclera were assessed through a series of slit-lamp biomicroscopy imaging as well as with anterior segment optical coherence tomography. FitConnect® was used to modify the device parameters to simulate different grading patterns on the proposed scale. Serial imaging was done for all the different lenses to compose the grading scale. Results: A clinically relevant grading scale was constructed that pictorially demonstrated grades for the different aspect of scleral lens fitting. The grades were conveniently scaled within three categories: “optimal”, “acceptable” and “not acceptable”. Conclusion: The gradation of scleral lens fitting parameters would take a step towards objectifying the assessment patterns in practise. This will also help reducing the gap between a novice and an experienced practitioner in terms of understanding of scleral lens fitting.

scholarly journals Spectral-domain optical coherence tomography for evaluating palisades of Vogt in ocular surface disorders with limbal involvement

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ying-Yi Chen ◽  
Yi-Chen Sun ◽  
Chia-Ying Tsai ◽  
Hsiao-Sang Chu ◽  
Jo-Hsuan Wu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Ocular Surface ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Slit Lamp ◽  
Ocular Rosacea ◽  
Unilateral Disease ◽  
Healthy Eyes ◽  
Slit Lamp Biomicroscopy ◽  
Sd Oct

AbstractSpectral-domain optical coherence tomography (SD-OCT) has been used to observe the morphology of the palisades of Vogt (POV) with satisfactory resolutions. In this study, we used SD-OCT to examine the microstructure of the POV in ocular surface disorders with limbal involvement. We detect subclinical limbal pathologies based on five parameters, including (1) decreased epithelial thickness, (2) loss of the sharp stromal tip, (3) loss of the smooth epithelial-stromal interface, (4) dilated stromal vessels, and (5) decreased POV density. Eighteen eyes of 10 patients with advancing wavelike epitheliopathy (AWE) and 15 eyes of 9 patients with phlyctenular keratitis/ocular rosacea were recruited. SD-OCT could detect abnormal changes in the POV in 100% of the lesion sites. In presumed-healthy areas of the diseased eyes diagnosed by slit-lamp biomicroscopy, SD-OCT detected abnormal changes in the POV in 100% of the eyes in both groups. In patients with unilateral disease, abnormal changes in the POV were detected by SD-OCT in 50% and 100% of presumed-healthy eyes diagnosed by slit-lamp biomicroscopy in the AWE group and phlyctenular keratitis/ocular rosacea group, respectively. SD-OCT is powerful in detecting POV changes in ocular surface disorders and can provide useful information that cannot be provided by slit-lamp biomicroscopy.

scholarly journals Spectral-Domain Optical Coherence Tomography For Evaluating Palisades of Vogt in Ocular Surface Disorders With Limbal Involvement

2021 ◽  
Author(s):  
Ying-Yi Chen ◽  
Yi-Chen Sun ◽  
Chia-Ying Tsai ◽  
Hsiao-Sang Chu ◽  
Jo-Hsuan Wu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Ocular Surface ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Slit Lamp ◽  
Ocular Rosacea ◽  
Unilateral Disease ◽  
Healthy Eyes ◽  
Slit Lamp Biomicroscopy ◽  
Sd Oct

Abstract Spectral-domain optical coherence tomography (SD-OCT) has been used to observe the morphology and epithelial thickness of the palisades of Vogt (POV) with satisfactory resolutions. In this study, we used SD-OCT to examine the microstructure of the POV in ocular surface disorders with limbal involvement and to detect subclinical limbal pathologies based on five parameters. Eighteen eyes of 10 patients (2 men and 8 women; mean age, 48.7 ± 14.0 years) with advancing wavelike epitheliopathy (AWE) and 15 eyes of 9 patients (2 men and 7 women; mean age, 30.3 ± 18.2 years) with phlyctenular keratitis/ocular rosacea were recruited. SD-OCT could detect abnormal changes in the POV in 100% of the lesion sites. In presumed-healthy areas of the diseased eyes diagnosed by slit-lamp biomicroscopy, SD-OCT detected abnormal changes in the POV in 100% of the eyes in both the AWE and phlyctenular keratitis/ocular rosacea groups. In patients with unilateral disease, abnormal changes in the POV were detected by SD-OCT in 50% and 100% of presumed-healthy eyes diagnosed by slit-lamp biomicroscopy in the AWE and the phlyctenular keratitis/ocular rosacea group, respectively. SD-OCT is powerful in detecting POV changes in ocular surface disorders and can provide useful information that cannot be provided by slit-lamp biomicroscopy.

scholarly journals Non-malignant conjunctival epithelial masses with ocular surface squamous neoplasia-like optical coherence tomography features

2021 ◽  
Author(s):  
Ágnes Füst ◽  
Jeannette Tóth ◽  
László Imre ◽  
Zoltán Zsolt Nagy
Keyword(s):  
Optical Coherence Tomography ◽  
Ocular Surface ◽  
Anterior Segment ◽  
Histological Diagnosis ◽  
Optical Coherence ◽  
Ocular Surface Squamous Neoplasia ◽  
Ocular Coherence Tomography ◽  
Maximal Thickness ◽  
Epithelial Lesions ◽  
Mass Lesions

Abstract Purpose To observe and describe the anterior segment optical coherence tomography features of limbally localised non-malignant epithelial mass lesions Methods Thirteen patients (age: 66.9 ± 16.3 years) with conjunctival mass suggesting ocular surface squamous neoplasia with biomicroscopic examination were imaged using anterior segment ocular coherence tomography (anterior segment optical coherence tomography)/Cirrus HD-OCT, Model 4000, Carl Zeiss Meditec, Inc., Dublin, CA, and Spectralis HRA + OCT system, Heidelberg Engineering, Vista, CA/. Cases with ocular surface squamous neoplasia-like anterior segment optical coherence tomography (hyperreflective, thickened epithelium and an abrupt transition from normal to abnormal) were included in the study. Maximal thickness of the epithelium was measured. Histological diagnosis was gained from an excisional or incisional biopsy or impression cytology specimens. Results In six patients (age: 68.5 ± 15.4 years) with ocular surface squamous neoplasia-like anterior segment optical coherence tomography features, the histological diagnosis was other than ocular surface squamous neoplasia (papilloma, parakeratosis and a keratotic plaque with mild dysplasia), and ocular surface squamous neoplasia in seven cases (age: 65.6 ± 18.0 years). The maximal epithelial thickness was between 250 and 859 µm in non-ocular surface squamous neoplasia cases and between 252 and 596 µm in ocular surface squamous neoplasia cases. Conclusion Non-malignant epithelial lesions can mimic ocular surface squamous neoplasia on anterior segment optical coherence tomography.

Real-time optical coherence tomography of the anterior segment using hand-held and slit-lamp adapted systems

2002 ◽  
Author(s):  
Sunita Radhakrishnan ◽  
Chetan A. Patil ◽  
Andrew M. Rollins ◽  
Diana Reeves ◽  
Jonathan H. Lass ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Slit Lamp

Role of anterior segment optical coherence tomography angiography in assessing limbal vasculature in acute chemical injury of the eye

2021 ◽  
pp. bjophthalmol-2021-318847
Author(s):  
Marcus Ang ◽  
Valencia Foo ◽  
Mengyuan Ke ◽  
Bingyao Tan ◽  
Louis Tong ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Rapid Assessment ◽  
Anterior Segment ◽  
Vessel Density ◽  
Optical Coherence ◽  
Slit Lamp ◽  
Swept Source ◽  
Chemical Injury

PurposeTo study the role of two anterior segment optical coherence tomography angiography (AS-OCTA) systems in eyes with acute chemical injury.MethodsProspective study in subjects with unilateral chemical injuries. Sequential slit-lamp assessment with spectral domain (SD) (AngioVue, Optovue, USA) and swept source (SS) (Plex Elite, Zeiss, Carl Zeiss Meditec, Dublin, California, USA) AS-OCTA was performed in both eyes within 24–48 hours of injury. Subjects were managed with a standard clinical protocol and followed-up for 3 months. We assessed limbal disruption (loss of normal limbal vessel architecture), limbal vessel density measurements and agreement (kappa coefficient, κ) between masked assessors of limbal disruption based on AS-OCTA scans and slit-lamp assessment.ResultsTen subjects with median age 31 (25–33) years, 20% women, 60% suffered alkali injuries (Roper-Hall grade 1.5±0.7, Dua grade 2.3±1.2) at presentation. Mean limbal vessel density was lower in quadrants of affected eyes compared with controls detected by SD AS-OCTA (9.4%±2.0% vs 15.5%±1.8%, p<0.001) and SS AS-OCTA (8.8%±2.5% vs 13.9%±1.3%, p=0.01). There was substantial agreement when assessing limbal disruption on AS-OCTA (κ=0.7) compared with slit-lamp evaluation (κ=0.4). Overall, we found good agreement between SD and SS AS-OCTA systems in assessing limbal vessel density in eyes with chemical injury at presentation (mean paired difference: −1.08, 95% CI −3.2 to 0.5; p=0.189).ConclusionsIn this pilot study, AS-OCTA provided objective, non-contact, rapid assessment of limbal vasculature involvement in eyes with acute chemical injury. Further studies are required to establish the role of AS-OCTA in determining the prognosis of eyes with chemical injury.

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