Abstract
PurposeTo assess the effects of age and refractive status on anterior segment anatomical structures, including the ciliary body, using a new swept-source anterior segment optical coherence tomography (AS-OCT) device.MethodsThis prospective observational study included 63 healthy volunteers (mean age: 44.2 years). Images of the anterior segment were obtained using a new swept-source AS-OCT (ANTERION, Heidelberg Engineering GmbH, Heidelberg, Germany) with tracking and image averaging from the right eye of all participants. Repeatability as well as inter- and intra-observer reliability of biometric measurements were evaluated. The impact of image tracking and averaging on ciliary muscle measurements was tested. Univariate and multivariable statistical models were developed to evaluate the relationship of age and refractive status on anterior segment biometric measurements.ResultsFor all test-retest repeatability and inter- and intra-observer reproducibility of swept-source AS-OCT measurements, high intraclass correlation (ICC) was noted (0.88–1.00). The nasal maximum ciliary muscle thickness (CMTMAX) and distance between scleral spur to the thickest point of the ciliary muscle (SSMAX) were larger than those on the temporal side (p<0.001 and p = 0.006, respectively). Nasal and temporal CMTMAX (p = 0.004 and p<0.001, respectively) and lens thickness (p<0.01) increased with age. Nasal and temporal SSMAX decreased with older age and increasing hyperopia (p = 0.01 and p<0.001, respectively). Image averaging resulted in improved ciliary muscle measurements (p = 0.008 to 0.02). Lens vault increased with older age and increased hyperopia (p<0.01). OCT measurements of the angle decreased with older age and increased hyperopia (p<0.001 to 0.03). Aqueous depth decreased with older age and increased hyperopia (p<0.01). Pupil diameter decreased with older age (p<0.01).ConclusionsRepeatability and reproducibility of biometric measurements using the ANTERION AS-OCT were excellent. Image averaging improved the accuracy of ciliary muscle measurements. The device produced measurements of biometric parameters that described superficial and deep structures including the ciliary body and full lens thickness from a single image.
Highlights
Optical coherence tomography (OCT) was described over 20 years ago [1], with widespread use
Posterior segment OCT measurements are highly repeatable so that they can be considered advantageous to functional visual end-points during FDA-trials of age-related macular degeneration and inherited retinal diseases [2]
anterior segment optical coherence tomography (AS-OCT) has been developed for clinical purposes [3, 4]
Summary
Optical coherence tomography (OCT) was described over 20 years ago [1], with widespread use. Posterior segment OCT is nearly standard-of-care for every patient presenting with the posterior-segment disease around the macula and nerve. Posterior segment OCT measurements are highly repeatable so that they can be considered advantageous to functional visual end-points during FDA-trials of age-related macular degeneration and inherited retinal diseases [2]. AS-OCT has been developed for clinical purposes [3, 4]. It is widely used for research but less so during clinical care (compared to posterior-segment OCT) as not every patient with suspected anterior segment alteration necessarily receives AS-OCT. Limitations of AS-OCT include the absence of image tracking for image averaging and longitudinal follow-up, and the need to better capture the entire anterior segment in one image
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