Polarization-Sensitive OCT Imaging of Scleral Abnormalities in Eyes With High Myopia and Dome-Shaped Macula.

Importance: The relevance of visualizing scleral fiber orientation may offer insights into the pathogenesis of pathologic myopia, including dome-shaped maculopathy (DSM). Objective: To investigate the orientation and density of scleral collagen fibers in highly myopic eyes with and without DSM by polarization-sensitive optical coherence tomography (PS-OCT). Design, Setting, and Participants: This case series included patients with highly myopic eyes (defined as a refractive error ≥6 diopters or an axial length ≥26.5 mm) with and without a DSM examined at a single site in May and June 2019. Analysis was performed from September 2019 to October 2023. Exposures: The PS-OCT was used to study the birefringence and optic axis of the scleral collagen fibers. Main Outcomes and Measures: The orientation and optic axis of scleral fibers in inner and outer layers of highly myopic eyes were assessed, and the results were compared between eyes with and without a DSM. Results: A total of 72 patients (51 [70.8%] female; mean [SD] age, 61.5 [12.8] years) were included, and 89 highly myopic eyes were examined (mean [SD] axial length, 30.4 [1.7] mm); 52 (58.4%) did not have a DSM and 37 (41.6%) had a DSM (10 bidirectional [27.0%] and 27 horizontal [73.0%]). Among the 52 eyes without DSM, the 13 eyes with simple high myopia had primarily inner sclera visible, displaying radially oriented fibers in optic axis images. In contrast, the entire thickness of the sclera was visible in 39 eyes with pathologic myopia. In these eyes, the optic axis images showed vertically oriented fibers within the outer sclera. Eyes presenting with both horizontal and bidirectional DSMs had clusters of fibers with low birefringence at the site of the DSM. In the optic axis images, horizontally or obliquely oriented scleral fibers were aggregated in the inner layer at the DSM. The vertical fibers located posterior to the inner fiber aggregation were not thickened and appeared thin compared with the surrounding areas. Conclusions and Relevance: This study using PS-OCT revealed inner scleral fiber aggregation without outer scleral thickening at the site of the DSM in highly myopic eyes. Given the common occurrence of scleral pathologies, such as DSM, and staphylomas in eyes with pathologic myopia, recognizing these fiber patterns could be important. These insights may be relevant to developing targeted therapies to address scleral abnormalities early and, thus, mitigate potential damage to the overlying neural tissue.

Retinal pigment epithelium melanin imaging using polarization-sensitive optical coherence tomography for patients with retinitis pigmentosa.

This study aimed to evaluate the distribution of retinal pigment epithelium (RPE) melanin in patients with retinitis pigmentosa (RP) using entropy measurements by custom-made polarization-sensitive optical coherence tomography (PS-OCT) images, and compare entropy with the intensity of short-wavelength (SW) and near-infrared (NIR) autofluorescence (AF). We retrospectively reviewed the retinal images, including PS-OCT, SW-AF, and NIR-AF of patients with RP who had a hyperautofluorescent ring on AF. A total of 12 eyes of 12 patients (8 women and 4 men; mean age: 37.9 years) were included. There was a strong positive correlation between entropy value and NIR-AF intensity (r = 0.626, p < 0.001), and there was a very weak negative correlation between entropy value and SW-AF (r = - 0.197, p = 0.001). The mean values of the entropy in the foveal, temporal (2 mm from the fovea), and nasal (2 mm from the fovea) sections were 0.41 (± 0.09), 0.29 (± 0.08), and 0.26 (± 0.08), respectively. The entropy was significantly higher in the foveal section than in the temporal and nasal sections (p = 0.002 and p = 0.003, respectively). There was no significant difference between the entropies values for the temporal and nasal sections (p = 0.157). Age, logMAR best-corrected visual acuity, ellipsoid zone width, and central retinal thickness were not correlated with foveal entropy. We presented RPE melanin imaging in patients with RP using PS-OCT for the first time. PS-OCT can be a useful tool for monitoring patients with RP.

Retinal pigment epithelium melanin distribution estimated by polarisation entropy and its association with retinal sensitivity in patients with high myopia.

PURPOSE: To investigate retinal sensitivity of highly myopic eyes without choroidal neovascularisation (CNV) or patchy chorioretinal atrophy (PCA) and investigated its association with anatomical characteristics including melanin distribution at the retinal pigment epithelium (RPE), which was evaluated with polarisation-sensitive optical coherence tomography (PS-OCT). DESIGN: Retrospective consecutive observational cohort study. METHODS: We included highly myopic eyes (refractive error ≤-8.0 dioptres or axial length of ≥26.5 mm) from patients at the University of Tokyo Hospital. Retinal sensitivity was measured by microperimetry at 25 sectors within 6 degrees from the fovea. Depolarisation value, which reflected melanin pigmentation, was measured by a clinical prototype of PS-OCT and was parameterised as polarimetric entropy. Retinal sensitivity or entropy at the RPE in high myopia was compared with emmetropic control subjects. The association of retinal sensitivity with age, axial length, entropy, or choroidal thickness was assessed in per-eye and per-sector analysis. RESULTS: Twenty-three highly myopic eyes (age, 66.6±12.3 years) were included. The average retinal sensitivity was 25.3±3.0 dB, which was significantly decreased compared with the control (p<0.0001). The average entropy at the RPE in the highly myopic eyes was significantly lower than in the control (p<0.0001). Univariate analysis followed by multivariate analysis showed that besides age, axial length or choroidal thickness, RPE entropy was independently associated with retinal sensitivity (ß=4.4; 95% CI 0.5 to 8.3; p=0.03). CONCLUSIONS: Decreased depolarisation at the RPE measured with PS-OCT, which reflected altered melanin pigmentation, was independently associated with reduced retinal sensitivity in patients with early stages of myopic maculopathy without CNV or PCA.

Visualization of Anterior Chamber Angle Structures With Scattering- and Polarization-Sensitive Anterior Segment Optical Coherence Tomography.

Purpose: The purpose of this study was to compare three optical coherence tomography (OCT) modalities in the observation of anterior chamber angle structures; trabecular meshwork (TM), Schlemm's canal (SC), and band of extracanalicular limbal lamina (BELL). Methods: Three OCT modalities were used: (1) 2 × 2 Jones-matrix scattering OCT (S-OCT) representing conventional intensity OCT, (2) polarization-diverse S-OCT that was calculated as summation of all elements of the Jones-matrix to eliminate the influence of artifacts caused by sample birefringence, and (3) polarization-sensitive OCT (PS-OCT) to assess depth-resolved phase retardation. Results: In a total of 97 eyes of 55 subjects, nasal and temporal angles were scanned. The detection rate of TM and BELL was significantly different among modalities; highest with PS-OCT (95.1% and 99.2%), followed by 2 × 2 Jones-matrix S-OCT (71.1% and 88.7%) and polarization-diverse S-OCT (33.2% and 25.0%), indicating the influence of artifacts on 2 × 2 Jones-matrix S-OCT measurements. SC was visible with 2 × 2 Jones-matrix S-OCT, polarization-diverse S-OCT, and PS-OCT in 14.2%, 14.9%, and 0.3% of images, respectively. The intergrader agreement as evaluated with the prevalence-adjusted bias-adjusted κ value was higher with PS-OCT than with other S-OCTs. Conclusions: Visibility of anterior chamber angle structures was assessed with three OCT modalities. For TM and BELL that are rich in collagen fibers, PS-OCT provides significantly better visibility than S-OCT without the influence of artifacts arising from polarization or birefringence. Visualization of SC was more difficult with any OCT modalities. Translational Relevance: PS-OCT is a useful tool to investigate the anterior chamber angle structures which are difficult to observe with conventional OCT.

Changes in entropy on polarized-sensitive optical coherence tomography images after therapeutic subthreshold micropulse laser for diabetic macular edema: A pilot study.

PURPOSE: To investigate the dynamics of the healing process after therapeutic subthreshold micropulse laser (SMPL) for diabetic macular edema (DME) using polarization-sensitive optical coherence tomography (PS-OCT). METHODS: Patients with treatment-native or previously-treated DME were prospectively imaged using PS-OCT at baseline, 1, 2, 3, and 6 months. The following outcomes were evaluated: changes in the entropy value per unit area (pixel2) in the retinal pigment epithelium (RPE) on the B-scan image; changes in the entropy value in each stratified layer (retina, RPE, choroid) based on the ETDRS grid circle overlaid with en face entropy mapping, not only the whole ETDRS grid area but also a sector irradiated by the SMPL; and the relationship between edema reduction and entropy changes. RESULTS: A total of 11 eyes of 11 consecutive DME patients were enrolled. No visible signs of SMPL treatment were detected on PS-OCT images. The entropy value per unit area (pixel2) in the RPE tended to decrease at 3 and 6 months from baseline (35.8 ± 17.0 vs 26.1 ± 9.8, P = 0.14; vs 28.2 ± 18.3, P = 0.14). Based on the en face entropy mapping, the overall entropy value did not change in each layer in the whole ETDRS grid; however, decrease of entropy in the RPE was observed at 2, 3, and 6 months post-treatment within the SMPL-irradiated sectors (P < 0.01, each). There was a positive correlation between the change rate of retinal thickness and that of entropy in the RPE within the SMPL-irradiated sector at 6 months (r2 = 0.19, P = 0.039). CONCLUSION: Entropy measured using PS-OCT may be a new parameter that facilitates objective monitoring of SMPL-induced functional changes in the RPE that could not previously be assessed directly. This may contribute to a more promising therapeutic evaluation of DME. CLINICAL TRIAL: This clinical study was registered in UMIN-CTR (ID: UMIN000042420).

Assessment of macular function in patients with non-vascularized pigment epithelial detachment.

Non-vascularized pigment epithelial detachments (PED) are usually associated with dry age-related macular degeneration (AMD). In this study, we aimed to investigate the correlation between visual function and morphologic parameters. Seventeen eyes of eleven patients with non-vascularized AMD were enrolled. In addition to conventional optical coherence tomography (OCT), polarization-sensitive optical coherence tomography (PS-OCT) measurements were performed by evaluating the regularity of retinal pigment epithelium (RPE) entropy within the PED area. Retinal sensitivity was measured with MP-3 microperimetry, and retinal sensitivities within (RSin) and outside (RSout) the PED area were calculated. The relationship between OCT parameters and visual function was analyzed. As a result, there was a significant difference between the RSin and RSout (p < 0.001, Wilcoxon signed rank test). Moreover, RSin was significantly related to logMAR VA (p = 0.033, linear mixed model). The regularity of RPE entropy was significantly related to visual acuity and RSin (p = 0.00038, p = 0.031, linear mixed model), although neither the height nor area of PED correlated with visual function. Our results suggest that retinal sensitivity is significantly deteriorated within the PED area and RPE entropy measured with PS-OCT was closely related to visual function in eyes with non-vascularized PED.

Three-Dimensional Distribution Of Fundus Depolarization and Associating Factors Measured Using Polarization-Sensitive Optical Coherence Tomography.

Purpose: To investigate the three-dimensional distribution and associating demographic factors of depolarization, using polarization-sensitive optical coherence tomography (PS-OCT), to evaluate melanin pigmentation in the retinal pigment epithelium (RPE) and choroid in healthy eyes. Methods: In total, 39 unaffected healthy eyes of 39 subjects were examined using a PS-OCT clinical prototype. The degree of depolarization, expressed as the polarimetric entropy, was assessed in the RPE, the superficial and the total choroid layer, especially in the center, the inner, or the outer areas centered at the fovea. The values and their association with the demographic data were analyzed. Near-infrared fundus autofluorescence (NIRAF) was also used, in the same manner, for the comparison. Twenty-eight of 39 eyes were measured twice to evaluate intrasession repeatability. Results: Both the polarimetric entropy in the RPE and the gray level in NIRAF, decreased from the center to the periphery (P < 0.001). The polarimetric entropy in the RPE was significantly associated with age in each area (P ≤ 0.001). In the RPE and the superficial choroid, the polarimetric entropy was negatively associated with axial length in each area (P ≤ 0.002). The intraclass correlation coefficient of the polarimetric entropy in the same session was excellent in each area of the RPE, superficial choroid, or total choroid layer (0.94-0.98). Conclusions: The distribution of fundus melanin pigment-related depolarization was evaluated using PS-OCT. The depolarization was associated with the subjects' demographic data, such as age or axial length. Translational Relevance: The presented information in healthy eyes provides an essential basis for the investigation into a variety of chorioretinal pathologies.

Usefulness of Polarization-sensitive Optical Coherence Tomography-derived Attenuation-coefficient Images to Visualize the Internal Structure of the Filtering Bleb.

PURPOSE/AIM OF THE STUDY: Polarization-sensitive anterior-segmental optical coherence tomography (PS-OCT) is useful to evaluate the filtering blebs after trabeculectomy. However, the attenuation phenomenon of OCT signal disturbs the visibility of intra-bleb's structure and distribution of birefringence; a specific parameter of PS-OCT. This study aimed to evaluate the effectiveness of the attenuation-coefficient image of the filtering blebs. MATERIALS AND METHODS: This study included 25 eyes 6 months after TLE. The attenuation-coefficient image of blebs was calculated from OCT intensity signal information. The contrast level of the image (reflectivity of bleb's surface wall/reflectivity of scleral flap) in both attenuation-coefficient image and intensity image and the height of the bleb's wall were calculated. The improvement extent of contrast was defined as the ratio of contrast (attenuation-coefficient image's contrast/intensity image's contrast). We compared the contrast of attenuation-coefficient image and intensity image and investigated the relationship between improvement extent of contrast and height of bleb's wall. RESULTS: The contrast of the attenuation-coefficient image (317.7 ± 255.4%) was significantly higher than that of the intensity image (39.1 ± 24.5%) (P < .01) and the improvement extent of contrast was 9.5 ± 4.6 times. Furthermore, there was a positive correlation between the improvement extent of contrast and the height of the bleb's wall (r = 0.44, P = .03). CONCLUSIONS: The contrast of the image at depth of filtering blebs was improved by attenuation-coefficient image. It is suggested that the attenuation-coefficient image may improve the visibility of the structure and distribution of birefringence in the blebs compared to the intensity image.

Imaging of a retinal pigment epithelium aperture using polarization-sensitive optical coherence tomography.

PURPOSE: To evaluate cases with a retinal pigment epithelium (RPE) aperture using polarization-sensitive optical coherence tomography (PS-OCT). STUDY DESIGN: Retrospective consecutive case series. METHODS: A retrospective study that included three eyes (three patients) with RPE aperture and age-related macular degeneration (AMD) evaluated at the Macular Clinic in Tokyo University Hospital. A three-dimensional dataset of depolarization information was obtained with a clinical prototype of PS-OCT. RESULTS: All patients were categorized as intermediate AMD. RPE apertures were identified with PS-OCT as discontinuities of depolarization in the RPE layer of the pigment epithelial detachment (PED). A nonuniform decrease of depolarization in the RPE layer was also observed around the aperture. Two findings were observed above the aperture, intraretinal focal areas with high reflectivity and increased depolarization and subretinal bands with moderate reflectivity and low depolarization. Retinal sensitivity according to fundus microperimetry measured at 25 points was significantly associated with the degree of depolarization at the corresponding area (r-square = 0.60, p = 0.0001). CONCLUSION: The RPE aperture was characterized as a round discontinuity of depolarization. The findings with PS-OCT suggest atrophic changes in the overlying RPE of the PED. The degree of depolarization was associated with retinal sensitivity. The current results indicate that RPE apertures developed within the spectrum of atrophic AMD.

Melanin concentration and depolarization metrics measurement by polarization-sensitive optical coherence tomography.

Imaging of melanin in the eye is important as the melanin is structurally associated with some ocular diseases, such as age-related macular degeneration. Although optical coherence tomography (OCT) cannot distinguish tissues containing the melanin from other tissues intrinsically, polarization-sensitive OCT (PS-OCT) can detect the melanin through spatial depolarization of the backscattered light from the melanin granules. Entropy is one of the depolarization metrics that can be used to detect malanin granules in PS-OCT and valuable quantitative information on ocular tissue abnormalities can be retrived by correlating entropy with the melanin concentration. In this study, we investigate a relationship between the melanin concentration and some depolarization metrics including the entropy, and show that the entropy is linearly proportional to the melanin concentration in double logarithmic scale when noise bias is corrected for the entropy. In addition, we also confirm that the entropy does not depend on the incident state of polarization using the experimental data, which is one of important attributes that depolarization metrics should have. The dependence on the incident state of polarization is also analyzed for other depolarization metrics.

Polarization-sensitive optical coherence tomography for estimating relative melanin content of autologous induced stem-cell derived retinal pigment epithelium.

Transplantation of autologous human induced pluripotent stem cell-derived retinal pigment epithelial (hiPSC-RPE) sheets is a promising therapy for age-related macular degeneration (AMD). As melanin content is a representative feature of healthy RPE, we used polarization-sensitive optical coherence tomography (PS-OCT) to estimate the relative melanin content of RPE in diseased and non-diseased area, and in human iPSC-RPE sheets in vitro and in vivo by evaluating the randomness of polarization (entropy). Two aged Japanese women, one with neovascular AMD that underwent transplantation of an autologous hiPSC-RPE cell sheet and another with binocular dry AMD, were selected for this study. Entropy value was minimal in cells containing no melanin, whereas that of human RPE and hiPSC-RPE sheets was high. En face entropy of the cultured hiPSC-RPE sheet was compared with its grey-scale photo and its values were found to be inversely correlated with the extent of absence of pigmentation in vitro. En face entropy maps were compared to colour fundus photographs, fundus autofluorescence images, and fluorescein angiography images from patients. Entropy values of intact and defective RPEs and of iPSC-RPE transplant areas were determined in vivo using PS-OCT B-scan images. PS-OCT was found to be applicable in the estimation of relative melanin content of cultured and transplanted RPEs in regenerative medicine.

Parallel detection of Jones-matrix elements in polarization-sensitive optical coherence tomography.

The polarization properties of a sample can be characterized using a Jones matrix. To measure the Jones matrix without assumptions of the sample, two different incident states of polarization are usually used. This requirement often causes certain drawbacks in polarization-sensitive optical coherence tomography (PS-OCT), e.g., a decrease in the effective A-scan rate or axial depth range, if a multiplexing scheme is used. Because both the A-scan rate and axial depth range are important for clinical applications, including the imaging of an anterior eye segment, a new PS-OCT method that does not have these drawbacks is desired. Here, we present a parallel-detection approach that maintains the same A-scan rate and axial measurement range as conventional OCT. The interferometer consists of fiber-optic components, most of which are polarization-maintaining components with fast-axis blocking free from polarization management. When a parallel detection is implemented using swept-source OCT (SS-OCT), synchronization between the A-scans and synchronization between the detection channels have critical effects on the Jones-matrix measurement. Because it is difficult to achieve perfect synchronization using only hardware, we developed a solution using a numerical correction with signals from a static mirror. Using the developed system, we demonstrate the imaging of an anterior eye segment from the cornea to the back surface of the crystalline lens.

Erratum: Estimation of Jones matrix, birefringence and entropy using Cloude-Pottier decomposition in polarization-sensitive optical coherence tomography: erratum.

[This corrects the article on p. 3551 in vol. 7, PMID: 27699120.].

Estimation of Jones matrix, birefringence and entropy using Cloude-Pottier decomposition in polarization-sensitive optical coherence tomography.

Estimation of polarimetric parameters has been a fundamental issue to assess biological tissues that have form birefringence or polarization scrambling in polarization-sensitive optical coherence tomography (PS-OCT). We present a mathematical framework to provide a maximum likelihood estimation of the target covariance matrix and its incoherent target decomposition to estimate a Jones matrix of a dominant scattering mechanism, called Cloude-Pottier decomposition, thereby deriving the phase retardation and the optic axis of the sample. In addition, we introduce entropy that shows the randomness of the polarization property. Underestimation of the entropy at a low sampling number is mitigated by asymptotic quasi maximum likelihood estimator. A bias of the entropy from random noises is corrected to show only the polarization property inherent in the sample. The theory is validated with experimental measurements of a glass plate and waveplates, and applied to the imaging of a healthy human eye anterior segment as an image filter.

Fiber-based polarization-sensitive OCT for birefringence imaging of the anterior eye segment.

We demonstrate a prototype system of polarization-sensitive optical coherence tomography (PS-OCT) designed for clinical studies of the anterior eye segment imaging. The system can measure Jones matrices of the sample with depth-multiplexing of two orthogonal incident polarizations and polarization-sensitive detection. An optical clock is generated using a quadrature modulator and a logical circuit to double the clock frequency. Systematic artifacts in measured Jones matrices are theoretically analyzed and numerically compensated using signals at the surface of the sample. Local retardation images of filtering blebs after trabeculectomy show improved visualization of subconjunctival tissue, sclera, and scar tissue of the bleb wall in the anterior eye segment.

Scleral birefringence as measured by polarization-sensitive optical coherence tomography and ocular biometric parameters of human eyes in vivo.

The relationship between scleral birefringence and biometric parameters of human eyes in vivo is investigated. Scleral birefringence near the limbus of 21 healthy human eyes was measured using polarization-sensitive optical coherence tomography. Spherical equivalent refractive error, axial eye length, and intraocular pressure (IOP) were measured in all subjects. IOP and scleral birefringence of human eyes in vivo was found to have statistically significant correlations (r = -0.63, P = 0.002). The slope of linear regression was -2.4 × 10(-2) deg/µm/mmHg. Neither spherical equivalent refractive error nor axial eye length had significant correlations with scleral birefringence. To evaluate the direct influence of IOP to scleral birefringence, scleral birefringence of 16 ex vivo porcine eyes was measured under controlled IOP of 5-60 mmHg. In these ex vivo porcine eyes, the mean linear regression slope between controlled IOP and scleral birefringence was -9.9 × 10(-4) deg/µm/mmHg. In addition, porcine scleral collagen fibers were observed with second-harmonic-generation (SHG) microscopy. SHG images of porcine sclera, measured on the external surface at the superior side to the cornea, showed highly aligned collagen fibers parallel to the limbus. In conclusion, scleral birefringence of healthy human eyes was correlated with IOP, indicating that the ultrastructure of scleral collagen was correlated with IOP. It remains to show whether scleral collagen ultrastructure of human eyes is affected by IOP as a long-term effect.

Comparison of three-dimensional optical coherence tomography and combining a rotating Scheimpflug camera with a Placido topography system for forme fruste keratoconus diagnosis.

OBJECTIVE: To evaluate the ability of parameters measured by three-dimensional (3D) corneal and anterior segment optical coherence tomography (CAS-OCT) and a rotating Scheimpflug camera combined with a Placido topography system (Scheimpflug camera with topography) to discriminate between normal eyes and forme fruste keratoconus. METHODS: Forty-eight eyes of 48 patients with keratoconus, 25 eyes of 25 patients with forme fruste keratoconus and 128 eyes of 128 normal subjects were evaluated. Anterior and posterior keratometric parameters (steep K, flat K, average K), elevation, topographic parameters, regular and irregular astigmatism (spherical, asymmetry, regular and higher-order astigmatism) and five pachymetric parameters (minimum, minimum-median, inferior-superior, inferotemporal-superonasal, vertical thinnest location of the cornea) were measured using 3D CAS-OCT and a Scheimpflug camera with topography. The area under the receiver operating curve (AUROC) was calculated to assess the discrimination ability. Compatibility and repeatability of both devices were evaluated. RESULTS: Posterior surface elevation showed higher AUROC values in discrimination analysis of forme fruste keratoconus using both devices. Both instruments showed significant linear correlations (p<0.05, Pearson's correlation coefficient) and good repeatability (ICCs: 0.885-0.999) for normal and forme fruste keratoconus. CONCLUSIONS: Posterior elevation was the best discrimination parameter for forme fruste keratoconus. Both instruments presented good correlation and repeatability for this condition.

Anisotropic alteration of scleral birefringence to uniaxial mechanical strain.

PURPOSE: To investigate the relationship between scleral mechanical properties, its birefringence, and the anisotropy of birefringence alteration in respect of the direction of the strain by using PS-OCT. METHODS: The scleral birefringence of thirty-nine porcine eyes was measured with a prototype PS-OCT. A rectangle strip of sclera with a width of 4 mm was dissected at the temporal region 5 mm apart from the optic nerve head. The strain and force were measured with a uniaxial tension tester as the sample was stretched with a speed of 1.8 mm/min after preconditioning. The birefringence of the sample was measured by PS-OCT at the center of the sample before applying, denoted as inherent birefringence, and after applying stretching of 6.5% strain. The birefringence alteration was obtained by these two measurements and correlations between birefringence and elastic parameters, tangent modulus, and structural stiffness were examined. Twenty and 19 porcine eyes were stretched in meridional or equatorial directions, respectively. RESULTS: A moderate positive correlation was found between the inherent birefringence and the structural stiffness. A moderate positive correlation was also found between the inherent birefringence and the tangent modulus. The birefringence increased by strains. Marginal significance was found in the birefringence alteration between meridional and equatorial strains, where the mean birefringence elevation by meridional strain was higher than that by equatorial strain. CONCLUSIONS: The birefringence was found to be altered by applying strain and also be related with inherent birefringence. This implies the birefringence of the sclera of the in vivo eye also could be affected by its mechanical property.

Relationship between changes in crystalline lens shape and axial elongation in young children.

PURPOSE: To evaluate the relationship between changes in crystalline lens shape and axial elongation during growth in young children. METHODS: Twenty-five patients (age: 1 month to 6 years) who underwent head magnetic resonance imaging (MRI) were included in the analysis. Refractive error was measured with an autorefractor in 22 patients. Crystalline lens dimensions and axial length (AL) were obtained from the MR images. The radius of curvature and asphericity of the crystalline lens were measured using reconstructed MR images. Crystalline lens shape and eyeball shape were numerically expressed by elliptic Fourier descriptors (EFDs) on the basis of MR images. The contours of the crystalline lens and eyeball were evaluated by principal component analysis of the EFDs. RESULTS: The average anterior and posterior radii of curvature were 6.21 mm (range across ages from 3.89-7.26 mm) and -4.81 mm (range across ages from -2.93 to -5.67 mm). These were closely correlated with age by logarithmic analysis. The first principal component (PC1) of the crystalline lens explained 89.15% of the total variance in lens shape, and it was also significantly correlated with age (Pearson's r = 0.648, P < 0.001) and AL (r = 0.847, P < 0.001). In the multiple linear regression analysis in which AL was a dependent variable, only the PC1 of the crystalline lens was associated with AL. CONCLUSIONS: Axial elongation is related to the entire contour of the crystalline lens. This result shows that axial elongation progresses in parallel to change in the crystalline lens shape.