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PurposeThis study aims to evaluate the repeatability of anterior segment optical coherence tomography (AS-OCT) in diverse ocular surface disorder (OSD) cohorts, exploring various anterior segment parameters and their accuracy in different disease groups.MethodsA total of 239 participants across six distinct OSD groups and healthy controls underwent nonmydriatic AS-OCT imaging using the Tomey CASIA 2 device. Anterior segment parameters including anterior chamber depth, width, angle metrics, corneal thickness, keratometry, lens vault, and others were meticulously assessed. Statistical analyses determined repeatability limits and coefficients of variation for each parameter within the different OSD cohorts.ResultsRepeatability for anterior chamber and corneal parameters remained consistent across all OSD groups, indicating minimal impact of ocular surface disease on accuracy. The coefficient of variation (CoV) for the trabecular iris-space area was about 20% for all cohorts. Ocular surface inflammation emerged as a key factor in dry eye, affecting immune-mediated and non-immune conditions alongside age-related ocular surface changes. While anterior chamber depth measurements showed variations, particularly in immune (CoV = 2.5%) and non-immune (CoV = 3.8%) OSD groups, parameters like anterior chamber width and angle to angle showed similar values among the cohorts. Keratometry measures remained stable despite OSD (CoV lower than 1%).ConclusionThe Tomey CASIA 2 demonstrated reliable repeatability for measuring anterior segment parameters in diverse OSD cohorts. Despite challenges posed by dry eye conditions, this technology holds promise in assessing OSD, suggesting potential clinical protocols similar to those in healthy controls.

Abstract We assessed the repeatability and agreement of ganglion cell complex (GCC) in the macular area and the peripapillary retinal nerve fiber layer (ppRNFL) with individual and combined macula and disc scans. The macular GCC and ppRNFL thicknesses from 34 control eyes and 43 eyes with glaucoma were measured with the Canon Optical Coherence Tomography (OCT) HS-100. Two repeated measurements were performed with both scan modes. The repeatability limit (Rlim) and agreement analysis were performed. The individual scan showed better repeatability than the combined scan in both groups. However, the differences in the Rlim for the GCC in most sectors were lower than 3 μm (axial resolution of the OCT), and this was larger than 3 μm for most of the ppRNFL sectors. The mean differences in the thickness between both scan modes for the GCC and ppRNFL measurements were less than 3 and 6 μm, respectively. The interval of the limits of agreement was about 10 μm in some sectors for the GCC, and about 40 and 60 μm in some sectors in controls and glaucoma eyes, respectively. Both scan modes showed good repeatability in both groups. The agreement results suggest that the scan modes cannot be used interchangeably.

Abstract Background To evaluate the repeatability of a fully automated swept-source optical coherence tomography (SS-OCT) and its agreement with an optical low coherence reflectometry (OLCR) for several biometric parameters. Methods In this study, 74 eyes of 74 patients were measured using the Eyestar 900 SS-OCT and Lenstar LS 900 OLCR. Flat keratometry (K1) and steep keratometry (K2), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were measured three times with each device. The repeatability was analyzed with the intrasubject standard deviation, coefficient of variability (CoV), and coefficient of repeatability (CoR) for each instrument. The agreement between the instruments was evaluated with Bland-Altman analysis. Results K1, K2 and CCT CoV values were

Abstract The similarities between horizontal and vertical Optical Coherence Tomography (OCT) scans for the individual retinal layer thickness measurements in the macula was evaluated. Two volumetric scans (B-scans oriented horizontally and vertically) were performed in 64 multiple sclerosis subjects with history of unilateral optic neuritis and 64 healthy controls. The agreement between the thickness measurements with horizontal and vertical OCT scans was evaluated in 3 groups of eyes: healthy controls, eyes with history of optic neuritis and the fellow eyes. The mean difference in individual layer thickness between the scans was smaller than the instrument’s axial resolution in all 3 groups. The limit of agreement (LoA) varied among the different layers and sectors analyzed and this trend was similar in all the groups. For the inner retinal layers (retinal nerve fiber layer to inner nuclear layer), the inner macular sectors had a larger LoA compared to the corresponding outer sectors. In the outer plexiform and nuclear layers, the central and inner sectors (except inner temporal) had LoA larger than the other sectors and layers. The larger LoA seen for different layers and sectors suggests that the scan direction must be same for the follow-up OCT measurements and in clinical studies.

PurposeTo evaluate the precision of objective refraction measurements with six different autorefractors that have different designs and measurement principles and to compare the objective refraction values with the subjective refraction.MethodObjective refraction of 55 participants was measured using six autorefractors with different designs. The instrument features mainly varied in terms of measurement principles, inbuilt fogging, open or closed view, and handheld or stationary designs. Two repeated measurements of objective refraction were performed with each autorefractor. The objective refractions from the six autorefractors were compared with the standard subjective refraction. The repeatability limit and Bland-Altman were used to describe the precision and accuracy of each autorefractor, respectively. The analysis was done using the spherical component of the refraction and the power-vector components, spherical equivalent (M), and cylindrical vectors.ResultsThe repeatability of all autorefractors was within 1.00 and 0.35D for measuring the M and both cylindrical components, respectively. Inbuilt fogging was the common feature of the instruments that showed better repeatability. Compared to subjective refraction, the mean difference for sphere and M was below +0.50D, and it was close to zero for the cylindrical components. The instruments that had inbuilt fogging showed narrower limit of agreement. When combined with fogging, the open field refractors showed better precision and accuracy.ConclusionsThe inbuilt fogging is the most important feature followed by the open view in determining the precision and accuracy of the autorefractor values.

Purpose: The aim of this study was to evaluate the effect of four different filters on contrast sensitivity under photopic and mesopic conditions with and without glare.Methods: A forced choice algorithm in a Bayesian psychophysical procedure was utilized to evaluate the spatial luminance contrast sensitivity. Five different spatial frequencies were evaluated: 1.5, 3, 6, 12, and 18 cycles per degree (cpd). The measurements were performed under 4 settings: photopic and mesopic luminance with glare and no glare. Two long pass filters (LED light reduction and 511nm filter) and two selective absorption filters (ML41 and emerald filter) and a no filter condition were evaluated. The measurements were performed in 9 young subjects with healthy eyes.Results: For the no filter condition, there was no difference between glare and no glare settings for the photopic contrast sensitivity measurements whereas in the mesopic setting, glare reduced the contrast sensitivity significantly at all spatial frequencies. There was no statistically significant difference between contrast sensitivity measurements obtained with different filters under both photopic conditions and the mesopic glare condition. In the mesopic no glare condition, the contrast sensitivity at 6 cpd with 511, ML41 and emerald filters was significantly reduced compared to no filter condition (p = 0.045, 0.045, and 0.071, respectively). Similarly, with these filters the area under the contrast sensitivity function in the mesopic no glare condition was also reduced. A significant positive correlation was seen between the filter light transmission and the average AULCSF in the mesopic non-glare condition.Conclusion: The contrast sensitivity measured with the filters was not significantly different than the no filter condition in photopic glare and no glare setting as well as in mesopic glare setting. In mesopic setting with no glare, filters reduced contrast sensitivity.

Purpose: To evaluate the precision of individual and combined macula and optic disc volumetric analysis, and the agreement between these two scan modes with spectral domain optical coherence tomography (OCT).Methods: Macular and optic disc volumetric measurements were performed with individual and combined scan protocols in one eye of 75 healthy subjects. Three repeated measurements were performed with each protocol. From the macular area, retinal thickness in nine different sectors and ganglion cell complex thickness in eight different sectors were analyzed from both scan modes. From the optic disc area, the peripapillary retinal nerve fiber layer (pRNFL) thickness in 12 clock sectors and the optic disc parameters were evaluated. For all the parameters, repeatability limit and agreement analysis were performed.Results: For the retinal thickness measurements in macula, the combined scan had two to three times larger repeatability limit than the individual scan for all the sectors except the central sector, where the repeatability limit was five times larger. The limits of agreement intervals were lower than 20 μm for all sectors, except the central. The ganglion cell complex measurements also had larger repeatability limits for the combined scans, and the limits of agreement intervals were

Nicotinamide adenine dinucleotide (NAD) is a REDOX cofactor and metabolite essential for neuronal survival. Glaucoma is a common neurodegenerative disease in which neuronal levels of NAD decline. We assess the effects of nicotinamide (a precursor to NAD) on retinal ganglion cells (the affected neuron in glaucoma) in normal physiological conditions and across a range of glaucoma relevant insults including mitochondrial stress and axon degenerative insults. We demonstrate retinal ganglion cell somal, axonal, and dendritic neuroprotection by nicotinamide in rodent models which represent isolated ocular hypertensive, axon degenerative, and mitochondrial degenerative insults. We performed metabolomics enriched for small molecular weight metabolites for the retina, optic nerve, and superior colliculus which demonstrates that ocular hypertension induces widespread metabolic disruption, including consistent changes to α-ketoglutaric acid, creatine/creatinine, homocysteine, and glycerophosphocholine. This metabolic disruption is prevented by nicotinamide. Nicotinamide provides further neuroprotective effects by increasing oxidative phosphorylation, buffering and preventing metabolic stress, and increasing mitochondrial size and motility whilst simultaneously dampening action potential firing frequency. These data support continued determination of the utility of long-term nicotinamide treatment as a neuroprotective therapy for human glaucoma.

PurposeTo evaluate the intradevice repeatability and agreement for peripapillary retinal nerve fiber layer (pRNFL) measurements in healthy eyes with two different scan directions and two different number of B scans.MethodspRNFL was measured with a spectral domain optical coherence tomography on 54 healthy participants. Three-dimensional optic disc scans (6 mm x 6 mm) were performed on the right eye of the participants. Two repeated scans were performed in four different settings: H1: Horizontal scan with 512 A-scans x 96 B-scans; H2: Horizontal scan with 512 A-scans x 128 B-scans; V1: Vertical scan with 512 A-scans x 96 B-scans; V2: Vertical scan with 512 A-scans x 128 B-scans. The pRNFL thickness was evaluated in twelve clock-hour sector in a circle of 3.45 mm diameter centred at the optic disc. Repeatability and agreement were assessed with within subject standard deviation (Sw) and Bland-Altman test respectively.ResultsThe repeatability of pRNFL measurements varied depending on the scan direction and sectors. The repeatability for the horizontal sectors were better with H1 and H2, with sector 9 having the best Sw (< 3 μm). The repeatability for the vertical sectors were better with V1 and V2 with sector 5 and 9 having the best Sw (< 4 μm). The repeatability with vertical scan was more symmetric among the sectors than with horizontal scans. The repeatability metrics of the sectors did not vary much between H1 and H2 (difference < 2 μm) and between V1 and V2 (difference < 3.2 μm). Comparing horizontal and vertical scans, the vertical sectors had larger limits of agreement of about 45 μm.ConclusionThe reliability of the pRNFL thickness measurements is dependent on the direction of the scan and independent on the numbers of B-scans. Vertical scans for pRNFL gives more homogeneous repeatability across the different sectors.

AIM: To evaluate the repeatability of an optical device for measuring the Zernike coefficients of toric intraocular lenses (IOLs) and assess whether its toricity has any impact in its repeatability. METHODS: An experienced technician used the NIMO TR1504 to measure the Zernike coefficients 30 times for an aperture of 4.50 mm for all lenses included. The IOLs included were divided into two group: toric and non-toric ones. The cylindrical powers of the toric lenses included in the present study were 1.00, 1.50, 2.25, 3.00 and 3.75 D. Finally, the repeatability of the NIMO TR1504 was described in terms of within subject standard deviation (Sw) and repeatability limit. RESULTS: The Sw was smaller than 0.011 µm for both lens groups and all Zernike coefficients, and the difference between both groups was smaller than 0.004 µm for all Zernike coefficients. Regarding the repeatability limit, this value was smaller than 0.025 µm for the toric lens group, and smaller than 0.031 µm for the non-toric lens one for all Zernike coefficients. Furthermore, the maximum difference between both lens groups was 0.010 µm. CONCLUSION: The repeatability of the NIMO TR1504 to measure the optical quality is high and independent of the lens toricity. These results reflect that this system is robust and could be used to measure the in-vitro optical quality of either toric or non-toric IOLs.

PurposeTo evaluate the repeatability of the new spectral domain optical coherence tomography (HOCT-1F), and also to evaluate the agreement between vertical and horizontal scan protocols. In addition, we also evaluated the relation between the repeatability and age.MethodsThree consecutive measurements of the inner limiting membrane-retinal pigment epithelium (ILM-RPE), inner limiting membrane-inner plexiform layer (ILM-IPL) from macular horizontal and vertical scans, and inner limiting membrane-retinal nerve fiber layer (ILM-RNFL) from optic disc horizontal scan. 159 subjects were included in the analysis. The within subject standard deviation (Sw) and the repeatability limits (Rlimit) are used to represent the repeatability of the parameters for the different sectors.ResultsThe Sw for the ILM-RPE thickness was less than 3.5 μm for each sector and scan direction. The Sw values varied within the sectors and scan modes, with horizontal scan modes resulting in better values for the horizontal sectors, and vice versa. The Sw for the GCL-IPL thickness was less than 2 μm, and was similar between the vertical and horizontal scan modes for each sector map. For the optic disc scan, the Sw was not symmetric along the clock-hour map sectors, the largest Sw values were seen in the vertical sectors (8.6 μm). The mean difference between the vertical and horizontal scans was less than 2 μm for each retinal thickness sector map. Significant but weak correlation between the Sw and the subject's age was seen in both macular and optic disc scans.ConclusionsThe repeatability of the HOCT-1F to measure the ILM-RPE-, ILM-IPL- and ILM-RNFL-thickness is good. The repeatability of the ILM-RPE thickness is dependent on the scan direction, which should be taken into account when calculating retinal thickness. There is a weak correlation between the repeatability and the subject's age.

Background: We evaluated the performance of an automated algorithm available on a clinical OCT (Canon-HS100) for macular volumetric measurements of eight individual retinal layers. Methods and Analysis: Two consecutive three-dimensional scans were acquired on 29 subjects with healthy retinas. Thickness measurements were obtained from eight individual retinal layers in nine macular sectors based on Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. The repeatability was evaluated using the within-subject standard deviation from which the repeatability limits (Rlimit) and coefficient of variation (CoV) were calculated. Results: The repeatability metrics varied among different layers and sectors. The variation among the sectors was larger in two of the outer layers (plexiform and nuclear layer) and the retinal nerve fiber layer. For the other five layers, the repeatability limit was less than 5µm and CoV was less than 7.5% in all nine ETDRS sectors. Conclusions: The repeatability of the OCT-HS100 to measure eight individual retinal layers is good in general. Nevertheless, the repeatability is not homogeneous among different layers and sectors. This needs to be taken into account while designing clinical measurement protocols.

Background: To evaluate the precision and accuracy of objective refraction measurement obtained with combinations of instrument design and technique. We also compared the performance of the instruments with subjective refraction measurements. Method and analysis: The objective refraction was measured in 71 subjects with three autorefractometers that have different designs and measurement principles (binocular with fogging, binocular without fogging, and monocular with fogging). Repeatability and reproducibility metrics were calculated for the objective refraction measurements. The agreement of the objective refraction measurements between the three instruments and the agreement with the subjective refraction measurements were evaluated. Results: All three autorefractometers had repeatability and reproducibility limits smaller than 0.70D. The smallest difference (0.10D) in the spherical equivalent was seen between the two binocular instruments. Compared with the subjective refraction, the binocular without fogging technique had the smallest mean difference in spherical equivalent (

Aims: To assess and compare the optical quality of the myopic and hyperopic implantable collamer lens (ICL) from its wavefront aberrations for different powers and pupil diameters. Settings and Design: Prospective study. Material and Methods: The wavefront aberrations of two myopic (−3 and −6 diopters (D)) and two hyperopic V4b ICLs (+3 and +6D) were measured in vitro. To assess and compare the optical quality of different powers of ICLs, we analyzed the root mean square (RMS) of total higher order aberrations (HOAs), trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration at 3- and 4.5-mm pupil. In addition, the point spread functions (PSFs) of each ICL evaluated were calculated from the wavefront aberrations at 3- and 4.5-mm pupil. Statistical Analysis: A Student′s t-test for unpaired data was used for comparison between myopic and hyperopic ICLs. Results: Myopic ICLs showed negative spherical aberration, in contrast hyperopic ICLs showed positive spherical aberration, which increases when the ICL power increases, due to the innate optical properties of the lens. All ICLs evaluated had negligible amounts of other aberrations. We did not find statistical significant differences in any Zernike coefficient RMS values analyzed between myopic and hyperopic ICLs at 3- and 4.5-mm pupil (P > 0.05). Conclusions: Myopic and hyperopic ICLs provide good and comparable optical quality for low to moderate refractive error. The ICLs evaluated showed values of wavefront aberrations clinically negligible to affect the visual quality after implantation.

PURPOSE:To assess nuclear and cortical opacities through the objective analysis of Scheimpflug images, and to check the correlation with the Lens Opacity Classification System III (LOCS III). METHODS:Nuclear and cortical opacities were graded according to the LOCS III rules after pupil dilation. The maximum and average pixel intensity values along an elliptical mask within the lens nucleus were taken to analyse nuclear cataracts. A new metric based on the percentage of opaque pixels within a region of interest was used to analyse cortical cataracts. The percentage of opaque pixels was also calculated for half, third and quarter areas from the region of interest's periphery. RESULTS:The maximum and average intensity values along the nucleus were directly proportional to the LOCS III grade: The larger the LOCS III value, the larger maximum and average intensity ones. These metrics showed a positive and significant correlation with the LOCS grade: The larger the LOCS grade, the higher was percentage of opaque pixels along the cortex within the same mask's size. This metric showed a significant correlation to the LOCS grade. CONCLUSION:The metrics used to assess nuclear opacities showed good correlation with the LOCS III. The percentage of opaque pixels showed to be a useful metric to measure objectively the severity of the cortical opacity. These metrics could be implemented in an algorithm to detect and grade lens opacities automatically and objectively.