Segment Optical Coherence Tomography Findings Research Articles

Comparative Evaluation of Anterior Segment Optical Coherence Tomography Findings Following Accelerated Corneal Crosslinking Protocols Using Different Riboflavin Formulations and Soaking Durations

Purpose To comparatively evaluate the influence of different riboflavin formulations and soaking durations on the anterior segment optical coherence tomography (AS-OCT) findings following accelerated corneal crosslinking (ACXL) at 9 mW/cm2 for in progressive keratoconus. Methods In this prospective study, consecutive patients with progressive keratoconus were randomized into 4 groups. Group 1: hydroxypropyl methylcellulose (HPMC)-based riboflavin for 10 min; Group 2: HPMC-based riboflavin for 20 min; Group 3: dextran-based riboflavin (0.1%) for 30 min. Riboflavin soaking was followed by ultraviolet-A irradiation at 9 mW/cm2 for 10 min in all three groups. Group 4 underwent conventional CXL (CCXL) using Dresden protocol. The AS-OCT features of the crosslinked cornea were evaluated at postoperative month 1 and correlated to the clinical outcomes at postoperative month 12. Results The study enrolled 26 eyes of 26 patients in each group. In groups 1 and 2, the AS-OCT findings were similar (p > .05) and the demarcation lines depth (DLD) were deep as obtained following CCXL. The DLD was significantly shallower in group 3 compared to the other groups (p < .01). There were no between-group differences in regards to the visual, refractive, keratometric, and tomographic outcomes at postoperative month 12. No significant endothelial cell loss or any other clinically significant adverse event was encountered in any patient’s eye at 12 months follow-up. Conclusion Although structural variations were noted in the crosslinked cornea, DLDs observed following ACXL (9 mW/cm2) using HPMC-based solution for 10 or 20 min were similar to those observed following CCXL. Whereas, ACXL (9 mW/cm2) using dextran-based solution for 30 min resulted in the shallowest DLD. Despite these remodeling differences, the visual, refractive and tomographic outcomes of all groups were comparable at postoperative 1-year follow-up. Studies with a greater number of patients and longer follow-ups are required to establish any relation between AS-OCT characteristics of crosslinked cornea and ACXL efficacy.

Lenticule Intrastromal Keratoplasty for the Correction of Iatrogenic High Hyperopia.

The aim of this study was to evaluate the safety, efficacy, and predictability of lenticule intrastromal keratoplasty (LIKE) for the correction of iatrogenic high hyperopia. Three patients (4 eyes) were referred to our department because of overcorrection of myopia induced by femtosecond laser-assisted in situ keratomileusis. All eyes exhibited hyperopia (between +4.00 and +8.00 D) and thin corneas ranging from 307 to 378 μm. Because of the regression of the use of laser ablation to correct high hyperopia and thin corneas, we initially adopted LIKE to correct iatrogenic high hyperopia in all 4 eyes. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, corneal topography, and anterior segment optical coherence tomography findings were recorded during each follow-up evaluation. No postoperative complications, such as interface haze and opacification, were observed in the 4 eyes during each follow-up evaluation, with an average follow-up of 9.50 months. All eyes had significantly improved UDVA postoperatively. A total of 3 eyes achieved an UDVA of 20/25 or better while the other 1 eye had an UDVA of 20/40 postoperatively. In addition, 2 of the 4 eyes had a postoperative UDVA equal to or better than preoperative CDVA. No eyes lost any CDVA lines. All 4 eyes were within ±0.50 D of the spherical power (intended target of 0). The central corneal thickness and curvature of the anterior corneal surface in all 4 eyes increased postoperatively. Anterior segment optical coherence tomography revealed that the lenticule was transparent, with no wrinkles or offsets, during each follow-up evaluation. LIKE for the correction of iatrogenic hyperopia has good efficacy and safety. Although an extremely thin cornea after overcorrection may not be suitable for hyperopic laser enhancement, LIKE is a good choice because of its good predictability and ability to restore the normal corneal structure.

Anterior segment optical coherence tomography findings in the intrascleral migration of a 360-degree encircling band

Anterior segment optical coherence tomography findings in the intrascleral migration of a 360-degree encircling band

Ocular response analyzer and posterior segment optical coherence tomography findings in refractive surgery candidates

Aim The aim of the study was to report on the ocular response analyzer and posterior segment optical coherence tomography findings in refractive surgery candidates. Patients and methods The study was conducted on 100 eyes of 50 (37 females) patients seeking refractive surgery at a private eye center in Alexandria, Egypt. Following detailed history taking, all study participants were subjected to a thorough ophthalmic examination including assessment of uncorrected and best-corrected visual acuity, manifest and cycloplegic refraction, slit-lamp examination, measurement of intraocular pressure (IOP) using Goldmann applanation tonometry, and fundus examination using a high plus auxiliary lens. Optical coherence tomography and corneal biomechanical properties were then studied using the Reichert ocular response analyzer. Results The mean±SD age of the study patients was 25.27±4.9 years and of contact lens wear (24% of study patients) was 2.5±0.9 years. The mean±SD of the manifest refractive error was −5.6±5.2 D sphere and −1.6±1.2 D cylinder and of the best-corrected visual acuity was 0.9±0.2. The mean±SD of the IOPg, IOPcc, corneal hysteresis and cornea resistance factor were 14.9±3.8, 16.5±3.4, 9.3±1.9, and 9.4±2 mmHg, of the Peripapillary Retinal Nerve Fibre Layer (pRNFL) thickness were 68.9±20.5 μ nasal, 113.3±20.7 μ superior, 77.7±16 μ temporal, and 119.3±21.5 μ inferior and of the central macula thickness was 270.8±22.9 μ. Conclusions The corneal biomechanical properties and the macular nerve fiber layer thickness are not correlated with the refractive error of the eye, whereas the peripapillary nerve fiber layer thickness correlates with the refractive error and the visual acuity. Screening of the corneal biomechanical properties and the nerve fiber layers is recommended for refractive surgery candidates.

Anterior segment optical coherence tomography findings in the Infant Aphakia Treatment Study (IATS): a secondary analysis of a randomized clinical trial

To correlate the diagnosis of glaucoma among children in the Infant Aphakia Treatment Study (IATS) by age 10 years with anterior segment optical coherence tomography (AS-OCT) findings. A multicenter randomized controlled trial of 114 infants with unilateral congenital cataract who were 1-6 months of age at surgery. Data on long-term glaucoma-related status and outcomes were collected when children were 10.5 years old. Participants were randomized at cataract surgery to either primary intraocular lens (IOL) or no IOL implantation (contact lens [CL]). AS-OCT findings in eyes with glaucoma were compared to eyes which did not have glaucoma and to the fellow eyes, between fellow and treated eyes, and between the IOL and CL groups. There were no significant differences in the mean nasal and temporal anterior chamber angle (ACA) or mean nasal and temporal angle opening distance (AOD) for nonglaucomatous, glaucomatous, and fellow eyes (P = 0.31, 0.16, 0.43, 0.08 resp.). There were also no significant differences in mean nasal and temporal ACA and AOD between fellow and treated eyes (P = 0.44, 0.67, 0.57, 0.38 resp.), or between IOL and CL groups (P=0.36, 0.35, 0.49, 0.44, resp.). AS-OCT confirmed that eyes with glaucoma in IATS had predominantly open angles with similar ACA and AOD to eyes without glaucoma and to fellow eyes. Furthermore, congenital cataract surgery with or without an IOL did not result in a significant difference in ACA or AOD compared to fellow eyes in IATS.

Molluscum contagiosum of the corneal limbus in an AIDS patient: a clinicopathological case report

BackgroundMolluscum contagiosum, a pox virus infection, is likely to occur in the eyelid skin; however, corneal involvements by molluscum lesions are extremely rare. We report a case of molluscum contagiosum arising in the corneal limbus in an untreated AIDS patient, together with anterior segment optical coherence tomography (OCT) findings and histopathology of the excised tumor.Case presentationA 46-year-old man with AIDS was referred to our department for the management of an ocular lesion. Blood tests revealed an extremely low CD4+ T-cell count of 11 cells/μL, being strongly positive for anti-HIV antibody (591.36 S/CO) with a high copy number of HIV RNA (8070.0 × 100 copy/mL). Slit-lamp examination of his right eye showed a white nodule at the lower limbus. Anterior segment OCT findings of the nodule revealed a highly reflective elevated lesion, which was considered to involve the Bowman layer. The nodular lesion was excised from the limbus including the superficial corneal stroma, and then processed for histologic examination. Histopathology of the excised lesion showed acanthotic corneal epithelium containing swollen cells with eosinophilic inclusions known as molluscum bodies. He was diagnosed with molluscum contagiosum.ConclusionsAnterior segment OCT findings provide useful information for morphological evaluations of and preoperative strategies against molluscum contagiosum.

Anterior segment optical coherence tomography findings after penetrating keratoplasty

AbstractPurposeThis study aimed to assess the contribution of early anterior segment optical coherence tomography (AS‐OCT) after penetrating keratoplasty (PK) by analyzing the appositions of posterior graft‐host junction (GHJ), the tomographic aspect of the graft and the iridocorneal angle (ICA).MethodsA prospective cross‐sectional study including 33 eyes of 32 patients treated with penetrating keratoplasty for various preoperative diagnosis (hydrops, keratoconus, bullous keratopathy, infectious keratitis, ocular trauma, corneal perforation, corneal dystrophy and graft failure). All patients underwent complete ophthalmic examination. Early AS‐OCT (Day 1‐10 postoperative) was done to assess the posterior GHJ, the central corneal thickness, the posterior graft corrugations and the ICA. GHJ patterns were classified as well‐apposed, and mal‐apposed (gap, step, and protrusion). Tomographic features were correlated to best‐corrected visual acuity, and postoperative complications.ResultsThe mean early postoperative central corneal thickness was 643.63 μm. Posterior corrugations were found in 47% of cases, in patients with graft thickness higher than 590 μm. ICA was open except in 4 eyes, among them, two eyes presented anterior synechia, and developed ocular hypertension and graft rejection. A total of 132 graft‐ host cross‐sections were analyzed. 67% were well‐apposed and 33% were mal‐apposed. Steps have been noted in 8 eyes, followed by Gapes in 3 eyes, and Protrusion in 2 cases. Graft‐steps were present in 4 GHJ and all of these patients had keratoconus as a preoperative diagnosis. Among them, one eye underwent surgical revision for persistent graft edema. Host‐steps were detected in 4 mal‐apposed junctions. Best‐corrected visual acuity showed significant difference with the gap and step patterns of malapposition junctions.ConclusionsAS‐OCT is a non‐invasive imaging tool offering high‐resolution corneal imaging. It visualizes the posterior GHJ and ICA beyond a non‐transparent cornea. It is useful for evaluating and monitoring the PK outcomes allowing early detection and management of postoperative complications.

Anterior segment optical coherence tomography findings in epibulbar choristomas: Case Series

Anterior segment optical coherence tomography findings in epibulbar choristomas: Case Series

A comparison of posterior segment optical coherence tomography findings in full-term and preterm children without retinopathy of prematurity

Purpose:Structural differences have been described in the retina of prematurely born children, including increased macular thickness caused by failed migration of the inner retina during development and retinal nerve fiber layer (RNFL) thinning related to low birth weight. The present study aimed to evaluate the differences in macular and RNFL optical coherence tomography (OCT) findings between full-term and preterm children without retinopathy of prematurity (ROP).Methods:Thirty-four premature (study group) and 43 full-term patients (control group)—aged 3 to 8 years—were studied. All children underwent a complete ophthalmological exam and OCT of the macula and optic nerve in both eyes to determine macular and RNFL thickness and morphology. Correlation analysis between central macular thickness, age, and visual acuity was also performed.Results:Central macular thickness was greater in the study group than in the control group; a difference of 14.2 μm was observed for the right eye (P = 0.002) and 12.16 μm for the left eye (P = 0.019). The thickness of the parafoveal and the perifoveal zones was consistently greater in the study group. 44.3% of eyes in the study group had mild forms of foveal hypoplasia (grades 1a and 1b) in qualitative description. No correlation between central macular thickness and visual acuity was found. There was no difference in RNFL thickness between both groups.Conclusion:Statistically significant structural differences were found in the macula of premature children, with a greater foveal thickness possibly reflecting retention of the inner retina during development, with no repercussion over visual acuity. RNFL thickness was similar in both groups.

Anterior Segment Optical Coherence Tomography Findings in Corneal Blood Staining.

Anterior Segment Optical Coherence Tomography Findings in Corneal Blood Staining.

Clinical Features of Pingueculitis Revealed by Anterior Segment Optical Coherence Tomography Findings.

To investigate clinical features and treatment outcomes of pingueculitis with morphological assessments using anterior segment optical coherence tomography (AS-OCT). In this retrospective observational study, we examined 22 eyes of 22 patients with pingueculitis. All patients were treated with the same 2-week course of prednisolone acetate 1% drops four times per day. The clinical parameters evaluated were surface dimensions determined by slitlamp biomicroscopy, cross-sectional dimensions determined by AS-OCT, and symptom scores determined by patient surveys. Pretreatment and 1-month posttreatment values were compared with Wilcoxon signed-rank tests. Patients were followed up to 1 year after treatment. Twenty-two eyes from 22 patients (4 men and 18 women) with an average age of 37.7±8.8 (range, 27-57) years and an average duration of symptoms of 22 (range, 5-60) days were included. The average follow-up period was 14.7±0.8 (range, 12-22) months. Mean pretreatment horizontal length, vertical length, conjunctival thickness, and cross-sectional area were 2.4±0.69 mm, 2.0±0.6 mm, 1.82±0.60 μm, and 5.14±2.05 mm, respectively. Mean posttreatment horizontal length, vertical length, conjunctival thickness, and area were 1.93±0.5 mm, 1.52±0.6 mm, 1.03±0.46 μm, and 2.33±0.83 mm, respectively. Mean pretreatment and posttreatment dry eye symptom scores were 3.27±0.77 and 1.13±0.38, respectively. The median pretreatment and posttreatment changes were statistically significant by Wilcoxon signed-rank tests for horizontal length (P<0.001), vertical length (P<0.001), conjunctival thickness (P=0.003), cross-sectional area (P=0.003), and dry eye symptom scores (P<0.001). Anterior segment optical coherence tomography allows the quantification of differences in the pingueculitis measurements before and after treatment. In this retrospective study, a short course of topical steroids effectively treated the inflammation in a sustained manner. Anterior segment optical coherence tomography demonstrated significant reduction in the thickness and cross-sectional area of the pinguecula and a conversion back to a homogeneous conjunctival stroma.

Wound Integrity of 2.0 mm Transconjunctival Single-Plane Sclerocorneal Incision: A Comparison between a Motorized Injector with/without Pause Time and a Manual Injector.

Purpose. To compare the final incision size and wound structure after the intraocular lens implantation from 2.0 mm transconjunctival single-plane sclerocorneal incision (TSSI) between the use of a motorized injector at first speed and the use of a manual injector. Methods. Patients were divided into three groups as follows: Group A, a manual injector, Group B, a motorized injector with 0.5 s pause time, and Group C, a motorized injector without pause time. The change in incision size and anterior segment optical coherence tomography findings of the wound structure were analyzed. Results. 110 eyes were enrolled (Group A: 40, Group B: 30, and Group C: 40). The averaged change in incision size (mm) was 0.08, 0.01, and 0.03 in Groups A, B, and C, respectively (p < 0.001). The incision enlargement in Group A was statistically larger compared with other groups (p < 0.01). Descemet's membrane detachments were seen in 26, 9, and 27 eyes one day after the surgery in Groups A, B, and C, respectively (p = 0.001). The rate of Descemet's membrane detachment in Group B was significantly lower than other groups (p < 0.01). Conclusions. The use of a motorized injector by fastest setting with 0.5 s pause time is the best for less wound damage in 2.0 mm TSSI.

Anterior segment optical coherence tomography findings of iris granulomas in Hansen's disease: a case report

BackgroundA 50-year-old male was diagnosed to have a right eye sclerouveitis and left eye granulomatous anterior uveitis due to Hansen's disease. We are reporting the anterior segment optical coherence tomography (ASOCT) findings of iris granuloma in this case.FindingsSkin biopsy revealed plenty of acid fast bacilli with a bacteriological index of 5 suggestive of multibacillary polar lepromatous leprosy. ASOCT revealed well-demarcated smooth-surfaced nodular lesion with internal hyporeflectivity corresponding to the areas of granuloma which decreased in size following treatment with antileprosy drugs and systemic and topical steroids.ConclusionASOCT is a non-invasive technique to assess the extent of involvement of anterior segment in Hansen's disease and is a useful tool in follow-up. This is also the first report on ASOCT findings of iris granuloma in Hansen's disease.

Anterior Segment Optical Coherence Tomography Findings of Acute Hydrops in a Patient with Keratoconus

The authors describe the anterior segment optical coherence tomography (AS-OCT) findings of a 25-year-old patient with acute hydrops associated with keratoconus. The patient presented with decreased visual acuity, pain, and redness in the left eye. The symptoms, clinical presentation, and topographical findings of the right eye confirmed this condition to be acute corneal hydrops. The patient was closely followed up with hyper-osmotic (NaCl 5%) and nonsteroidal anti-inflammatory (ketorolac tromethamine 0.5%) topical treatment. At the initial examination and during follow-up, the evaluation of the anterior segment was performed using optical coherence tomography. Changes in the stroma and Descemet's membrane during the healing process of acute hydrops could be demonstrated by high-resolution AS-OCT.

Anterior Segment Optical Coherence Tomography Findings of Acute Hydrops in a Patient With Keratoconus

In this case report, the anterior segment optical coherence tomography (AS-OCT) findings of a 25-year-old patient with acute hydrops associated with keratoconus are described. The patient presented to our ophthalmology department in Turkey with decreased visual acuity, pain, and redness in the left eye. The symptoms, clinical presentation, and topographical findings of the right eye confirmed this condition to be acute corneal hydrops. The patient was closely observed with hyper-osmotic (NaCl 5%) and non-steroidal anti-inflammatory (ketorolac tromethamine 0.5%) topical treatment. At the initial examination and during follow-up, the evaluation of the anterior segment was performed using optical coherence tomography (Visante OCT; Carl Zeiss Meditec, Inc., Dublin, CA). By high-resolution AS-OCT, the changes in the stroma and Descemet's membrane during the healing process of acute hydrops were demonstrated.

One-Year Results and Anterior Segment Optical Coherence Tomography Findings of Descemet Stripping Automated Endothelial Keratoplasty Combined With Phacoemulsification

To report 1-year results and anterior segment optical coherence tomography findings of Descemet stripping automated endothelial keratoplasty combined with phacoemulsification in patients with cataract and Fuchs endothelial dystrophy. Twelve eyes of 11 patients with at least 1-year follow-up were retrospectively reviewed. Measured variables included best spectacle-corrected visual acuity, refractive spherical equivalent and predictability, anterior corneal keratometric values, complications, and anterior segment optical coherence tomography findings. The mean follow-up was 14.33 months (range, 12-18 months). The best spectacle-corrected visual acuity was unchanged (8%) or improved (92%) in all eyes compared with the preoperative levels. A mean (SD) discrepancy between the targeted postoperative refraction and the actual postoperative spherical equivalent refraction (hyperopic shift) of 1.46 (0.76) diopters (D) (range, -0.05 to 3.14 D) was observed. A significant correlation existed between the ratio of central graft thickness to mean peripheral donor corneal lenticule thickness at 3 mm and induced hyperopic shift (R(2) = 0.65, P < .001). Descemet stripping automated endothelial keratoplasty combined with phacoemulsification and intraocular lens implantation in patients with coexisting Fuchs endothelial dystrophy and cataract improved best spectacle-corrected visual acuity without progressive time-dependent complications. A correlation exists between donor corneal lenticule shape and induced hyperopic shift.