scholarly journals Comparison of Amsler–Krumeich and Sandali Classifications for Staging Eyes with Keratoconus

2021 ◽  
Vol 11 (9) ◽  
pp. 4007
Author(s):  
Giuseppe Giannaccare ◽  
Gianluca Murano ◽  
Adriano Carnevali ◽  
Angeli Christy Yu ◽  
Sabrina Vaccaro ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Surgical Planning ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
The Other ◽  
New Classification ◽  
Advanced Stages ◽  
Irregular Astigmatism ◽  
Corneal Thinning

Keratoconus (KC) is the most common corneal ectasia characterized by progressive corneal thinning, protrusion, and irregular astigmatism. The Amsler–Krumeich classification based on the analysis of corneal topography, corneal thickness, refraction and biomicroscopy is the most commonly used; recently, a new classification based on anterior segment Optical Coherence Tomography was introduced by Sandali and colleagues. Since there is no information about the possible agreement between these two classifications, the aim of this study is to compare the stratification of consecutive KC patients using the Amsler–Krumeich and Sandali classifications, and to further ascertain KC cases in which one classification is preferred over the other. Overall, 252 eyes of 137 patients (41.45 ± 16.93 years) were analyzed: in 156 eyes (61.9%), the Amsler and Sandali staging differed in one stage while in 75 cases (29.8%) it differed in two or more stages. In 222 eyes (88.1%), the Sandali staging was higher compared to the Amsler one. These results show that the two classifications are not fully interchangeable: the Amsler–Krumeich classification is more appropriate in identifying and longitudinally monitoring patients with early stages of KC, while the Sandali classification for the diagnosis and follow-up of patients with more advanced stages, particularly when a surgical planning has to be chosen.

scholarly journals Risk factors and evaluation of keratoconus progression after penetrating keratoplasty with anterior segment optical coherence tomography

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Junko Yoshida ◽  
Tetsuya Toyono ◽  
Rika Shirakawa ◽  
Takashi Miyai ◽  
Tomohiko Usui
Keyword(s):  
Risk Factors ◽  
Optical Coherence Tomography ◽  
Penetrating Keratoplasty ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Optical Coherence ◽  
Graft Size ◽  
Corneal Power ◽  
Corneal Thinning

Abstract To determine the risk factors and unique characteristics of keratoconus (KC) progression after penetrating keratoplasty (PK), anterior segment optical coherence tomography parameters were statistically analyzed in comparison with eyes undergoing PK for other diseases as a control. Ninety-one eyes maintaining clear PK grafts for over 10 years were divided into 2 groups according to the primary indication for PK (KC vs Others groups). Corneal thinning indicators (inferior host thinnest corneal thickness/central corneal thickness [IHT/CCT], inferior graft thinnest corneal thickness/CCT [IGT/CCT]), were smaller whereas anterior chamber depth, and steepest corneal power (Ks), and maximum corneal power (Kmax) were larger in the KC group with statistical significance. Graft size, Kmax and Ks correlated with IHT/CCT and IGT/CCT in the KC group. These correlations were not detected in controls. Graft size and postoperative period were selected by multivariate regression analysis as factors for corneal ectatic changes in the KC group. In conclusion, KC eyes long after PK show inferior graft and host corneal thinning, and corneal protrusion. Corneal power parameters such as Kmax or Ks can be used to monitor KC progression after PK. A small graft might lead to KC progression after PK.

scholarly journals Role of anterior segment optical coherence tomography in the evaluation of microbial keratitis

2021 ◽  
Vol 7 (3) ◽  
pp. 548-553
Author(s):  
Isha Chaturvedi ◽  
Kamaljeet Singh ◽  
Jagriti Rana ◽  
Kshama Dwivedi ◽  
Reena Sachan
Keyword(s):  
Optical Coherence Tomography ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Morphological Characteristics ◽  
Objective Evaluation ◽  
Response To Treatment ◽  
Optical Coherence ◽  
Microbial Keratitis ◽  
The Mean

Anterior segment optical coherence tomography (AS-OCT) is a newer technology that provides two-dimensional images of corneal infiltration. This study was undertaken to assess whether AS-OCT can aid objective evaluation and response to treatment in resolving microbial keratitis. This prospective study was performed on 17 patients of who underwent slit lamp and AS-OCT examination at presentation and follow up on days 3, 7, 14, 28 and 6 weeks. A standardized scanning protocol was used to measure the corneal thickness (CT) and infiltrate thickness (IT) using the caliper tool of a commercially available AS-OCT device. The mean CT in the infiltrated area and mean IT, both were thickest at presentation (710.88 um and 288.76 um respectively). The mean CT decreased to 665.12 µm, 650.24 µm, 584.35 µm, 549 µm, 507.47 µm on days 3, 7, 14, 28 and 6 weeks respectively. Similarly, the mean IT decreased to 287.24 µm, 244.41 µm, 197 µm, 174.59 µm and 154.82 µm. Paired t- test was used to calculate the statistical change in CT and IT, which was significant (p<0.0001) at 6 weeks, at the rate of 0.67% and 1.01% per day. AS-OCT can show morphological characteristics of microbial keratitis and give quantitative assessment at every follow up.

scholarly journals Using Anterior Segment Optical Coherence Tomography to Monitor Disease Progression in Peripheral Ulcerative Keratitis

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Aakriti Garg ◽  
Joaquin De Rojas ◽  
Priya Mathews ◽  
Albert Hazan ◽  
James Lin ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Multidisciplinary Approach ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Careful Monitoring ◽  
Laboratory Findings ◽  
Peripheral Ulcerative Keratitis ◽  
Ulcerative Keratitis ◽  
Corneal Thinning

We report two cases of peripheral ulcerative keratitis (PUK) imaged with anterior segment optical coherence tomography (AS-OCT). The first patient had prolonged nonsteroidal anti-inflammatory drug use, while the second had inflammatory arthritis by laboratory findings without any systemic findings as well as possible concurrent tuberculosis. In both patients, AS-OCT demonstrated corneal thinning at the onset of the disease with improvement six months after initiation of intensive medical therapy. Our cases highlight the need for a multidisciplinary approach and careful monitoring in PUK cases, especially with objective measures such as corneal thickness assessed with AS-OCT.

scholarly journals Anterior Segment Biometry with Phenylephrine and Tropicamide during Accommodation Imaged with Ultralong Scan Depth Optical Coherence Tomography

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Junna Zhang ◽  
Yang Ni ◽  
Peng Li ◽  
Wen Sun ◽  
Mengyun Liu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Crystalline Lens ◽  
Repeated Measurements ◽  
Optical Coherence ◽  
Posterior Surface ◽  
Optical Zone

Purpose. To investigate the influence of phenylephrine and tropicamide on anterior segment biometry with ultralong scan depth optical coherence tomography (UL-OCT) during accommodation. Methods. In this study, 20 left eyes of healthy volunteers with a mean ± standard deviation age of 31.05 ± 5.84 years and a mean refraction of −1.16 ± 1.11 diopters (range 0∼−3.0 D) were imaged using UL-OCT after instillation of artificial tears, phenylephrine, and tropicamide in three follow-up trials, respectively. At each follow-up trial, two repeated measurements were performed at states of relax and 5D accommodative stimulation. The dimensional parameters included central corneal thickness (CCT), anterior chamber depth (ACD), pupil diameter (PD), lens thickness (LT), and horizontal radii of the lens anterior and posterior surface curvatures (LAC and LPC). Results. Tropicamide led to larger pupil, deeper ACD, thinner LT, and flatter crystalline lens surface (P<0.05). Phenylephrine induced an increase in PD (P<0.05), while no significant changes were seen in ACD, LT, LAC, and LPC (P>0.05). CCT did not change after both phenylephrine and tropicamide instillation in this study (P>0.05). Tropicamide induced the loss of accommodation and phenylephrine achieved pupil dilation without affecting the accommodation. PD, ACD decreased, LT increased significantly and the anterior and posterior surface of the lens in a 6.294 mm of diameter optical zone became steeper during accommodation after administration of phenylephrine (P<0.05). Conclusion. The anterior segment physiology changed after tropicamide instillation. Besides, tropicamide induced the loss of accommodation and phenylephrine preserved the accommodation with a larger pupil. And, the anterior and posterior surface of lens in a 6.294 mm of diameter optical zone became steeper during the accommodation.

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

Spontaneous attachment of complex Descemet’s membrane detachment following multiple failed interventions

2021 ◽  
Vol 14 (8) ◽  
pp. e243960
Author(s):  
Shikha Gupta ◽  
Karthikeyan Mahalingam ◽  
Tushar Agarwal
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Corneal Transplant ◽  
Optical Coherence ◽  
Initial Attempt ◽  
Ocular Tissues ◽  
Surgical Interventions ◽  
Complicated Cataract ◽  
First Time

We describe a case with complex Descemet membrane detachment (DMD) which persisted despite initial two failed surgical attempts to appose the ocular tissues. However, over time, tissue alignment was obtained spontaneously. A 60-year-old woman, operated trabeculectomy, had a total DMD intraoperatively during a complicated cataract surgery. Initial attempt to DM repositioning with intracameral air injection failed. Anterior Segment Optical Coherence Tomography (ASOCT) showed detachment of both DM and pre-Descemet’s layer (PDL). After consultation with a corneal surgeon, patient was again attempted for Intra-operative Optical Coherence Tomography (iOCT)-guided settlement of DMD with intracameral air which again failed. So, the patient was registered for lamellar corneal transplant, but at 3 months follow-up, DM had spontaneously attached, confirmed on ASOCT. This case shows for the first time that even complex DMDs involving PDL, can spontaneously appose despite failed surgical interventions.

scholarly journals Correlation between Central Corneal Thickness and Degree of Myopia among Malaysian Patients Undergoing Laser Keratorefractive Surgery

2020 ◽  
pp. 52-58
Author(s):  
Sagili Chandrasekhara Reddy ◽  
Mohd Mansor Shariff ◽  
Aina Malindri Dasrilsyah
Keyword(s):  
Optical Coherence Tomography ◽  
Refractive Surgery ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Military Hospital ◽  
Moderate Degree ◽  
Optical Coherence ◽  
Corneal Refractive Surgery ◽  
The Mean

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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