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We used an ultra-long scan depth optical coherence tomography (UL-OCT) system to investigate changes in axial biometry of pseudophakic eyes during pilocarpine- induced accommodation. The right eyes from 25 healthy subjects (age range 49 to 84 years) with an intraocular lens (IOL) were imaged twice in the non-accommodative and the accommodative states. A custom-built UL-OCT instrument imaged the whole eye. Then accommodation was induced by two drops of 0.5% pilocarpine hydrochloride separated by a 5-minute interval. Following the same protocol, images were acquired again 30 minutes after the first drop. The central corneal thickness (CCT), anterior chamber depth (ACD), IOL thickness (IOLT), and vitreous length (VL) were obtained using custom automated software. The axial length (AL) was calculated by summing the CCT, ACD, IOLT, and VL. With accommodation, ACD increased by +0.08 ± 0.09 mm, while the VL decreased by -0.04 ± 0.09 mm (paired t-test each, P<0.05). CCT and IOLT remained constant during accommodation (P > 0.05). The non-accommodative AL was 23.47 ± 0.93 mm, and it increased by +0.04 ± 0.04 mm after accommodation (P<0.01). The AL increased and the IOL moved backward during pilocarpine-induced accommodation in pseudophakic eyes.

Objectives: To analyze the dynamic relationship between ocular geometrical structure and high-order aberrations (HOAs) in teal-time during accommodation of human eye., Methods: A custom-built spectral domain optical coherence tomography (OCT) system with high-speed and ultra-long scan depth was used to image the anterior segment, whereas a Shack-Hartmann wavefront sensor was used to detect the whole-eye aberration. A Badal optometer with switched visual targets was integrated with this system to induce 0 and 3.00 D accommodative stimuli. Three young adult subjects were measured and the structural parameters of anterior segment were measured from OCT images and accommodative response and HOAs were calculated and exponentially fitted in real time during the accommodation., Results: The dynamic process from nonaccommodation to 3.00 D accommodation results in reduced pupil diameter, shallower anterior chamber depth, and increased crystalline lens thickness. After an accommodative active time, the RMS of the HOAs changes sharply when an accommodative stimulus is introduced and then tends to be stable. The accommodative response time and velocity are characterized by fitted parameters. The individual differences of changing in HOAs between subjects can be explained by the different sign and changing tendency of certain terms of aberration coefficients in form of Zernike polynomials during the accommodation., Conclusions: Based on the integrated ocular measurement platform including OCT system and wavefront sensor, our research demonstrated how the morphology of the human anterior segment affect the aberration in real time during accommodation. The dynamic relationship between them helps us to deeply understand the mechanism of accommodation.

Purpose: We investigated the dynamic response of human accommodative elements as a function of age during accommodation using synchronized spectral domain optical coherence tomography devices (SD-OCT)., Methods: We enrolled 33 left eyes from 33 healthy subjects (age range, 20-39 years, 17 males and 16 females). Two SD-OCT devices were synchronized to simultaneously image the anterior segment through pupil and the ciliary muscle during 6.00 diopter (D) accommodation for approximately 3.7 seconds in two repeated measurements. The anterior segment parameters included the lens thickness (LT), radius of curvature of the lens anterior surface (LAC), maximum thickness of ciliary muscle (CMTMAX), and anterior length of the ciliary muscle (CMAL). A first-order exponential equation was used to fit the dynamic changes during accommodation. The age-related changes in the dynamic response and their relationship were calculated and compared., Results: The amplitude (r = -0.40 and 0.53 for LT and LAC, respectively) and peak velocity (r = -0.65 and 0.71 for LT and LAC, respectively) of the changes in LT and LAC significantly decreased with age (P < 0.05), whereas the parameters of the ciliary muscle remained unchanged (P > 0.05), except for the peak velocity of the CMAL (r = 0.44, P = 0.01). The difference in the time constant between the lens reshaping (LT and LAC) and CMTMAX increased with age (r = 0.46 and 0.57 for LT and LAC, respectively, P < 0.01). The changes in LT and LAC per millimeter of CMTMAX change decreased with age (r = -0.52 and -0.34, respectively, P < 0.05). The ciliary muscle forward movement correlated with the lens deformation (r = -0.35 and 0.40 for amplitude, while r = 0.36 and 0.58 for time constant, respectively, P < 0.05)., Conclusions: Age-related changes in the lens reshaping and ciliary muscle forward movement were found. Lens reshaping was much slower than the contraction of the ciliary muscle, especially in aging eyes, and this process required the ciliary muscle to contract more to reach a given response.

Objective: To test accuracy and repeatability of a software algorithm that performs automatic biometry of the anterior segment of the human eye imaged with long scan depth optical coherence tomography (OCT)., Methods: The ocular anterior segment imaging was performed with custom-built long scan depth OCT. An automatic software algorithm including boundary segmentation, image registration, and optical correction was developed for fast and reliable biometric measurements based on the OCT images. The boundary segmentation algorithm mainly used the gradient information of images and applied the shortest path search based on the dynamic programming to optimize the edge finding. The automatic algorithm was validated by comparison of the biometric dimensions between automatic and manual measurements and repeatability study., Results: Biometric dimensions of the anterior segment, including central corneal thickness, anterior chamber depth, pupil diameter, crystalline lens thickness, and radii of curvature of the anterior and posterior surfaces of lens, were obtained by the automatic algorithm successfully. There were no significant differences between the automatic and manual measurements for all biometric dimensions. The intraclass correlation coefficients (ICC) of agreement between automatic and manual measurements ranged from 0.85 to 0.98. The coefficients of repeatability and ICC for all automatic dimensions were satisfactory (1.1%-6.1% and 0.663-0.990, respectively)., Conclusions: The high accuracy, good repeatability, and fast execution speed for automatic measurement of the anterior segment dimensions on the OCT images were demonstrated. The application of this automatic biometry is promising for investigating dynamic changes of human anterior segment during accommodation in real time.

Purpose: To investigate changes of whole eye axial biometry during accommodation using ultra-long scan depth optical coherence tomography (UL-OCT)., Design: Prospective, observational case series., Methods: Twenty-one adult subjects were enrolled. Using UL-OCT, the left eye of each subject was imaged with relaxed diopters (0 D) and accommodative stimuli (+6 D). Full eye biometry included central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness, vitreous length, and axial length (AL)., Results: During accommodation (+6 D), the axial biometry of the whole eye changed significantly. Compared to the rest state, ACD at the accommodative state decreased significantly from 3.128 ± 0.305 mm to 2.961 ± 0.298 mm (paired t test, P < .001). The lens thickness increased significantly from 3.723 ± 0.237 mm to 3.963 ± 0.234 mm (P < .001). The vitreous length decreased significantly from 17.129 ± 0.864 mm to 17.057 ± 0.848 mm (P < .001). AL was 24.519 ± 0.917 mm at the rest state and increased to 24.545 ± 0.915 mm with +6 D accommodation stimulus. The elongated AL of 26.1 ± 13.4 μm between the rest and accommodative states was significant (P < .001)., Conclusions: During accommodation, whole eye axial biometry changed, including a decrease in ACD and vitreous length and an increase in lens thickness and AL. UL-OCT provides an alternative method that is suitable for full eye biometry during accommodation., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: Spectral-domain optical coherence tomography (SD-OCT) was used to automatically measure accommodative biometric changes in the anterior segment of eyes implanted with an intraocular lens (IOL). The repeatability and reliability of the automated measurements were also evaluated., Methods: Long scan depth SD-OCT was used to image the anterior segment of eyes implanted with IOLs. A fully automated algorithm was used to detect the boundaries of the cornea and IOL and yielded the measurements. The results included anterior segment dimensions in IOL eyes and the deflection of the IOLs. Automated measurements were validated in vitro and compared with the manual results in vivo on 15 cross-sectional images from patients with IOLs. Five eyes with five different types of IOLs, respectively, were enrolled to test the repeatability of the automated measurements during accommodation., Results: Intraocular lens central thickness and anterior and posterior curvature radii measured by long scan depth SD-OCT in vitro and in a model eye matched well with those determined by a micrometer caliper and interferometer. In vivo, there was good correlation of the biometric data determined by automated and manual segmentations (P<0.05, r-value range: 0.635-0.997). There were no significant differences for any variable between the two measurements at each accommodative state (P>0.05). Anterior chamber depth and pupil diameter showed significant changes between the nonaccommodative and 2.5-D accommodative states (P<0.05), whereas the shape of the IOLs did not change significantly (P>0.05)., Conclusions: The long scan depth SD-OCT with the automated algorithm was verified to have a great potential in studying accommodative biometric changes of the anterior segment in eyes with IOLs and IOL deflections.

Purpose: We investigated the relationships between the ocular anterior segment biometry and the ocular high-order aberrations (HOAs) during accommodation by combined ultralong scan depth optical coherence tomography (UL-OCT) and wavefront sensor., Methods: We enrolled 35 right eyes of young healthy subjects (21 women and 14 men; age, 25.6 ± 3.1 years; spherical equivalent refractive error, -0.41 ± 0.59 diopters [D]). A custom-built UL-OCT and a wavefront sensor were combined. They were able to image the ocular anterior segment and to measure the HOAs during accommodation. The differences in the biometric dimensions and in the HOAs between the nonaccommodative and accommodative states were compared, and the relationships between them were investigated., Results: Compared to the nonaccommodative condition, anterior chamber depth, pupil diameter, and radii of the crystalline lens surface curvatures decreased significantly, while the lens thickness and root-mean-square of high-order aberration (HORMS) of fixed 3-mm pupil size increased under the accommodative stimulus (P < 0.01). A negative correlation was found between the change in the radius of the lens anterior surface curvature and the change in HORMS (r = -0.370, P = 0.014). For nonaccommodative and accommodative conditions, HORMS for a fixed pupil size was correlated negatively with pupil diameter (r = -0.532 and -0.801, respectively, P < 0.01)., Conclusions: The anterior segment biometry and the HOAs changed significantly during accommodation. The increase in HOAs mainly was due to the increased convexity of the anterior surface of the lens during accommodation. Contraction of the pupil may help to decrease HOAs.