Image analysis and Sheimpflug photography of anterior segment of the eye--a review

Abstract

Light scattering properties of the cornea and lens change in relation to age. This process is influenced by noxious factors which may induce the formation of cataracts. Four different camera types based on the Scheimpflug principle have been developed for documentation and evaluation of light scattering in the eye. Topcon SL-45. Zeiss SLC, Oxford CASE 2000, Nidek EAS 1000. Only the SL-45 and EAS 1000, however, have found a wider application in clinical and experimental studies. Documentation of the eye with a Scheimpflug system is performed in a dark room after mydriasis induction. The rotating axis of the camera is aligned to the optical axis of the eye with fixation devices. Four meridians have been found appropriate for routine documentation. Image analysis is based on peak height and distance evaluation of 2 layers in the cornea and 10 layers in the lens. Standardization devices allow correction of technical differences in the recording process. Evaluation of the ageing properties of the lens has evidenced typical density developments for each individual layer, the cortex increasing in density earlier than the nucleus. Cataract classification using a Scheimpflug camera provides an objective characterization of cataract type and progression. The outcome of surgical procedures changing the refractive power of the eye can be evaluated with a Scheimpflug camera as well. Its application in studies dealing with the ocular effects of Quinolones and HMG-CoA-reductase inhibitors, has demonstrated that Scheimpflug photography is the method of choice for establishment of a safety profile for a new drug. Scheimpflug photography has proven to be ideal for objective documentation of the anterior eye segment in human and animal eyes, although both documentation and image analysis demand technical expertise to be reproducible.