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Anterior segment optical coherence tomography (AS-OCT) as a new method of detecting copper deposits forming the Kayser-Fleischer ring in patients with Wilson disease
摘要： Purpose: Kayser–Fleischer ring pathognomonic for Wilson disease (WD) is formed of corneal copper deposits present predominantly within the anterior chamber angle at the Schwalbe’s line. The slit-lamp assessment commonly used as a standard of care cannot detect them early enough, as the angle view is obscured by the corneal limbus. The aim of the research was to evaluate the anterior segment optical coherence tomography (AS-OCT), as objective diagnostic assessment of copper deposits forming KF ring in patients with WD. Methods: Twenty-nine subjects (17 women) and twenty-nine controls (14 women) were enrolled and underwent slit lamp and AS-OCT assessment. Results: Kayser–Fleischer ring was not detected – either with a slit lamp or with AS-OCT – in any of the controls. Fifteen subjects presenting without KF ring at a slit-lamp examination were found to have a KF ring when examined with AS-OCT (p < 0.001), which confirms improved accuracy of AS-OCT, as compared to the slit-lamp examination. Conclusion: Our results support AS-OCT as a diagnostic procedure to offer better objectivity and accuracy as compared to a slit-lamp examination, both at the diagnostic stage and when monitoring changes in KF ring during medical therapy to assess its efficacy and patient compliance.
关键词： anterior segment optical coherence tomography,Kayser–Fleischer ring,Wilson disease,copper deposit
更新于2025-09-23 15:22:29
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Estimation of Intraocular Lens Power Calculation after Myopic Corneal Refractive Surgery: Using Corneal Height in Anterior Segment Optical Coherence Tomography
摘要： Purpose: To investigate the feasibility of estimating effective lens position (ELP) and calculating intraocular lens power using corneal height (CH), as measured using anterior segment optical coherence tomography (AS-OCT), in patients who have undergone corneal refractive surgery. Methods: This study included 23 patients (30 eyes) who have undergone myopic corneal refractive surgery and subsequent successful cataract surgery. The CH was measured with AS-OCT, and the measured ELP (ELPm) was calculated. Intraocular lens power, which could achieve actual emmetropia (Preal), was determined with medical records. Estimated ELP (ELPest) was back-calculated using Preal, axial length, and keratometric value through the SRK/T formula. After searching the best-fit regression formula between ELPm and ELPest, converted ELP and intraocular lens power (ELPconv, Pconv) were obtained and then compared to ELPest and Preal, respectively. The proportion of eyes within a defined error was investigated. Results: Mean CH, ELPest, and ELPm were 3.71 ± 0.23, 7.74 ± 1.09, 5.78 ± 0.26 mm, respectively. The ELPm and ELPest were linearly correlated (ELPest = 1.841 × ELPm – 2.018, p = 0.023, R = 0.410) and ELPconv and Pconv agreed well with ELPest and Preal, respectively. Eyes within ±0.5, ±1.0, ±1.5, and ±2.0 diopters of the calculated Pconv, were 23.3%, 66.6%, 83.3%, and 100.0%, respectively. Conclusions: Intraocular lens power calculation using CH measured with AS-OCT shows comparable accuracy to several conventional methods in eyes following corneal refractive surgery.
关键词： Intraocular lens power calculation,Corneal height,Corneal refractive surgery,Effective lens position,Anterior segment optical coherence tomography
更新于2025-09-23 15:22:29
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Haab striae: Optical coherence tomographic analysis
摘要： Purpose. — To study Haab striae in adults with primary congenital glaucoma and describe them by anterior segment optical coherence tomography, as well as analyze their evolution over the patient’s lifetime. Material and methods. — Three patients with primary congenital glaucoma were recruited, aged between 17 and 48 years old, with incidentally noted Haab striae on glaucoma consultation. They were studied by: slit lamp; anterior segment optical coherence tomography, Heidelberg Engineering Inc., Germany, (with anterior segment module) and Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, California, USA (with 3D reconstruction); and specular biomicroscopy. The results obtained were contrasted with other studies performed in children. Results. — Rounded excrescences protruding towards the anterior chamber were found, as well as dense, irregular tissue between them. In addition, endothelial abnormalities (polymegathism and polymorphism) were found. These findings fit the evolution of those obtained in pediatric studies and remain stable in adult life. Conclusions. — Through noninvasive methods such as optical coherence tomography and specular biomicroscopy, it is possible to make the diagnosis and follow up these patients. The findings suggest posterior corneal topographic changes; additional studies on this subject may be necessary.
关键词： Haab striae,Primary congenital glaucoma,Anterior segment optical coherence tomography,Corneal endothelium,Specular biomicroscopy
更新于2025-09-23 15:22:29
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Anterior Segment Optical Coherence Tomography of Previously Operated Extraocular Muscles
摘要： Background and Purpose: To assess the possibility of determining the insertion distance from the limbus of previously operated extraocular rectus muscles (EOM) with the Heidelberg Spectralis anterior segment optical coherence tomography (AS-OCT). Patient and Method: Subjects with a history of previous strabismus surgery underwent AS-OCT of the EOM before planned additional strabismus surgery. The EOM insertion distances from the limbus were measured pre-operatively on the AS-OCT and compared to the caliper distance measured during the strabismus surgery. Results: Ten previously operated muscles on nine subjects underwent AS-OCT before subsequent additional strabismus surgery. Four additional un-operated muscles subsequently operated on, were also imaged with the AS-OCT pre-operatively. Subject ages ranged from 13-52 years old (mean± SD; 27.9 ± 13.2). The muscle insertion could be definitely identified in 6/10 muscles previously operated and 4/4 un-operated muscles. The difference between the two measurements oflimbus to insertion in previously operated muscles was :-:;1mm in 3/6, and :-:;1.5mm in 6/6; <1mm in 4/4 un-operated muscles. Of the four insertions not readily identifiable, two revealed the presence of the muscle with scar tissue; the other two, the muscle insertions, were not visible, which showed that the muscle was at least a minimal amount from the limbus. Conclusion: Our study showed that the Heidelberg AS-OCT is capable of imaging previously operated EOM, which can give valuable information to the strabismus surgeon. The information from the AS-OCT was useful in all cases. The insertion to limbus measurements between pre-operative and intra-operative were within 1.5mm in all ofthe cases that the muscle insertion was able to be identified. The ability to accurately image EOM insertions has significant implications for the pre-operative procedure planning in previously operated and complicated strabismus patients.
关键词： extraocular muscle,anterior segment optical coherence tomography,strabismus surgery
更新于2025-09-23 15:21:01
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Femtosecond laser-integrated anterior segment optical coherence tomography to detect preexisting posterior capsular dehiscence and increase safety in posterior polar cataracts
摘要： To determine the efficacy of the femtosecond laser with integrated anterior segment optical coherence tomography (AS-OCT) for the detection of posterior capsular dehiscence in posterior polar cataracts (PPCs). To evaluate the safety of phacoemulsification in these eyes undergoing femtosecond laser–assisted cataract surgery (FLACS).
关键词： posterior polar cataracts,anterior segment optical coherence tomography,femtosecond laser,posterior capsular dehiscence,phacoemulsification
更新于2025-09-19 17:13:59
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Iris Morphological Features in Patients with 360° Angle-Closure Neovascular Glaucoma: An Anterior Segment Optical Coherence Tomography Study
摘要： Purpose: To investigate iris morphological features in 360° angle-closure neovascular glaucoma (NVG) by swept-source anterior segment optical coherence tomography (ASOCT). Patients and Methods: In this retrospective, clinic-based, comparative study, 14 patients with 360° angle-closure NVG and 14 healthy age-matched control subjects were enrolled. All patients enrolled had no prior glaucoma surgery but underwent cataract surgery with intraocular lens implantation. Horizontal scanning images of swept-source ASOCT were analyzed using software calipers in temporal and nasal angle areas. The iris thickness at 1 and 2 mm from the pupil edge, iris length, trabecular meshwork length, peripheral anterior synechia (PAS) length, PAS height ratio (PAS length/trabecular meshwork length), and pupil diameter were measured. Results: Between the groups, there were no statistically significant differences in iris length, trabecular meshwork length, and pupil diameter (p > 0.05). However, the iris thickness was significantly reduced in the NVG group compared with the control group in the temporal and nasal areas (0.306 vs. 0.563 mm/0.326 vs. 0.645 mm at 1 mm, 0.278 vs. 0.523 mm/0.282 vs. 0.546 mm at 2 mm, respectively) (mean, all p < 0.001). In the NVG group, PAS height ratios were 1.55 ± 0.45 (mean ± standard deviation) (range, 0.58–2.30) and 1.55 ± 0.78 (range, 0.68–3.68) at the temporal and nasal angles, respectively. Conclusions: In patients with 360° angle-closure NVG, the iris thickness decreased to about 50% of that in healthy subjects, and the PAS length exceeded the trabecular meshwork length by about 1.5 times.
关键词： Neovascular glaucoma,Angle closure,Peripheral anterior synechia,Anterior segment optical coherence tomography
更新于2025-09-10 09:29:36
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Corneal stromal demarcation line after 4 protocols of corneal crosslinking in keratoconus determined with anterior segment optical coherence tomography
摘要： We read with great interest the recent publication by Spadea et al. about the depth of corneal stromal demarcation lines after the following 4 corneal crosslinking (CXL) protocols: epi-off Dresden (C-CXL), epi-off accelerated (TE-CXL), enhancers-assisted transepithelial (A-CXL), and iontophoresis-assisted CXL (I-CXL). The authors conclude that the difference in CXL efficiency estimated by the demarcation line would only be secondary to the stromal penetration of riboflavin and ultraviolet-A light. They suggest that because I-CXL had better stromal penetration, it would also have greater CXL efficacy.
关键词： anterior segment optical coherence tomography,Corneal stromal demarcation line,keratoconus,corneal crosslinking
更新于2025-09-10 09:29:36
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Assessment of Schlemm’s canal in acute primary angle closure: an anterior segment optical coherence tomography study
摘要： Purpose To image and quantitatively evaluate the Schlemm’s canal (SC) dimensions in the eyes with acute primary angle closure (APAC) with anterior segment optical coherence tomography (AS-OCT), and compare it with the SC measurements taken after the control of intraocular pressure (IOP) and in the normal age-matched controls. Materials and methods Seventeen eyes of 14 patients with the newly diagnosed APAC and 59 age-matched normal subjects underwent AS-OCT to image SC. SC cross-sectional area, SC meridional and coronal diameters were measured in the temporal and nasal regions at 3 and 9 o’clock position. After laser iridotomy and control of the IOP, all SC parameters were measured again at a week later, in APAC eyes. the SC Intrasession intraobserver reliability of measurements was assessed with intraclass correlation coef?cient. Results Mean SC-SCA (10,600 ± 2691 lm2), SC meridional (682 ± 125 lm) and coronal diameters (21.2 ± 8.2 lm) showed a signi?cant increase in the APAC eyes at presentation, when compared to the SC parameters measured at a week later (6499 ± 1754 lm2, 450 ± 169 lm and 15.75 ± 8.6 lm, p = \ 0.0001, \ 0.0001 and 0.01, respectively) and in the normal controls (7192 ± 1022 lm2, 499.2 ± 179.8 lm, p = 0.02, \ 0.0001, 0.01, respectively). There was no difference in the measured SC parameters between the normal controls and APAC eyes, when the parameters were measured at a week, after resolution of the acute attack (all p [ 0.05). Conclusion A signi?cant expansion of SC was observed in the APAC eyes at presentation, when compared to the normal controls and after the acute attack resolved. SC parameters may provide a useful research tool for evaluating morphological changes in the SC in APAC eyes, during an acute attack.
关键词： Schlemm’s canal,Anterior segment optical coherence tomography,Acute primary angle closure
更新于2025-09-09 09:28:46