Search

Objective In the past 20 years, the research application of anterior segment optical coherence tomography (AS-OCT) in the field of glaucoma has become a hot topic, but there is still a lack of bibliometric reports on this scientific field. The aim of this study is to explore the research hotspots and trends in the field using bibliometric methods. Method Analyzing literature from 2004 to 2023 on AS-OCT in glaucoma within the SCI database, this study utilized Bibliometric, VOS viewer, and Cite Space for a comprehensive bibliometric analysis covering document counts, countries, institutions, journals, authors, references, and keywords. Results A total of 931 eligible articles were collected, showing a continuous increase in annual research output over the past 20 years. The United States, China, and Singapore were the top three countries in terms of publication volume, with 288, 231, and 124 articles, respectively, and there was close cooperation among these countries. The NATIONAL UNIVERSITY OF SINGAPORE, SUN YAT SEN UNIVERSITY, and SINGAPORE NATIONAL EYE CENTRE were the most productive institutions with 93, 92, and 87 articles, respectively. JOURNAL OF GLAUCOMA, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, and OPHTHALMOLOGY were the journals with the highest number of publications, with 86, 69, and 46 articles, respectively. PROGRESS IN RETINAL AND EYE RESEARCH, published in the United States, was the top-cited journal. Researchers Aung Tin, He Mingguang, and David S. Friedman were highlighted for their contributions. The reference clustering was divided into 12 categories, among which “deep learning, anterior segment” were the most cited categories. The keywords of research frontiers include deep learning, classification, progression, and management. Conclusion This article analyses the academic publications on AS-OCT in the diagnosis and treatment of glaucoma over the last 20 years. Among them, the United States contributed the largest number of publications in this field, with the highest number of literature citations and mediated centrality. Among the prolific authors, aung, tin topped the list with 77 publications and 3,428 citations. Since the beginning of 2018, advances in artificial intelligence have shifted the focus of research in this field from manual measurements to automated detection and identification of relevant indicators.

Copyright of Journal of Computer Engineering & Applications is the property of Beijing Journal of Computer Engineering & Applications Journal Co Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Most cases of microsporidial keratoconjunctivitis are found in the Southern hemisphere. Our purpose was to investigate the first outbreak of microsporidial keratoconjunctivitis in Japan among healthy, immunocompetent soccer players from the same team during a 1-month period. Case presentation This study is an observational case series. The medical records were analyzed for five cases with microsporidial keratoconjunctivitis who presented within September 2022. All five cases were males between 28 and 36 years old. These previously healthy individuals belonged to the same football team. Their eyes were considered susceptible to contaminated water or dirt from the turf at game and practice sites. All cases involved unilateral conjunctivitis, with scattered round white lesions that showed positive fluorescein staining in the corneal epithelium. All cases experienced diminution of vision in the affected eye. In three cases, direct smears showed spores of approximately 2–3 μm in diameter. Polymerase chain reaction (PCR) analysis of corneal scrapes revealed partial amplification of microsporidial 18 S ribosomal RNA gene in four cases. Sequences of PCR products from all four cases showed 100% identity with strains of Vittaforma corneae previously reported from an outbreak in Singapore. All cases were treated with topical therapy, including voriconazole, fluorometholone, and levofloxacin. Four eyes underwent corneal scraping. After treatment, all eyes healed without residual opacities. Conclusions Only a few sporadic case reports of this disease have previously been reported in Japan. We detected V. corneae in our case series, representing what appears to be the first outbreak of microsporidial keratoconjunctivitis in Japan. Exposure to contaminated water or soil, in addition to inadequate sanitary facilities, represents a potential source of infection. Further investigations to clarify the characteristics of microsporidia seem warranted.

Background: Most cases of microsporidial keratoconjunctivitis are found in the Southern hemisphere. Our purpose was to investigate the first outbreak of microsporidial keratoconjunctivitis in Japan among healthy, immunocompetent soccer players from the same team during a 1-month period. Case presentation: This study is an observational case series. The medical records were analyzed for five cases with microsporidial keratoconjunctivitis who presented within September 2022. All five cases were males between 28 and 36 years old. These previously healthy individuals belonged to the same football team. Their eyes were considered susceptible to contaminated water or dirt from the turf at game and practice sites. All cases involved unilateral conjunctivitis, with scattered round white lesions that showed positive fluorescein staining in the corneal epithelium. All cases experienced diminution of vision in the affected eye. In three cases, direct smears showed spores of approximately 2–3 μm in diameter. Polymerase chain reaction (PCR) analysis of corneal scrapes revealed partial amplification of microsporidial 18 S ribosomal RNA gene in four cases. Sequences of PCR products from all four cases showed 100% identity with strains of Vittaforma corneae previously reported from an outbreak in Singapore. All cases were treated with topical therapy, including voriconazole, fluorometholone, and levofloxacin. Four eyes underwent corneal scraping. After treatment, all eyes healed without residual opacities. Conclusions: Only a few sporadic case reports of this disease have previously been reported in Japan. We detected V. corneae in our case series, representing what appears to be the first outbreak of microsporidial keratoconjunctivitis in Japan. Exposure to contaminated water or soil, in addition to inadequate sanitary facilities, represents a potential source of infection. Further investigations to clarify the characteristics of microsporidia seem warranted. [ABSTRACT FROM AUTHOR]

Objective: In the past 20 years, the research application of anterior segment optical coherence tomography (AS-OCT) in the field of glaucoma has become a hot topic, but there is still a lack of bibliometric reports on this scientific field. The aim of this study is to explore the research hotspots and trends in the field using bibliometric methods., Method: Analyzing literature from 2004 to 2023 on AS-OCT in glaucoma within the SCI database, this study utilized Bibliometric, VOS viewer, and Cite Space for a comprehensive bibliometric analysis covering document counts, countries, institutions, journals, authors, references, and keywords., Results: A total of 931 eligible articles were collected, showing a continuous increase in annual research output over the past 20 years. The United States, China, and Singapore were the top three countries in terms of publication volume, with 288, 231, and 124 articles, respectively, and there was close cooperation among these countries. The NATIONAL UNIVERSITY OF SINGAPORE, SUN YAT SEN UNIVERSITY, and SINGAPORE NATIONAL EYE CENTRE were the most productive institutions with 93, 92, and 87 articles, respectively. JOURNAL OF GLAUCOMA, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, and OPHTHALMOLOGY were the journals with the highest number of publications, with 86, 69, and 46 articles, respectively. PROGRESS IN RETINAL AND EYE RESEARCH, published in the United States, was the top-cited journal. Researchers Aung Tin, He Mingguang, and David S. Friedman were highlighted for their contributions. The reference clustering was divided into 12 categories, among which "deep learning, anterior segment" were the most cited categories. The keywords of research frontiers include deep learning, classification, progression, and management., Conclusion: This article analyses the academic publications on AS-OCT in the diagnosis and treatment of glaucoma over the last 20 years. Among them, the United States contributed the largest number of publications in this field, with the highest number of literature citations and mediated centrality. Among the prolific authors, aung, tin topped the list with 77 publications and 3,428 citations. Since the beginning of 2018, advances in artificial intelligence have shifted the focus of research in this field from manual measurements to automated detection and identification of relevant indicators., Competing Interests: The authors declare that they have no competing interests., (© 2024 Huang et al.)

A 74-year-old Japanese woman with a history of primary open-angle glaucoma (POAG) in both eyes underwent PreserFlo MicroShunt (PFM) (Osaka, Japan: Santen Pharmaceutical, Co., Ltd.) implantation two years prior. Despite slit-lamp examination and standard anterior segment optical coherence tomography (AS-OCT) evaluations, the detailed condition of the stents was unclear. By using raster scanning and three-dimensional (3D) AS-OCT imaging, stent deformation and displacement were clearly identified, including a C-shaped deformation in the right eye. This type of deformation has rarely been reported and may result from compression by surrounding scar tissue. AS-OCT is widely known to be useful in perioperative evaluation of PFM, but our experience suggests that the addition of 3D imaging significantly enhances its utility in assessing the precise condition of the stent postoperatively. In this case, we were able to gain valuable insights into the stent placement, which may aid in future perioperative management of PFM complications., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Masaki Tanito declare(s) personal fees from Santen Pharmaceutical, Co., Ltd. Masaki Tanito received honorarium and research donations from Santen Pharmaceutical, Co., Ltd. Other authors have no conflicts of interest associated with this report. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Tanito et al.)

Purpose: To evaluate the changes in the angle of the AC and lens vault after IPCL implantation by AS-OCT in myopic patients. Methods: This was a prospective observational study involving 30 myopic eyes implanted with IPCL. AS-OCT was used to evaluate lens vault and AC angle parameters including anterior chamber angle, angle opening distance and trabecular-iris space area (TISA) at 1, 3 and 6 months postoperatively. Results: All 3 AC angle parameters were significantly reduced at the 1st postoperative month compared to preoperative values, but remained stable thereafter with no significant change at the 3rd or 6th postoperative months. The lens vault showed no significant change over the entire follow-up period. Conclusion: IPCL implantation is a safe method for correction of myopia with stable AC angle narrowing over the course of 6 months postoperatively as monitored using AS-OCT. [ABSTRACT FROM AUTHOR]

Purpose: To develop a deep learning method to automatically monitor the implantable collamer lens (ICL) position and quantify subtle alterations in the anterior chamber using anterior segment optical coherence tomography (AS-OCT) images for high myopia patients with ICL implantation.Methods: In this study, 798 AS-OCT images of 203 patients undergoing ICL implantation at our eye center from April 2017 to June 2021 were involved. A deep learning system was developed to first isolate the corneoscleral, ICL, and lens, and then quantify clinical important parameters in AS-OCT images (central corneal thickness, anterior chamber depth, and lens vault).Results: The deep learning system was able to accurately isolate the corneoscleral, ICL, and lens with the Dice coefficient ranging from 0.911 to 0.960, and all the F1 scores >0.900. The relative error between automated measurements and the ground truth for 95% (188 images out of 198) of LVs was within 10%. Intraclass correlation coefficients (ICCs) of the machine-ground truth measurements ranged from 0.928 to 0.995. The deep learning method also showed better repeatability than human graders.Conclusion: The deep learning method provides reliable detection and quantification of AS-OCT scans for postoperative ICL implantation, which can simplify and optimize the management of clinical outcomes of ICL implantations. Also, this is a step towards an objective measurement of the postoperative vault, making the data more comparable and repeatable to each other.

Introduction: The aim of this study was to evaluate the efficacy of sutureless amniotic membrane transplantation (SAMT) in patients with corneal perforation secondary to ocular surface inflammatory diseases. Methods: Twelve eyes of eleven patients with corneal perforation associated with Sjögren's syndrome and ocular cicatricial pemphigoid were included. Surgical procedure consisted in the application of two layers of amniotic membrane covering the corneal perforation and a therapeutic contact lens placed above the two layers, followed by sutureless tarsorrhaphy with Steri-strip applied for 15 days to immobilize the eyelids. All patients underwent slit-lamp examination, fluorescein corneal staining, and anterior segment optical coherence tomography (AS-OCT), preoperatively and post-surgery, weekly for one month, and then every two weeks for three months. Results: All 12 eyes had complete resolution of corneal perforation. Pachymetry measurements improved in all eyes, and complete healing of the corneal ulcer was obtained following treatment and maintained up to 3 months follow-up in all patients. Conclusions: SAMT was proven to be a safe and effective option for the management of inflammatory corneal perforation. The procedure is non-traumatic and easy to perform since the surgical technique is sutureless and does not require topical therapy because it takes advantage of the intrinsic properties of the membrane itself. [ABSTRACT FROM AUTHOR]

Limbal stem cell deficiency (LSCD) can cause significant corneal vascularization and scarring and often results in serious visual morbidity. An early and accurate diagnosis can help prevent the same with a timely and appropriate intervention. This review aims to provide an understanding of the different diagnostic tools and presents an algorithmic approach to the management based on a comprehensive clinical examination. Although the diagnosis of LSCD usually relies on the clinical findings, they can be subjective and non-specific. In such cases, using an investigative modality offers an objective method of confirming the diagnosis. Several diagnostic tools have been described in literature, each having its own advantages and limitations. Impression cytology and in vivo confocal microscopy (IVCM) aid in the diagnosis of LSCD by detecting the presence of goblet cells. With immunohistochemistry, impression cytology can help in confirming the corneal or conjunctival source of epithelium. Both IVCM and anterior segment optical coherence tomography can help supplement the diagnosis of LSCD by characterizing the corneal and limbal epithelial changes. Once the diagnosis is established, one of various surgical techniques can be adopted for the treatment of LSCD. These surgeries aim to provide a new source of corneal epithelial stem cells and help in restoring the stability of the ocular surface. The choice of procedure depends on several factors including the involvement of the ocular adnexa, presence of systemic co-morbidities, status of the fellow eye and the comfort level of the surgeon. In LSCD with wet ocular surfaces, autologous and allogeneic limbal stem cell transplantation is preferred in unilateral and bilateral cases, respectively. Another approach in bilateral LSCD with wet ocular surfaces is the use of an autologous stem cell source of a different epithelial lineage, like oral or nasal mucosa. In eyes with bilateral LSCD with significant adnexal issues, a keratoprosthesis is the only viable option. This review provides an overview on the diagnosis and treatment of LSCD, which will help the clinician choose the best option amongst all the therapeutic modalities currently available and gives a clinical perspective on customizing the treatment for each individual case.

Purpose: To evaluate anterior segment optical coherence tomography (AS-OCT) to detect the wound healing process as per monitoring the effectiveness of cenegermin to treat moderate to severe neurotrophic keratoplasty. Methods: A retrospective chart review was realized to identify patients treated with cenegermin at the Clinica Oculistica, University of Genoa, Italy. All patients underwent careful examinations at baseline and follow-up visits. AS-OCT scans centered on the minimum corneal thickness (CT) area were always performed. We compared findings of AS-OCT with the findings from the slit-lamp examination. A linear regression analysis was used to evaluate factors associated with corneal healing. A further analysis, including a control group treated with 50% autologous serum (AS), was done to investigate and compare the efficacy of cenegermin. Results: Data from 16 eyes were studied. The average patients' age was 60.9 ± 21.1 years; five (31.2%) eyes experienced persistent epithelial defect and 11 (68.8%) eyes had neurotrophic corneal ulcer. The average reepithelialization time was 3.9 ± 0.5 weeks in the cenegermin group versus 5.9 ± 1.9 weeks in the AS group (p < 0.01). The AS‐OCT scans revealed an average CT at the thinnest point of 276.3 ± 74.1 μm before treatment with an average increase of 176.5 ± 60.3 μm at the end of the cenegermin treatment (B = −0.15; p = 0.035). The AS-OCT percentage increase in corneal thickness between the two groups was statistically significant (p < 0.02). Conclusion: Understanding the cascade of events involved in the nerve growth factor–driven corneal wound healing process is clinically meaningful for the clinician. AS-OCT is an effective tool for systematic anterior segment imaging, allowing the detailed detection of the front-to-back layered corneal structure for quantitative analysis and monitoring of the healing process. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate anterior segment optical coherence tomography (AS-OCT) to detect the wound healing process as per monitoring the effectiveness of cenegermin to treat moderate to severe neurotrophic keratoplasty.Methods: A retrospective chart review was realized to identify patients treated with cenegermin at the Clinica Oculistica, University of Genoa, Italy. All patients underwent careful examinations at baseline and follow-up visits. AS-OCT scans centered on the minimum corneal thickness (CT) area were always performed. We compared findings of AS-OCT with the findings from the slit-lamp examination. A linear regression analysis was used to evaluate factors associated with corneal healing. A further analysis, including a control group treated with 50% autologous serum (AS), was done to investigate and compare the efficacy of cenegermin.Results: Data from 16 eyes were studied. The average patients' age was 60.9 ± 21.1 years; five (31.2%) eyes experienced persistent epithelial defect and 11 (68.8%) eyes had neurotrophic corneal ulcer. The average reepithelialization time was 3.9 ± 0.5 weeks in the cenegermin group versus 5.9 ± 1.9 weeks in the AS group (p < 0.01). The AS‐OCT scans revealed an average CT at the thinnest point of 276.3 ± 74.1 μm before treatment with an average increase of 176.5 ± 60.3 μm at the end of the cenegermin treatment (B = −0.15; p = 0.035). The AS-OCT percentage increase in corneal thickness between the two groups was statistically significant (p < 0.02).Conclusion: Understanding the cascade of events involved in the nerve growth factor–driven corneal wound healing process is clinically meaningful for the clinician. AS-OCT is an effective tool for systematic anterior segment imaging, allowing the detailed detection of the front-to-back layered corneal structure for quantitative analysis and monitoring of the healing process.

Aim: The aim of the study was to determine any new findings provided by anterior segment optical coherence tomography (AS-OCT) in different corneal diseases diagnosed by slit lamp examination (SLE)., Methods: This cross-sectional, observational, hospital-based study was conducted at a tertiary care centre in Western Maharashtra from September 2022 to June 2024, and it included 93 eyes of 93 patients with isolated corneal diseases. A detailed SLE of the anterior segment was done to assess corneal pathology, corneal thickness, corneal structural integrity, presence of corneal opacities, corneal vascularization, presence of other abnormalities like corneal degeneration, corneal foreign bodies, Kayser-Fleischer (KF) ring, ocular surface squamous neoplasia (OSSN). All patients underwent AS-OCT with imaging protocols tailored to each corneal condition, including assessment of focal thinning in Keratoconus patients, graft-host junction integrity in post-keratoplasty cases, Descemet's membrane integrity in post-cataract surgery patients, localization and depth of invasion of corneal foreign bodies, detection of KF rings in Wilson's disease cases, and identifying and assessing extent of corneal dystrophies, corneal degenerations, and OSSN. AS-OCT findings were compared with SLE results to identify any additional information provided by AS-OCT over SLE in the study population. For statistical analysis, data was entered into Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States) and analysed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp; Armonk, New York, United States). Inter-rater agreements between SLE and AS-OCT were evaluated by Cohen's Kappa by using IBM SPSS Statistics for Windows, Version 26.0., Results:  AS-OCT enabled additional diagnosis of three (15.8%) more cases of keratoconus, which were declared normal on SLE. AS-OCT identified one (5.90%) case of deep-seated stromal corneal foreign body among the cases which were reported to have only superficial corneal foreign body on SLE. Two (50%) cases of suspected OSSN on SLE were ruled out on AS-OCT, whereas two (50%) cases of suspected OSSN on SLE were confirmed on AS-OCT. AS-OCT found a KF ring among two (12.5%) cases that were reported to have no KF ring on SLE. On both SLE and AS-OCT, 26 (81.2%) cases showed the same findings, whereas in 30 (49.2%) cases, AS-OCT rejected the suggested findings of the SLE. In six (18.8%) cases, SLE did not show any findings, but AS-OCT showed findings. Both SLE and AS-OCT showed no findings in 31 (50.8%) cases., Conclusion: This study highlights the significant role of AS-OCT in enhancing the diagnostic accuracy of various corneal diseases. Its ability to detect additional findings in various corneal conditions such as keratoconus, corneal foreign bodies, OSSN, and KF ring in Wilson's disease underscores its value in clinical practice. The utility of AS-OCT in diagnosing subclinical corneal diseases which are beyond the scope of routine SLE has been demonstrated in our study. These capabilities make AS-OCT an effective additional diagnostic tool in evaluating cornea and should be routinely incorporated along with traditional SLE in evaluating various corneal diseases., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Sub-Committee, Dr. D.Y. Patil Medical College, Hospital and Research Centre issued approval IESC/PGS/2022/108 dated Septembr 28, 2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ta et al.)

Keratoconus (KC) is the most common corneal ectasia characterized by progressive corneal thinning, protrusion, and irregular astigmatism. The Amsler–Krumeich classification based on the analysis of corneal topography, corneal thickness, refraction and biomicroscopy is the most commonly used; recently, a new classification based on anterior segment Optical Coherence Tomography was introduced by Sandali and colleagues. Since there is no information about the possible agreement between these two classifications, the aim of this study is to compare the stratification of consecutive KC patients using the Amsler–Krumeich and Sandali classifications, and to further ascertain KC cases in which one classification is preferred over the other. Overall, 252 eyes of 137 patients (41.45 ± 16.93 years) were analyzed: in 156 eyes (61.9%), the Amsler and Sandali staging differed in one stage while in 75 cases (29.8%) it differed in two or more stages. In 222 eyes (88.1%), the Sandali staging was higher compared to the Amsler one. These results show that the two classifications are not fully interchangeable: the Amsler–Krumeich classification is more appropriate in identifying and longitudinally monitoring patients with early stages of KC, while the Sandali classification for the diagnosis and follow-up of patients with more advanced stages, particularly when a surgical planning has to be chosen. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the efficacy of sutureless amniotic membrane transplantation (SAMT) in patients with corneal perforation secondary to ocular surface inflammatory diseases. Methods: Twelve eyes of eleven patients with corneal perforation associated with Sjögren’s syndrome and ocular cicatricial pemphigoid were included. Surgical procedure consisted in the application of two layers of amniotic membrane covering the corneal perforation and a therapeutic contact lens placed above the two layers, followed by sutureless tarsorrhaphy with Steri-strip applied for 15 days to immobilize the eyelids. All patients underwent slit-lamp examination, fluorescein corneal staining, and anterior segment optical coherence tomography (AS-OCT), preoperatively and post-surgery, weekly for one month, and then every two weeks for three months. Results: All 12 eyes had complete resolution of corneal perforation. Pachymetry measurements improved in all eyes, and complete healing of the corneal ulcer was obtained following treatment and maintained up to 3 months follow-up in all patients. Conclusions: SAMT was proven to be a safe and effective option for the management of inflammatory corneal perforation. The procedure is non-traumatic and easy to perform since the surgical technique is sutureless and does not require topical therapy because it takes advantage of the intrinsic properties of the membrane itself.

This prospective observational study investigates the impact of cataract surgery on anterior segment parameters in nonglaucomatous and primary open-angle glaucoma (POAG) eyes, utilizing anterior segment optical coherence tomography (AS-OCT). The study involved 42 Caucasian patients, divided into a control group and a POAG group. Comprehensive ophthalmic examinations were performed along with AS-OCT imaging and biometry preoperatively, as well as on one day, one week, and one month following cataract surgery. The results showed significant post-operative changes in anterior chamber depth (ACD) and angle width in both groups, suggesting that cataract surgery may influence the structural parameters associated with glaucoma risk and management. Specifically, a marked increase in ACD and improvement in angle-opening distances were observed, highlighting the potential of cataract extraction to alter intraocular fluid dynamics favorably. Despite these changes, the study noted an initial spike in increased intraocular pressure (IOP) in POAG patients immediately post-operative, which stabilized during follow-up. For the control group, IOP showed gradually reducing IOP values in the follow-up visits. The findings underscore the role of advanced imaging technologies in understanding glaucoma's pathophysiology and the potential benefits of cataract surgery in glaucoma patients. The study advocates for further research with a larger, more diverse patient population and extended follow-up to explore the long-term implications of cataract surgery on glaucoma dynamics, emphasizing the importance of personalized management and treatment strategies particularly for glaucoma patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Kouroupaki et al.)

Irreversible visual impairment is often caused by primary angle-closure glaucoma, which could be detected via anterior segment optical coherence tomography (AS-OCT). In this paper, an automated system based on deep learning is presented for angle-closure detection in AS-OCT images. Our system learns a discriminative representation from training data that captures subtle visual cues not modeled by handcrafted features. A multilevel deep network is proposed to formulate this learning, which utilizes three particular AS-OCT regions based on clinical priors: 1) the global anterior segment structure; 2) local iris region; and 3) anterior chamber angle (ACA) patch. In our method, a sliding window-based detector is designed to localize the ACA region, which addresses ACA detection as a regression task. Then, three parallel subnetworks are applied to extract AS-OCT representations for the global image and at clinically relevant local regions. Finally, the extracted deep features of these subnetworks are concatenated into one fully connected layer to predict the angle-closure detection result. In the experiments, our system is shown to surpass previous detection methods and other deep learning systems on two clinical AS-OCT datasets. [ABSTRACT FROM AUTHOR]

Abstract Background Vitreous cysts are rare clinical findings and seldom cause visual disturbance. They are generally classified as congenital or acquired and are considered idiopathic when the etiology can not be determined. A previous electron microscopic observation on an idiopathic pigmented vitreous cyst has confirmed its pigment epithelial origin. However, the specific kind of pigment epithelium involved remains unclear. Case presentation A 39-year-old female presented with a round-shaped floater causing frequent visual disturbance in the left eye. A pigmented, non lobulated and freely mobile vitreous cyst was observed in the anterior vitreous by slit lamp examination and anterior segment optical coherence tomography. The pigment clumps on the cyst wall showed no autofluorescence. No persistent hyaloid artery or connection between the cyst and ocular structures was found by fundus fluorescein angiography and B-scan ultrasound. Serum tests for cysticercoids, sparganosis and toxoplasma were negative. A diagnosis of idiopathic vitreous cyst was made and no intervention was given. The cyst sank to the inferior part of the vitreous and the patient felt less visual disturbance during one-year follow-up. Conclusions We described the features of a pigmented vitreous cyst revealed by autofluorescence and anterior segment optical coherence tomography for the first time. The intact retina, the absence of lipofuscin of the cyst and its location in the anterior vitreous led to the hypothesis that the cyst may originate from the ciliary pigment epithelium rather than the retinal pigment epithelium.

This article reviews literature on the use of artificial intelligence (AI) methods for the diagnosis and treatment of primary angle-closure disease (PACD). The review describes how AI techniques enhance the efficiency of population screening for anterior chamber angle closure, presents technologies utilizing deep learning, including neural networks, for the analysis of large datasets obtained through anterior segment imaging methods, such as anterior segment optical coherence tomography (AS-OCT), digital gonioscopy, and ultrasound biomicroscopy, and discusses methods for treating PACD with the help of AI. Integration of deep learning and imaging techniques represents a crucial step in optimizing the diagnosis and treatment of PACD, reducing the burden on the healthcare system.

Keratoconus (KC) is the most common corneal ectasia characterized by progressive corneal thinning, protrusion, and irregular astigmatism. The Amsler–Krumeich classification based on the analysis of corneal topography, corneal thickness, refraction and biomicroscopy is the most commonly used; recently, a new classification based on anterior segment Optical Coherence Tomography was introduced by Sandali and colleagues. Since there is no information about the possible agreement between these two classifications, the aim of this study is to compare the stratification of consecutive KC patients using the Amsler–Krumeich and Sandali classifications, and to further ascertain KC cases in which one classification is preferred over the other. Overall, 252 eyes of 137 patients (41.45 ± 16.93 years) were analyzed: in 156 eyes (61.9%), the Amsler and Sandali staging differed in one stage while in 75 cases (29.8%) it differed in two or more stages. In 222 eyes (88.1%), the Sandali staging was higher compared to the Amsler one. These results show that the two classifications are not fully interchangeable: the Amsler–Krumeich classification is more appropriate in identifying and longitudinally monitoring patients with early stages of KC, while the Sandali classification for the diagnosis and follow-up of patients with more advanced stages, particularly when a surgical planning has to be chosen.

Neurotrophic keratopathy (NK) is a rare degenerative corneal disorder characterized by instability of epithelial integrity with consequent epithelial defects that can worsen up to persistent epithelial defects with stromal melting and ulceration. The pathogenesis of NK springs from a variable degree of damage to the trigeminal nerve plexus, leading to a reduction or total loss of corneal sensitivity. Mackie classification (1995) distinguishes three stages of NK, based on the severity of clinical presentation. The technological innovations in corneal diagnostic imaging allow clinicians to accurately study the morphometry and morphology of corneal structure with microscopic resolution. In this study, 45 patients affected by NK at different stages underwent in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS‐OCT) with particular attention to analyze subbasal nerve plexus fibers and the stromal structure. At the light of IVCM and AS‐OCT observations, we propose a different staging of NK with respect to the Mackie's classification that takes into account the severity of subbasal nerve fibers damage and the extension in depth of stromal ulceration; this classification better defines, at the time of diagnosis, the cellular and structural alterations in the affected corneas, with possible prognostic and therapeutic values in the management of NK. In vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS‐OCT) are diagnostic devices useful to analyze neurotrophic keratopathy (NK). Based on the IVCM and AS‐OCT results, a new classification of NK can be proposed. According to this classification, important information about prognosis, follow‐up, and therapeutic approach can be achieved [ABSTRACT FROM AUTHOR]

Purpose: To introduce the use of corneal epithelial mapping by anterior segment optical coherence tomography (AS-OCT) as an ancillary testing for the identification of areas of loose epithelial adherence in recurrent corneal erosion syndrome (RCES), and the subsequent treatment of the latter with anterior stromal puncture (ASP). Methods: Five patients were presented with RCES following traumatic corneal abrasions. Following resolution of acute episodes, AS-OCT epithelial mapping was performed revealing in all patients an area of increased epithelial thickness (hot spot) corresponding to the site of loose attachment of the epithelium to the epithelial basement membrane. ASP to the area of epithelial thickening, as delineated by the epithelial map, was performed. Results: To date, none of the patients has shown any signs of disease recurrence over a period ranging from 6 to 20 months following the application of epithelial map-guided ASP. Conclusions: AS-OCT epithelial mapping can reveal the exact area of loose epithelial adherence in RCES. Hence, epithelial mapping can delineate the target area for treatment with ASP and may decrease the high failure rates of ASP. [ABSTRACT FROM AUTHOR]

Abstract: A 1‐year‐old, female spayed, domestic shorthair cat presented for blepharospasm of the right eye. Slit‐lamp biomicroscopic examination showed focal corneal ulceration and presumptive keratomalacia of the right eye. Examination of the left eye was normal apart from a focal endothelial opacity. Within the first 24 h of medical management, the right eye developed marked corneal edema and globular anterior protrusion of the corneal surface consistent with feline acute corneal hydrops (FACH). Surgical management consisted of a bridge conjunctival graft, nictitating membrane flap, and temporary tarsorrhaphy. Resolution of corneal edema and pain occurred in the right eye within 24 days. Spectral domain optical coherence tomography (SD‐OCT) of the anterior segment was performed in both eyes. Conjunctival tissue from the bridge graft precluded examination of deeper corneal structures in the right eye. The left eye displayed a focal separation of the corneal endothelium and Descemet's membrane from the overlying stroma. These SD‐OCT findings are similar to the analogous syndrome found in humans and represent a potential etiology for FACH of the right eye in the case presented here. Unfortunately, the cat was lost to follow‐up and the progression of this lesion to FACH in the left eye could not be determined. [ABSTRACT FROM AUTHOR]

Copyright of Acta Ophthalmologica Polonica / Klinika Oczna is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Highlights: [•] Mutagenesis of mtDNA in Fuchs corneal dystrophy (FECD) was investigated. [•] mtDNAs from FECD patients had more lesions, copies and 4977-bp deletions. [•] FECD patients slower repaired H2O2-induced mtDNA damage. [•] FECD pathogenesis involves impairment in repair and degradation of mtDNA. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the appearance of supraciliochoroidal fluid (SCF) within 1 week after trabeculectomy with anterior segment optical coherence tomography (AS-OCT), a high-resolution, non-contact detection method. Methods: In this prospective, non-comparative study, AS-OCT was used to assess the incidence of SCF in 25 eyes of 22 glaucoma patients who underwent trabeculectomy. Eyes were examined for SCF before and at 1, 3 days, and 1 week after surgery. Eyes with SCF were additionally examined at 2, 3, 4, and 8 postoperative weeks. Eyes were examined for the intraocular pressure (IOP), central depth of anterior chamber, and anterior inflammation. Results: None of the 25 eyes displayed preoperative SCF. Postoperative SCF was found in 19 eyes (76%), which first appeared on day 1 (10/19), day 3 (5/19), or 1 week (4/19) after surgery. Diagnoses of the 19 eyes included primary open-angle glaucoma (8 eyes), chronic primary angle-closure glaucoma (5 eyes), acute primary angle closue glaucoma (5 eyes), and secondary glaucoma (1 eye). SCF was found in four (16 eyes, 84.2%), two (2 eyes, 10.5%), or one quadrant (1 eye, 5.3%). Most of the 19 eyes displayed grade I (10 eyes, 52.6%) or grade II detachment (8 eyes, 42.1%), with 1 eye (5.3%) showing grade III detachment. The lowest IOP was lower in eyes with SCF (4.3 ± 2.7 mmHg) than in those without (16.3 ± 6.0 mmHg) ( p == 0.000). The IOP rose from 7.55 ± 4.33 mmHg at SCF detection to 13.47 ± 5.52 mmHg at SCF disappearance ( p == 0.009). Most eyes (17 eyes, 89.5%) had displayed no SCF by week 4, but one eye still displayed SCF at 8 postoperative weeks. Conclusions: At the very early stages after trabeculectomy (within 1 postoperative week), SCF was detected frequently with AS-OCT. Compared with previous reports using other detection methods, AS-OCT diagnosed postoperative SCF more frequently and at earlier time points. [ABSTRACT FROM AUTHOR]

Limbal stem cell deficiency (LSCD) can cause significant corneal vascularization and scarring and often results in serious visual morbidity. An early and accurate diagnosis can help prevent the same with a timely and appropriate intervention. This review aims to provide an understanding of the different diagnostic tools and presents an algorithmic approach to the management based on a comprehensive clinical examination. Although the diagnosis of LSCD usually relies on the clinical findings, they can be subjective and non-specific. In such cases, using an investigative modality offers an objective method of confirming the diagnosis. Several diagnostic tools have been described in literature, each having its own advantages and limitations. Impression cytology and in vivo confocal microscopy (IVCM) aid in the diagnosis of LSCD by detecting the presence of goblet cells. With immunohistochemistry, impression cytology can help in confirming the corneal or conjunctival source of epithelium. Both IVCM and anterior segment optical coherence tomography can help supplement the diagnosis of LSCD by characterizing the corneal and limbal epithelial changes. Once the diagnosis is established, one of various surgical techniques can be adopted for the treatment of LSCD. These surgeries aim to provide a new source of corneal epithelial stem cells and help in restoring the stability of the ocular surface. The choice of procedure depends on several factors including the involvement of the ocular adnexa, presence of systemic co-morbidities, status of the fellow eye and the comfort level of the surgeon. In LSCD with wet ocular surfaces, autologous and allogeneic limbal stem cell transplantation is preferred in unilateral and bilateral cases, respectively. Another approach in bilateral LSCD with wet ocular surfaces is the use of an autologous stem cell source of a different epithelial lineage, like oral or nasal mucosa. In eyes with bilateral LSCD with significant adnexal issues, a keratoprosthesis is the only viable option. This review provides an overview on the diagnosis and treatment of LSCD, which will help the clinician choose the best option amongst all the therapeutic modalities currently available and gives a clinical perspective on customizing the treatment for each individual case., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kate and Basu.)

Purpose: The aim of this study was to use swept-source anterior segment optical coherence tomography (OCT) to explore imaging the meibomian gland openings and to identify their in vivo characteristics in patients with obstructive meibomian gland dysfunction (MGD) and healthy participants. Methods: We enrolled 49 patients with MGD and 54 health controls in this case-control study. Each participant underwent slit-lamp examination, meibography, and OCT scanning. Sixteen patients with MGD underwent a repeat OCT examination after eyelid massage. The outcome measures included determinations of meibomian gland openings (orifices and terminal ducts) from OCT images and comparisons of the meibomian openings between patients with MGD and normal controls before and after meibomian gland massage. Results: Using the same OCT scanning model, the number of visible orifices of the meibomian glands was similar between eyes with MGD and normal eyes (9.2 ± 2.3 vs. 9.7 ± 2.4). The mean diameter of the terminal ducts in patients with MGD was larger (120.22 ± 27.92 µm vs. 100.96 ± 20.30 µm) than in the normal controls, and had a larger coefficient of variation. Significant differences were observed in the mean diameter of the terminal ducts of patients with MGD before and after meibum gland massage (133.73 ± 27.81 μm vs. 102.26 ± 24.30 μm, p < 0.001). Conclusions: Patients with MGD have more diversified orifices and larger meibomian gland terminal duct diameters than normal subjects. In addition, meibomian gland terminal duct diameters seem to decrease in patients with MGD after meibum gland massage. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the diagnostic performance of deep learning (DL) anterior segment optical coherence tomography (AS-OCT) as a plateau iris prediction model., Design: We used a cross-sectional study of the development and validation of the DL system., Methods: We conducted a collaboration between a referral eye center and an informative technology department. The study enrolled 179 eyes from 142 patients with primary angle closure disease (PACD). All patients had remaining appositional angle after iridotomy. Each eye was scanned in four quadrants for both AS-OCT and ultrasound biomicroscopy (UBM). A DL algorithm for plateau iris prediction of AS-OCT was developed from training datasets and was validated in test sets. Sensitivity, specificity, and area under the receiver operating characteristics curve (AUC-ROC) of the DL for predicting plateau iris were evaluated, using UBM as a reference standard., Results: Total paired images of AS-OCT and UBM were from 716 quadrants. Plateau iris was observed with UBM in 276 (38.5%) quadrants. Trainings dataset with data augmentation were used to develop an algorithm from 2500 images, and the test set was validated from 160 images. AUC-ROC was 0.95 (95% confidence interval [CI] = 0.91 to 0.99), sensitivity was 87.9%, and specificity was 97.6%., Conclusions: DL revealed a high performance in predicting plateau iris on the noncontact AS-OCT images., Translational Relevance: This work could potentially assist clinicians in more practically detecting this nonpupillary block mechanism of PACD., Competing Interests: Disclosure: B. Wanichwecharungruang, None; N. Kaothanthong, None; W. Pattanapongpaiboon, None; P. Chantangphol, None; K. Seresirikachorn, None; C. Srisuwanporn, None; N. Parivisutt, None; A. Grzybowski, None; T. Theeramunkong, None; P. Ruamviboonsuk, None, (Copyright 2021 The Authors.)

Background: To assess the radius of anterior lens surface curvature (RAL) measurements with anterior segment optical coherence tomography (AS-OCT) in comparison with Scheimpflug imaging., Methods: This prospective, cross-sectional study was carried out at Zhongshan Ophthalmic Center, Guangzhou, China. We enrolled 59 eyes, including 30 eyes from 30 cataractous volunteers (59 to 87 years) and 29 eyes from 29 young participants (19 to 49 years). After mydriasis, the RAL was measured automatically by the built-in software in the AS-OCT (CASIA 2). The Scheimpflug images were measured with the build-in caliper tool of the Scheimpflug camera (Pentacam), and RAL were further calculated with the principle of best-fitted circle. Intraobserver and interobserver reproducibility of RAL measurement using Scheimpflug camera were evaluated with limit of agreement (LoA) and intraclass correlation coefficient (ICC). Consistency between RAL measurement of Scheimpflug camera and AS-OCT were assessed with LoA, correlation analysis and linear regression., Results: For all subjects, intraobserver (LoA: -0.25 to 0.23 mm, ICC: 0.996) and interobserver reproducibility (LoA: -0.85 to 0.92 mm, ICC: 0.947) of RAL were good using Scheimpflug imaging. Both AS-OCT and Scheimpflug imaging found that the age-related cataract participants had smaller RAL (P=0.010, P=0.001 respectively). LoA of RAL measurement between AS-OCT and Scheimpflug imaging was -3.83 to -0.79 mm, and the Pearson correlation efficient was 0.909 (P<0.001). The RAL values measured by AS-OCT were significantly greater than that by Scheimpflug camera with a mean difference of 2.31 mm for all participants (P<0.001). The RAL measurement could be converted using the equation: Y CASIA 2 =1.155 × X Pentacam + 1.060., Conclusions: Both Scheimpflug camera system with internal caliper tool and the AS-OCT are fast and non-contact tools that could measure RAL successfully. The two measurement results are highly correlated and interchangeable through linear regression equation., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare., (2020 Annals of Translational Medicine. All rights reserved.)

In this article, the significance of anterior segment optical coherence tomography (AS-OCT) to aid the clinical diagnosis and treatment of Descemet membrane (DM) detachment after phacoemulsification combined with intraocular lens implantation was retrospectively analyzed using 26 patients (26 eyes). The location and scope of DM detachment, its causative factors and the percentage of each detachment type are considered for clinical treatments. Based on the location and scope, the detachment can be divided into three types: (1) simple, (2) symmetrical and (3) complete DM detachment. Simple detachment, confined to the area of surgical incision (detachment range <1/4 corneal area), occurred in 69.20 % of cases (18/26), in which the DM detachment in the anterior lip accounted for 42.30% (11/26) and in the posterior lip accounted for 26.90% (7/26). Symmetrical DM detachment, referring to detachment (1/4 cornea area < detached area <1/2 corneal area) that appeared symmetrically on the surgical incision and the opposite site, accounted for 19.20% (5/26). Complete DM detachment (>1/2 of the corneal area), accounted for 11.50% (3/26). Interestingly, our findings suggest that the DM detachment after phacoemulsification is closely related to the location (simple and symmetrical DM detachment) and the skillfulness (complete DM detachment) of the surgical incision. Therefore, appropriate classification of DM detachment by AS-OCT and wise selection of surgical location can better guide cataract surgery in the future., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.

Background: Vitreous cysts are rare clinical findings and seldom cause visual disturbance. They are generally classified as congenital or acquired and are considered idiopathic when the etiology can not be determined. A previous electron microscopic observation on an idiopathic pigmented vitreous cyst has confirmed its pigment epithelial origin. However, the specific kind of pigment epithelium involved remains unclear., Case Presentation: A 39-year-old female presented with a round-shaped floater causing frequent visual disturbance in the left eye. A pigmented, non lobulated and freely mobile vitreous cyst was observed in the anterior vitreous by slit lamp examination and anterior segment optical coherence tomography. The pigment clumps on the cyst wall showed no autofluorescence. No persistent hyaloid artery or connection between the cyst and ocular structures was found by fundus fluorescein angiography and B-scan ultrasound. Serum tests for cysticercoids, sparganosis and toxoplasma were negative. A diagnosis of idiopathic vitreous cyst was made and no intervention was given. The cyst sank to the inferior part of the vitreous and the patient felt less visual disturbance during one-year follow-up., Conclusions: We described the features of a pigmented vitreous cyst revealed by autofluorescence and anterior segment optical coherence tomography for the first time. The intact retina, the absence of lipofuscin of the cyst and its location in the anterior vitreous led to the hypothesis that the cyst may originate from the ciliary pigment epithelium rather than the retinal pigment epithelium.