Continuous ultrasound biomicroscopic imaging of accommodative changes in the human ciliary body

Abstract

Slitlamp observations of the position of the ciliary body behind the iris root are possible only in cases of gross anatomic, and probably also functional, abnormalities. This study was performed to investigate physiological changes of the human ciliary body configuration during accommodation. We used the 50 MHz ultrasound biomicroscope to measure the ciliary body changes in 5 left eyes of normal subjects during accommodation, while the right eye, wearing corrective spectacles, focussed Snellen letters at a distance of 3 m. For desaccommodation plus lenses were utilized, while negative lenses were applied to blur vision as a stimulus for accommodation. During postprocessing the best images of the video sequence were recalled on a monitor and the profile of the ciliary body was manually drawn on a transparent folder. For interpretation we used a projection system with vector analysis. During accommodation there is a shift of the ciliary body anteriorly toward the scleral spur and in the direction of the lens equator. In 4 out of 5 eyes a contact between the ciliary body and the posterior iris surface could be demonstrated. There was a measurably widening of the anterior chamber angle in 3 out of 5 eyes. Ultrasoundbiomicroscopy seems to be a way for assessing ciliary body deformation during accommodation. Our results are in accordance with histologic and gonioscopic findings and confirm biomechanical theories of the accommodation process. Further investigations including online digital image processing will be necessary to evaluate accommodation in its complexity.