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The aim of the study was to compare the anterior segment parameters after cataract surgery in pseudoexfoliation syndrome (PEX) and control eyes. We conducted a prospective comparative study of 36 eyes (PEX group), 16 eyes (PEXG group) and 46 eyes (control group) of 98 patients after phacoemulsification with intraocular lens implantation. Before surgery, 1 week, 1 month and 3 months postoperatively, anterior chamber parameters were evaluated by swept source anterior segment optical coherence tomography (AS-OCT). Anterior chamber depth (ACD), angle opening distance (AOD500/750), trabecular-iris space area (TISA500/750), trabecular-iris angle (TIA500/750) and lens vault (LV) were assessed at each study visit. Preoperatively, ACD, AOD500/750 and TISA500/750 were significantly smaller, while LV was significantly greater in PEX and PEXG eyes than in controls. 3 months postoperatively all irido-corneal parameters and ACD were significantly greater in all study groups without intergroup differences. ACD and LV significantly increased in PEX group between 1 and 3 months after surgery while being stable in control group. Relative increases in ACD, AOD500, TISA750, TIA500/750 were significantly higher in PEX and PEXG groups than in controls. Our study finds that ACD and iridocorneal parameters in AS-OCT demonstrated significantly greater relative increases 3 months after phacoemulsification in PEX and PEXG groups than in control eyes. Significantly greater deepening of anterior chamber and opening of the irido-corneal angle may be a reason for different refractive outcomes and IOP control in patients with PEX and PEXG after routine cataract surgery. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the magnitude of IOL transversal shift (ITS) after phacoemulsification and to analyse the factors contributing to IOL decentration and ITS. Methods: 94 consecutive patients who underwent cataract surgery and IOL implantation was enrolled. Each patient underwent anterior segment optical coherence tomography with CASIA 2 (Tomey, Nagoya, Japan) to assess crystalline lens decentration, thickness and diameter seven days preoperatively and at one and sixty days postoperatively. Univariate and multivariate linear regression analysis were performed to evaluate the determinants of ITS and final decentration. Results: The preoperative crystalline lens diameter was associated with the ITS and with the IOL final decentration. A positive association between the final IOL decentration and the first post-surgical day decentration was found (p < 0.0001). Conclusion: Greater crystalline lens diameter was associated with greater decentration and with greater ITS. Day-one IOL decentration seems to be the main determinant of final IOL decentration. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the effects of external dacryocystorhinostomy (DCR) surgery on tear meniscus parameters and assess its relationship with improvements in quality of life (QoL) in patients with nasolacrimal duct obstruction (NLDO). Methods: This prospective study included 30 patients diagnosed with NLDO who underwent external DCR surgery. Tear meniscus (TM) parameters, including height, depth and area, were measured using anterior segment optical coherence tomography. Lacrimal symptom questionnaire (LacQ), Munk scores and Glasgow benefit inventories (GBI) were collected. Statistical analysis was performed to evaluate the correlation between tear meniscus changes and improvements in QoL. Results: TM height, depth and area decreased from preoperative median measurements (0.09 mm2, 0.37 mm, 0.56 mm) to postoperative median measurements (0.03 mm2, 0.21 mm, 0.30 mm) (p < 0.001). Lacrimal symptom scores and Munk scores showed a significant improvement at 3-month postoperatively (p < 0.001). The GBI scores also demonstrated a significant improvement, indicating a positive impact on the patients’ QoL. (p < 0.001). A statistically significant correlation was found between the change in TM parameters and LacQ lacrimal symptom scores. Conclusion: External DCR surgery leads to significant improvements in tear meniscus parameters and quality of life outcomes in patients with NLDO. The decreased in TM height and TM area indicates improved tear film dynamics and decreased tear volume, which positively impact the patients’ ocular comfort and overall well-being. This study highlights the importance of tear meniscus evaluation as a potential market for assessing the success of DCR surgery and its impact on patients’ QoL. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the corneal epithelial thickness by anterior segment OCT in children with vernal keratoconjunctivitis (VKC) compared to normal participants. Patient and methods: A cross-sectional case control observational study was conducted on children aged from 5 to 18 years with VKC. The study included 142 eyes divided into two groups: 71 eyes of VKC group and 71 eyes of age matched control group. Anterior segment OCT epithelial mapping for the central 5-mm was done to evaluate epithelial thickness-based variables. Results: Corneal epithelial thickness mapping showed significant superior thinning (51.07 ± 4.11) μm in VKC group compared to controls (52.54 ± 2.01) μm (p = 0.008), a decreased MIN epithelial thickness (45.99 ± 6.52) μm compared to controls (50.11 ± 1.91) μm (p < 0.001) and more negative (MIN–MAX) value (− 11.77 ± 9.38) indicating focal epithelial thinning compared to (− 5.80 ± 1.88) in controls (p = 0.001). In palpebral VKC, MIN epithelial thickness showed significant thinning (48. 38 ± 3.45) μm compared to controls (50.11 ± 1.91) μm (p = 0.001). Eyes with mixed VKC showed superior epithelial thinning (50.70 ± 4.59) μm compared to (52.54 ± 2.01) μm in controls (p = 0.025) and significant decreased MIN epithelial thickness (43.78 ± 7.83) μm compared to (50.11 ± 1.91) μm in control group. Conclusions: VKC is a disease primarily affecting the corneal epithelium. Corneal epithelial thickness mapping may be considered to assess the integrity of the ocular surface in eyes with VKC, and to detect corneal epithelial changes. Disease phenotype may influence the corneal epithelial changes, and the disease duration is another factor influencing these changes. [ABSTRACT FROM AUTHOR]

Aim: To evaluate a useful, non-contact method for the follow-up of pericardium patch graft changes in patients undergoing PAUL® Glaucoma Implant (PGI) surgery using high-resolution anterior segment optical coherence tomography (OCT) to predict tube erosions.Prospective analysis over six months of tube pericardium patch graft thickness of PGI surgical cases at the University Eye Hospital Bonn, Germany, from November 2021 to August 2022. In all eyes, Tutopatch® (RTI Surgical, United States) pericardium was used to cover the implant intra-operatively. Anterior segment OCT (AS-OCT, Heidelberg ANTERION® Swept-Source-OCT) examinations were performed following a standardized protocol to measure quantitative and qualitative aspects of the patch grafts before surgery, and at three and six months after surgery.Twenty-six eyes of 26 patients were included. Thickness of the patch material was 1188 µm (IQR 415 µm) directly after implantation and decreased over time to 1068 µm (IQR 478 µm) at 3 months and 846 µm (IQR 677 µm) at 6 months. No significant differences between groups were shown concerning gender (p = 0.128), ethnicity (p = 1.000), age (p = 0.741), glaucoma type (p = 0.173), other concurrent diseases (p = 0.302), former glaucoma surgeries (p = 1.000) and the quadrant of implantation (p = 0.555). Five eyes developed implant exposure. When comparing eyes with and without tube exposure, no significant differences were shown in average patch thickness above the tube directly after implantation (p = 0.476). However, significant differences in average thickness were observed at 3 months (p = 0.013) and 6 months (p = 0.005).Pericardial patch grafts tend to thin over time which can be assessed by AS-OCT, the latter proving to be a useful method to follow-up patients who undergo patch graft implantation during PGI surgery. This investigation could potentially help identify patients at risk of tube exposure which in turn could lead to modification of patient management. It could also possibly be used in future studies to find more suitable patch materials.Methods: To evaluate a useful, non-contact method for the follow-up of pericardium patch graft changes in patients undergoing PAUL® Glaucoma Implant (PGI) surgery using high-resolution anterior segment optical coherence tomography (OCT) to predict tube erosions.Prospective analysis over six months of tube pericardium patch graft thickness of PGI surgical cases at the University Eye Hospital Bonn, Germany, from November 2021 to August 2022. In all eyes, Tutopatch® (RTI Surgical, United States) pericardium was used to cover the implant intra-operatively. Anterior segment OCT (AS-OCT, Heidelberg ANTERION® Swept-Source-OCT) examinations were performed following a standardized protocol to measure quantitative and qualitative aspects of the patch grafts before surgery, and at three and six months after surgery.Twenty-six eyes of 26 patients were included. Thickness of the patch material was 1188 µm (IQR 415 µm) directly after implantation and decreased over time to 1068 µm (IQR 478 µm) at 3 months and 846 µm (IQR 677 µm) at 6 months. No significant differences between groups were shown concerning gender (p = 0.128), ethnicity (p = 1.000), age (p = 0.741), glaucoma type (p = 0.173), other concurrent diseases (p = 0.302), former glaucoma surgeries (p = 1.000) and the quadrant of implantation (p = 0.555). Five eyes developed implant exposure. When comparing eyes with and without tube exposure, no significant differences were shown in average patch thickness above the tube directly after implantation (p = 0.476). However, significant differences in average thickness were observed at 3 months (p = 0.013) and 6 months (p = 0.005).Pericardial patch grafts tend to thin over time which can be assessed by AS-OCT, the latter proving to be a useful method to follow-up patients who undergo patch graft implantation during PGI surgery. This investigation could potentially help identify patients at risk of tube exposure which in turn could lead to modification of patient management. It could also possibly be used in future studies to find more suitable patch materials.Results: To evaluate a useful, non-contact method for the follow-up of pericardium patch graft changes in patients undergoing PAUL® Glaucoma Implant (PGI) surgery using high-resolution anterior segment optical coherence tomography (OCT) to predict tube erosions.Prospective analysis over six months of tube pericardium patch graft thickness of PGI surgical cases at the University Eye Hospital Bonn, Germany, from November 2021 to August 2022. In all eyes, Tutopatch® (RTI Surgical, United States) pericardium was used to cover the implant intra-operatively. Anterior segment OCT (AS-OCT, Heidelberg ANTERION® Swept-Source-OCT) examinations were performed following a standardized protocol to measure quantitative and qualitative aspects of the patch grafts before surgery, and at three and six months after surgery.Twenty-six eyes of 26 patients were included. Thickness of the patch material was 1188 µm (IQR 415 µm) directly after implantation and decreased over time to 1068 µm (IQR 478 µm) at 3 months and 846 µm (IQR 677 µm) at 6 months. No significant differences between groups were shown concerning gender (p = 0.128), ethnicity (p = 1.000), age (p = 0.741), glaucoma type (p = 0.173), other concurrent diseases (p = 0.302), former glaucoma surgeries (p = 1.000) and the quadrant of implantation (p = 0.555). Five eyes developed implant exposure. When comparing eyes with and without tube exposure, no significant differences were shown in average patch thickness above the tube directly after implantation (p = 0.476). However, significant differences in average thickness were observed at 3 months (p = 0.013) and 6 months (p = 0.005).Pericardial patch grafts tend to thin over time which can be assessed by AS-OCT, the latter proving to be a useful method to follow-up patients who undergo patch graft implantation during PGI surgery. This investigation could potentially help identify patients at risk of tube exposure which in turn could lead to modification of patient management. It could also possibly be used in future studies to find more suitable patch materials.Conclusions: To evaluate a useful, non-contact method for the follow-up of pericardium patch graft changes in patients undergoing PAUL® Glaucoma Implant (PGI) surgery using high-resolution anterior segment optical coherence tomography (OCT) to predict tube erosions.Prospective analysis over six months of tube pericardium patch graft thickness of PGI surgical cases at the University Eye Hospital Bonn, Germany, from November 2021 to August 2022. In all eyes, Tutopatch® (RTI Surgical, United States) pericardium was used to cover the implant intra-operatively. Anterior segment OCT (AS-OCT, Heidelberg ANTERION® Swept-Source-OCT) examinations were performed following a standardized protocol to measure quantitative and qualitative aspects of the patch grafts before surgery, and at three and six months after surgery.Twenty-six eyes of 26 patients were included. Thickness of the patch material was 1188 µm (IQR 415 µm) directly after implantation and decreased over time to 1068 µm (IQR 478 µm) at 3 months and 846 µm (IQR 677 µm) at 6 months. No significant differences between groups were shown concerning gender (p = 0.128), ethnicity (p = 1.000), age (p = 0.741), glaucoma type (p = 0.173), other concurrent diseases (p = 0.302), former glaucoma surgeries (p = 1.000) and the quadrant of implantation (p = 0.555). Five eyes developed implant exposure. When comparing eyes with and without tube exposure, no significant differences were shown in average patch thickness above the tube directly after implantation (p = 0.476). However, significant differences in average thickness were observed at 3 months (p = 0.013) and 6 months (p = 0.005).Pericardial patch grafts tend to thin over time which can be assessed by AS-OCT, the latter proving to be a useful method to follow-up patients who undergo patch graft implantation during PGI surgery. This investigation could potentially help identify patients at risk of tube exposure which in turn could lead to modification of patient management. It could also possibly be used in future studies to find more suitable patch materials. [ABSTRACT FROM AUTHOR]

Purpose: To compare iris affectation in cytomegalovirus anterior uveitis (CMVAU), rubella virus-associated uveitis (RVU), and healthy contralateral eyes, using swept-source anterior segment optical coherence tomography (SS-AS-OCT). Materials and methods: A comparative, transversal, retrospective study examining 60 eyes from 30 patients—18 eyes (17 patients) with CMVAU, 14 eyes (13 patients) with RVU, and 28 healthy eyes—was performed. Six-millimeter cross-sectional SS-AS-OCT B-scans were obtained in each iris quadrant. Images were exported to ImageJ®. Qualitative and quantitative analyses were done: stromal thickness (ST), smooth index (SI), and optical density (OD) of pigment epithelium. Comparisons between measurements and clinical-demographic parameters were performed using SPSS®. Results: Qualitative analysis showed extensive damage in iris stroma but was unable to differentiate between both uveitis. RVU eyes had a lower mean ST (315.72 μm ± 42.4) compared to those with CMVAU (348.6 μm ± 46) (p = 0.047) and a lower ST in the upper (338.9 μm ± 38.52)/(386.25 μm ± 47.2) (p = 0.005) and temporal (281.5 μm ± 57.3)/(326.43 μm ± 62.3) (p = 0.016) quadrants. Mean (0.94 ± 0.02)/(0.9 ± 0.03) (p = 0.001), temporal (0.94 ± 0.02)/(0.89 ± 0.03) (p < 0.001), and nasal SI (0.094 ± 0.02)/(0.9 ± 0.04) (p = 0.005) were higher in RVU. OD was similar in both uveitis. In healthy eyes, mean ST (376.8 μm ± 39.7) was higher and mean SI was lower (0.87 ± 0.04) than in RVU (p < 0.001) and CMVAU eyes (p = 0.032). Mean OD was higher in healthy eyes (911 ± 130) than in CMVAU eyes (800 ± 200) (p = 0.037). Conclusions: The quantitative analysis of the SS-AS-OCT iris images allows for the differentiation between healthy eyes and those with CMVAU and RVU, as well as between both uveitis. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the agreement and reliability of anterior segment optical coherence tomography (AS-OCT) and Scheimpflug imaging in measuring the distance from the anterior edge of an iris-fixated phakic intraocular lens (IF-pIOL) to the corneal endothelium. Methods: Anterior segment configuration was assessed in a total of 62 eyes of which 25 hyperopic and 37 myopic eyes, all corrected with an IF-pIOL. Measurements were performed by two independent observers using AS-OCT (Visante, Model 1000, Carl Zeiss Meditec Inc.) and Scheimpflug imaging (Pentacam HR, Oculus Optikgerate). The distance from the anterior edge of the pIOL to the endothelium was measured in five different positions using both modalities with their corresponding pIOL software. The measurements as well as the inter- and intra-observer reliability of the two imaging modalities were then compared. Results: Distance measurements for all positions performed by AS-OCT were found to be significantly larger than those performed by Scheimpflug imaging, with mean differences ranging from 0.11 to 0.22 mm. Both instruments exhibited good inter- and intra-observer reliability. Conclusion: Anterior pIOL edge to endothelium distance measurements by AS-OCT and Scheimpflug imaging have good intra- and inter-observer reliability. However, as AS-OCT provides larger measurements, these two modalities cannot be used interchangeably. Correction of this difference might be essential for proper decision-making during pre-operative screening for pIOL implantation and post-operative safety monitoring. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of scleral-fixated intraocular lens (IOL) tilt on visual outcomes. Methods: Ninety-four eyes of consecutive 94 patients who underwent scleral-fixated IOL implantation with Z-suture technique were included in this prospective study. The values of pre- and postoperative 12th month uncorrected visual acuity (UCVA), cylindrical refractive error, best-corrected visual acuity (BCVA) and corneal and lenticular astigmatism were recorded. The position of the implanted IOL was evaluated with anterior segment optical coherence tomography (AS-OCT). The relationships between the AS-OCT measurements and the visual acuity or refractive errors were investigated. Results: The IOL position was evaluated as tilted in 68 (72.3%) patients: 29 (30.8%) in both vertical + horizontal axes, 30 (31.9%) in the horizontal axis and 9 (9.6%) in the vertical axis. There were no significant differences between patients with and without tilt IOL position in terms of the UCVA, BCVA, cylindrical refractive error and lenticular astigmatism (p > 0.05, for each). The mean BCVA was significantly higher in the no-tilt group than in the both horizontal + vertical tilt and the vertical tilt groups (p = 0.03, p = 0.04, respectively). The mean lenticular astigmatism was significantly higher in the vertical tilt group than the other groups (p = 0.04). Conclusion: Tilting in IOL position occurs commonly; however, IOLs with tilting on any of the axes do not have significantly worse outcomes when compared with IOLs with no tilt, in terms of visual results and refractive errors. On the other hand, tilting on the vertical axis is observed less commonly, yet is more effective on visual results and refractive errors, when compared with tilting on the horizontal axis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to describe findings demonstrated by anterior segment spectral domain optical coherence tomography (AS-OCT) in various types of deeply embedded corneal foreign bodies. Methods: In this experimental study, an ex vivo model of calf eyes was used and seven different foreign bodies were deeply embedded in the cornea, consisting of five different materials: glass, plastic, metal, wood, and pencil graphite. The eyes were photographed and then scanned by AS-OCT. The images were analyzed to determine distinguishing characteristics for each material. Results: Various materials presented unique characteristics in AS-OCT. The opaque materials (pencil graphite, metals, and wood) demonstrated a hyper-reflective anterior border, whereas the posterior border signal could not be clearly identified due to the shadowing effect. Moreover, a chain of signals was characteristic of both pencil graphite and metals though a "mirroring effect" was unique for metals. Wood, as an opaque material, appears as a hyper-reflective mass with a spectrum of penetrability depending on the degree of concentration. Transparent materials demonstrated hyper-reflective sharp borders when surrounded by air or fluid, as opposed to when being embedded purely in the corneal stroma. Conclusions: This study shows that AS-OCT was used to systematically define a novel set of distinguishing characteristics specific to various materials extruding from the cornea, fully embedded in the cornea, and intruding into the anterior chamber. Hopefully, the described characteristics of each material can aid clinicians in diagnosing the type of the material embedded and the depth of its involvement in ocular injury. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to use Triton® SweptSource OCT to evaluate the morphology of blebs formed when eyes are treated with XEN® implants and to compare these with the blebs in successfully functioning eyes after trabeculectomy (TB) and with eyes of healthy controls. Methods: A cross-sectional, observational study. We analyzed 25 eyes, 15 after TB and 10 with XEN® implants, comparing them with 23 healthy eyes (controls). We evaluated the conjunctival morphology of the eyes using AS-OCT. The main parameters evaluated were bleb height, sub-epithelial fibrosis, epithelial thickness, and changes in intraocular pressure (IOP). Results: We found that the filtering blebs formed in eyes in which a XEN® stent was implanted were significantly flatter (bleb height 417 ± 183 μm) than the blebs formed in TB eyes (bleb height 618 ± 256 μm, p < 0.05). Moreover, sub-epithelial fibrosis did not develop in any of the blebs produced by the XEN stent, whereas some fibrosis was evident in 40% of the blebs that formed after TB (p < 0.05). The epithelium was thicker when the XEN implant was used (65 ± 18.5 μm) than when eyes underwent TB (60 ± 17.7 μm), and it was thicker than in control eyes (51 ± 9.7 μm, p < 0.05). Moreover, the decrease in the IOP induced by the XEN® stent (− 8.5 ± 5.3 mmHg) was similar to that produced by TB (− 8.8 ± 5.2 mmHg, p > 0.05). Conclusions: Filtering blebs obtained after the introduction of a XEN® stent were morphologically distinct to those produced by TB, and they are more similar to the healthy conjunctiva. [ABSTRACT FROM AUTHOR]

Purpose: To investigate prospectively the characteristics in the higher-order aberrations and anterior segment tomography in patients with pathologic myopia. Methods: One hundred and twelve consecutive highly myopic patients (mean age 43.4 ± 9.3 years, spherical equivalent of refractive error ≥8 D and an axial length ≥26.5 mm) were studied. Thirty-seven emmetropic individuals (mean age 37.0 ± 14.5 years, spherical equivalent of refractive error ≤ ±1 D) were analyzed as controls. The ocular and cornea higher-order aberrations were measured using a Hartmann-Shack wavefront sensor (KR-1W; Topcon Corporation, Tokyo, Japan). The crystalline lens rise, the angle-to-angle, and the white-to-white values were measured using anterior segment OCT (SS-1000; Tomey Corporation, Nagoya, Japan). The mean curvature of the anterior corneal surface, the thickness at the thinnest central corneal point, the location of the central corneal point, the corneal volume, the anterior chamber volume, and the anterior chamber depth were measured using the Pentacam HR (Oculus, Inc., Wetzlar, Germany). Results: The ocular total higher-order aberration for 4-mm pupil, the ocular spherical aberrations, and internal spherical aberration for 6-mm pupil were significantly higher in highly myopic eyes than in the emmetropic controls. The crystalline lens rise was significantly smaller in highly myopic eyes than in the emmetropic controls. The anterior chamber depth and the anterior chamber volume were significantly larger in highly myopic eyes than in the emmetropic controls. Conclusion: Highly myopic eyes had higher-order aberrations than emmetropic eyes because of the increasing internal aberrations. [ABSTRACT FROM AUTHOR]

The aim of this study is to compare a portable spectral domain optical coherence tomography (SD-OCT) device with a non-portable SD-OCT for the identification of anterior chamber angle parameters based on location of Schwalbe's line (SL) and to measure their reproducibility. 99 eyes from 46 normal, healthy participants underwent imaging of the inferior iridocorneal angle with the iVue and Cirrus SD-OCT under well-controlled low-light conditions. SL-angle opening distance (SL-AOD) and SL-trabecular iris space area (SL-TISA) were measured by masked, certified graders at the Doheny Image Reading Center using customized Image J grading software. Inter- and intrainstrument, as well as inter- and intraobserver reproducibility of SL-AOD and SL-TISA measurements were evaluated with intraclass correlation coefficients (ICCs) and Bland-Altman plots with limits of agreement. The mean SL-AOD was 0.814 ± 0.315 mm with the iVue and 0.797 ± 0.294 mm with the Cirrus. The mean SL-TISA was 0.247 ± 0.112 mm with iVue and 0.259 ± 0.113 mm with Cirrus. Interinstrument correlation coefficients ( r) were 0.93 ( P < 0.0001), 0.92 ( P < 0.0001), and 0.92 ( P < 0.0001) for SL_AOD and SL_TISA, respectively. Intraclass correlation coefficient showing the degree of agreement among SL-AOD and SL-TISA was 0.923 (95 % confidence interval 0.885-0.948) and 0.921 (95 % confidence interval 0.883-0.947) for both devices. The agreement for intrainstrument (ICCs > 0.95), intragrader (ICCs > 0.93), and intergrader (ICCs > 0.96) was excellent. Excellent agreement between the two devices was also documented with Bland-Altman analysis. Both instruments provide consistent and reproducible measurements of anterior chamber angle metrics. [ABSTRACT FROM AUTHOR]

Purpose: Graves' orbitopathy (GO) is an extraocular eye disease with symptoms ranging from minor discomfort from dry eyes to strabismus and visual loss. One of the hallmarks of active GO is visible hyperemia at the insertion of the extraocular muscles. The aim of the present study was to evaluate the use of enhanced-depth imaging spectral domain anterior segment optical coherence tomography (EDI SD AS-OCT) for detecting pathological changes in horizontal recti muscles of patients with GO. Methods: Prospective cross sectional study of 27 eyes. Only women were included. EDI AS-OCT was used to measure the thickness of the tendons of the horizontal recti muscles in a predefined area in patients with GO and healthy controls. Results: EDI AS-OCT was able to image the tendons of the horizontal recti muscles in both healthy controls and patients suffering from GO. The mean thickness of the medial rectus muscle (MR) tendon was 256.4 μm [±17.13 μm standard deviation (SD)] in the GO group and, therefore, significantly thicker ( p = 0.046) than in the healthy group which had a mean thickness of 214.7 μm (±5.516 μm SD). There was no significant difference in the mean thickness of the tendon of the lateral recti muscles (LRs) between these groups. Conclusion: This is the first report showing that EDI AS-OCT is suitable to detect swelling at the insertion site of the MR muscle in GO. MR tendon thickness may be a useful parameter to monitor activity in these patients. [ABSTRACT FROM AUTHOR]

Background: To investigate anterior scleral thickness in a cohort of healthy subjects using enhanced depth imaging anterior segment optical coherence tomography. Methods: Observational case series. The mean scleral thickness in the inferonasal, inferotemporal, superotemporal, and superonasal quadrant was measured 2 mm from the scleral spur on optical coherence tomography in healthy volunteers. Results: Fifty-three eyes of 53 Caucasian patients (25 male and 28 female) with an average age of 48.6 years (range: 18 to 92 years) were analysed. The mean scleral thickness was 571 μm (SD 84 μm) in the inferonasal quadrant, 511 μm (SD 80 μm) in the inferotemporal quadrant, 475 (SD 81 μm) in the superotemporal, and 463 (SD 64 μm) in the superonasal quadrant. The mean scleral thickness was significantly different between quadrants ( p < 0.0001, repeated measures one-way ANOVA). The association between average scleral thickness and age was statistically significant ( p < 0.0001, Pearson r = 0.704). Conclusions: Enhanced depth imaging optical coherence tomography revealed the detailed anatomy of the anterior sclera and enabled non-invasive measurements of scleral thickness in a non-contact approach. The anterior scleral thickness varies significantly between quadrants, resembling the spiral of Tillaux. An association of increasing scleral thickness with age was found. [ABSTRACT FROM AUTHOR]

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Purpose: To study quantitative changes in anterior chamber angle (ACA) after laser peripheral iridotomy (LPI) in narrow-angle eyes using anterior segment optical coherence tomography (AS-OCT). Methods: Eighteen subjects with narrow angles were imaged with AS-OCT for determining test-retest variability. Forty-six participants with narrow angles were scanned with AS-OCT before LPI and 4 weeks after LPI. The presence of ACA closure by both AS-OCT imaging and gonioscopy was compared before and after LPI. Three ACA parameters by AS-OCT, angle opening distance at 500 μm (AOD), trabecular-ris space area at 500 μm (TISA) and angle recess area at 500 μm (ARA), at both nasal and temporal quadrants were incorporated for analysis. The increment of ACA parameters defined as exceeding the 95% confidence interval of test-retest variability was assessed after LPI. Results: All 3 parameters obtained from the 18 eyes showed good measurement reproducibility (intraclass correlation coefficient 0.850-0.979). Persistent angle closure was detected in 23.9% of eyes by gonioscopy, and in 34.8% of eyes by AS-OCT images at temporal quadrant after LPI. When assessed by measurement variability criteria, the percentage of eyes that showed no significant change in ACA parameters ranged from 23.9% to 45.7% after LPI. Conclusions: Overall, ACA parameters changed significantly after LPI; however, when assessed by AS-OCT, ACA remained unchanged in some narrow-angle eyes despite LPI. Our findings suggest that multiple causes other than pupillary block may contribute to narrow-angle closure following LPI. [ABSTRACT FROM AUTHOR]

PurposeTo compare the performance of anterior chamber volume (ACV) and anterior chamber depth (ACD) obtained using Scheimpflug imaging with angle opening distance (AOD500) and trabecular-iris space area (TISA500) obtained using spectral domain anterior segment optical coherence tomography (SD-ASOCT) in detecting narrow angles classified using gonioscopy.MethodsIn this prospective, cross-sectional observational study, 265 eyes of 265 consecutive patients underwent sequential Scheimpflug imaging, SD-ASOCT imaging, and gonioscopy. Correlations between gonioscopy grading, ACV, ACD, AOD500, and TISA500 were evaluated. Area under receiver operating characteristic curve (AUC), sensitivity, specificity, and likelihood ratios (LRs) were calculated to assess the performance of ACV, ACD, AOD500, and TISA500 in detecting narrow angles (defined as Shaffer grade ≤1 in all quadrants). SD-ASOCT images were obtained at the nasal and temporal quadrants only.ResultsTwenty-eight eyes (10.6%) were classified as narrow angles on gonioscopy. ACV correlated with gonioscopy grading (P<0.001) for temporal (r=0.204), superior (r=0.251), nasal (r=0.213), and inferior (r=0.236) quadrants. ACV correlated with TISA500 for nasal (r=0.135, P=0.029) and temporal (P=0.160, P=0.009) quadrants and also with AOD500 for nasal (r=0.498, P<0.001) and temporal (r=0.517, P<0.001) quadrants. For detection of narrow angles, ACV (AUC=0.935; 95% confidence interval (CI) =0.898-0.961) performed similar to ACD (AUC=0.88, P=0.06) and significantly better than AOD500 nasal (AUC=0.761, P=0.001), AOD500 temporal (AUC=0.808, P<0.001), TISA500 nasal (AUC=0.756, P<0.001), and TISA500 temporal (AUC=0.738, P<0.001). Using a cutoff of 113 mm3, ACV had 90% sensitivity and 88% specificity for detecting narrow angles. Positive and negative LRs for ACV were 8.63 (95% CI=7.4-10.0) and 0.11 (95% CI=0.03-0.4), respectively.ConclusionsACV measurements using Scheimpflug imaging outperformed AOD500 and TISA500 using SD-ASOCT for detecting narrow angles. [ABSTRACT FROM AUTHOR]

AimsTo report corneal endothelial cell loss and in vivo visualization of the Ahmed glaucoma valve implant in eyes with refractory glaucoma.MethodsTen eyes underwent Ahmed valve implant surgery and were followed-up for 12 months. Data collected included intraocular pressure (IOP), number of antiglaucoma medications and surgery-related complications. At 6 and 12 months postoperatively, the intracameral length of the drainage tube (ICL) and the distance between the tube and the cornea (T–C distance), and the iris (T–I distance) were assessed using anterior segment optical coherence tomography (AS-OCT). Heidelberg cornea tomograph II (HRT II) was used to measure the corneal endothelial cell density.ResultsMean (±SEM) preoperative IOP was 29.5±4 mmHg. Mean postoperative IOP was 11.6±2 at 12 months (P<0.01). Over a 6-month period, mean corneal endothelial loss was 7.9%±2.5 in the central and 7.5%±2.4 in the peripheral cornea (P<0.01). There was no correlation between central or peripheral corneal endothelial cell loss and the T–C, T–I distance or the ICL of the tube.ConclusionsCorneal endothelial cell loss occurs following Ahmed valve implant surgery, this appears to be multifactorial. AS-OCT and HRT II are promising methods for the follow-up of patients with a glaucoma drainage device. [ABSTRACT FROM AUTHOR]