RESUMO
Purpose: Fabry disease is an X-linked lysosomal storage disorder that results in multi-systemic renal, cardiovascular, and neuropathological damage, including in the eyes. We evaluated anterior segment ocular abnormalities based on age, sex (male and female), and genotype (wild-type, knockout [KO] male, heterozygous [HET] female, and KO female) in a rat model of Fabry disease. Methods: The α-Gal A KO and WT rats were divided into young (6-24 weeks), adult (25-60 weeks), and aged (61+ weeks) groups. Intraocular pressure (IOP) was measured. Eyes were clinically scored for corneal and lens opacity as well as evaluated for corneal epithelial integrity and tear break-up time (TBUT). Anterior chamber depth (ACD) and central corneal thickness (CCT) using anterior segment-optical coherence tomography (AS-OCT). Results: The Fabry rats showed an age-dependent increase in IOP, predominantly in the male genotype. TBUT was decreased in both male and female groups with aging. Epithelial integrity was defective in KO males and HET females with age. However, it was highly compromised in KO females irrespective of age. Corneal and lens opacities were severely affected irrespective of sex or genotype in the aging Fabry rats. AS-OCT quantification of CCT and ACD also demonstrated age-dependent increases but were more pronounced in Fabry versus WT genotypes. Conclusions: Epithelial integrity, corneal, and lens opacities worsened in Fabry rats, whereas IOP and TBUT changes were age-dependent. Similarly, CCT and ACD were age-related but more pronounced in Fabry rats, providing newer insights into the anterior segment ocular abnormalities with age, sex, and genotype in a rat model of Fabry disease.
Assuntos
Segmento Anterior do Olho , Modelos Animais de Doenças , Doença de Fabry , Pressão Intraocular , Tomografia de Coerência Óptica , Animais , Doença de Fabry/genética , Doença de Fabry/patologia , Doença de Fabry/fisiopatologia , Feminino , Masculino , Ratos , Segmento Anterior do Olho/patologia , Segmento Anterior do Olho/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Pressão Intraocular/fisiologia , Fatores Sexuais , Envelhecimento/fisiologia , Anormalidades do Olho/genética , Anormalidades do Olho/patologia , alfa-Galactosidase/genéticaAssuntos
Segmento Anterior do Olho , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/patologia , Glaucoma/diagnóstico por imagem , Glaucoma/diagnóstico , Opacidade da Córnea/diagnóstico por imagem , Técnicas de Diagnóstico Oftalmológico , Doenças da Córnea/diagnóstico por imagem , Doenças da Córnea/diagnóstico , Oftalmopatias/diagnóstico por imagem , Oftalmopatias/diagnóstico , Córnea/diagnóstico por imagem , Córnea/patologia , Ceratocone/diagnóstico por imagem , Ceratocone/diagnósticoRESUMO
PURPOSE: To evaluate the repeatability of automatic measurements of a new anterior segment optical coherence tomographer (ANTERION; Heidelberg Engineering) and their agreement with an anterior segment optical coherence tomography device combined with Placido disc corneal topography (MS-39; CSO) in patients affected by keratoconus. METHODS: Fifty-four consecutive patients were included. Three measurements were performed with the ANTERION and one with the MS-39. Repeatability was assessed by means of within-subject standard deviation, coefficient of variation (CoV), and intraclass correlation coefficient (ICC). Agreement was investigated with the 95% limits of agreement. The paired t-test and Wilcoxon matched-pairs test were performed to compare the measurements of the different devices. RESULTS: Repeatability of ANTERION measurements was high, with an ICC greater than 0.98 for all parameters. Many parameters revealed a CoV of less than 1% and a CoV within 5% was obtained for astigmatism measurements. The ANTERION measured a significantly higher corneal power and the MS-39 more negative posterior keratometric values. These differences were mirrored by a moderate agreement for mean simulated keratometry and poor agreement for total corneal power and posterior keratometry. CONCLUSIONS: The ANTERION revealed high repeatability of automatic measurements and good agreement with the MS-39 for many parameters in patients affected by keratoconus, but for most parameters the two instruments cannot be considered interchangeable. [J Refract Surg. 2024;40(7):e445-e452.].
Assuntos
Segmento Anterior do Olho , Topografia da Córnea , Ceratocone , Tomografia de Coerência Óptica , Humanos , Ceratocone/diagnóstico , Ceratocone/fisiopatologia , Tomografia de Coerência Óptica/métodos , Reprodutibilidade dos Testes , Adulto , Topografia da Córnea/métodos , Masculino , Feminino , Segmento Anterior do Olho/diagnóstico por imagem , Adulto Jovem , Biometria/instrumentação , Biometria/métodos , Estudos Prospectivos , Córnea/patologia , Córnea/diagnóstico por imagem , Pessoa de Meia-Idade , AdolescenteRESUMO
BACKGROUND: This study assessed the agreement of ocular parameters of patients with myopia measured using Colombo intraocular lens (IOL) 2 and IOLMaster 700. METHODS: Eighty patients (male, 22; average age, 29.14 ± 7.36 years) with myopia (159 eyes) were included in this study in May 2023. The participants' axial length (AXL), central corneal thickness (CCT), lens thickness (LT), white-to-white distance (WTW), front flat (K1), steep (K2), mean (Km) corneal keratometry, astigmatism (Astig), J0 vector, and J45 vector were measured using the IOLMaster 700 and Colombo IOL 2. The measurements from both devices were compared using the generalized estimating equation, correlation analysis, and Bland-Altman plots. RESULTS: With the Colombo IOL 2, lower values for K2 and J0 (odds ratio [OR] = 0.587, p = 0.033; OR = 0.779, p < 0.0001, respectively), and larger values for WTW, Astig, and J45 (OR = 1.277, OR = 1.482, OR = 1.1, all p < 0.0001) were obtained. All ocular measurements by both instruments showed positive correlations, with AXL demonstrating the strongest correlation (r = 0.9996, p < 0.0001). The intraclass correlation coefficients for AXL and CCT measured by both instruments was 0.999 and 0.988 (both p < 0.0001), and Bland-Altman plot showed 95% limits of agreement (LoA) of -0.078 to 0.11 mm and - 9.989 to 13.486 µm, respectively. The maximum absolute 95% LoA for LT, WTW, K1, K2, and J0 were relatively high, achieving 0.829 mm, 0.717 mm, 0.983 D, 0.948 D, and 0.632 D, respectively. CONCLUSIONS: In young patients with myopia, CCT and AXL measurements obtained with the Colombo IOL 2 and IOLMaster 700 were comparable. However, WTW, LT, corneal refractive power, and astigmatism values could not be used interchangeably in clinical practice.
Assuntos
Comprimento Axial do Olho , Biometria , Miopia , Humanos , Masculino , Biometria/métodos , Biometria/instrumentação , Comprimento Axial do Olho/patologia , Miopia/fisiopatologia , Miopia/diagnóstico , Feminino , Adulto , Adulto Jovem , Análise de Fourier , Tomografia de Coerência Óptica/métodos , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/patologia , Córnea/patologia , Córnea/diagnóstico por imagem , Refração Ocular/fisiologiaRESUMO
PURPOSE: To perform tear meniscus particle analysis using anterior segment spectral domain-optical coherence tomography (SD-OCT) and ImageJ software in keratoconus patients. METHODS: A total of 76 participants (76 eyes) were included in the study. A comprehensive analysis of tear meniscus parameters, including tear meniscus height (TMH), tear meniscus depth (TMD), tear meniscus turbidity (TMT), and percentage of area occupied by particles (PAOP) within the meniscus, was performed in kerataconus patients and healthy controls. RESULTS: TMT was significantly higher in the keratoconus group, while PAOP was significantly lower (P < 0.05). However, TMH and TMD did not show significant differences between the two groups (P > 0.05). There was a negative correlation observed between TMT and PAOP. In binary logistic regression analysis, TMT and Schirmer score were found to be the most influential factors in predicting keratoconus (odds ratio [OR] = 0.995, P = 0.039 and OR = 1.143, P = 0.021, respectively). CONCLUSION: This study revealed novel findings on analysis of the tear film in keratoconus patients, with higher TMT and lower POAP levels in the keratoconus group compared to the healthy control group.
Assuntos
Segmento Anterior do Olho , Ceratocone , Lágrimas , Tomografia de Coerência Óptica , Humanos , Ceratocone/diagnóstico , Tomografia de Coerência Óptica/métodos , Lágrimas/metabolismo , Masculino , Feminino , Adulto , Segmento Anterior do Olho/diagnóstico por imagem , Adulto Jovem , Topografia da Córnea/métodosRESUMO
To optimize and evaluate the accuracy of the vault-predicting formula generated from a very high-frequency digital ultrasound robotic scanner (Artemis Insight 100). The relationship between the achieved lens vault (LVa) at one month after intraocular collamer lens (ICL) implantation surgery and the predicted vault (LVp) was analyzed by a retrospective study, and an optimized formula was built up. Then, the accuracy of the optimized vault-predicting formula was evaluated in a prospective study by comparing the LVa and the predicted vault from the optimized formula (LVop). The retrospective study included 77 patients (133 eyes) while the prospective study enrolled 90 patients (170 eyes). The difference between LVp and LVa at one month after surgery was statistically significant (P < 0.05), and the linear regression analysis of LVa against LVp yielded a good fit (R2 = 0.68). The optimized vault-predicting formula was LVop (µm) = 1.21 × LVp (µm) + 124.73. In the validation study, the difference between LVop and LVa was not statistically significant (P = 0.10), and a good agreement between LVop and LVa was shown by Bland-Altman analysis. The optimized vault-predicting formula could predict the actual LV after ICL implantation surgery, help to select an appropriate ICL size and reduce the need for re-operation.
Assuntos
Implante de Lente Intraocular , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Estudos Prospectivos , Implante de Lente Intraocular/métodos , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/cirurgia , Miopia/cirurgia , Ultrassonografia/métodos , Cristalino/cirurgia , Cristalino/diagnóstico por imagemRESUMO
PURPOSE: To evaluate the effect of pregnancy on the anterior chamber, corneal parameter, and intraocular pressure measurements; and compare the results between trimesters, postpartum and non-pregnant healthy age-matched women. METHODS: This prospective study included 41 pregnant women and 53 non-pregnant women. Four measurements were taken from the pregnant women, in each trimester and postpartum third month, and once from the control group. Of the individuals included in the study, anterior chamber depth (ACD), anterior chamber volume (ACV), K1 (flat keratometry), K2 (steep keratometry), Kmean (mean value of K1 and K2), anterior chamber angle (ACA), central corneal thickness (CCT), thinnest corneal thickness (TCT), astigmatism value (AST), corneal volume (CV), biometry, axial length (AL), spherical equivalent (SFEQ), intraocular lens power (ILP), VA (visual acuity) datas were recorded. RESULTS: We observed a statistically significant decrease in K2, CCT, ACD, AL and CV in the postpartum period (p = 0.025, p < 0.001, p = 0.029, p = 0.005, p = 0.004 respectively) and a statistically significant increase in ACV, CCT, and TCT as the gestational week progressed in the pregnant group (p = 0.007, p < 0.001, p = 0.025, respectively). A statistically significant decrease in IOP towards to the third trimester, and an increase in the postpartum period was observed (p < 0.001). We did not observe statistically significant changes in K1, Kmean, AST, ACA, VA, ILP, and SFEQ values. CONCLUSION: It is important to investigate the physiological changes that may occur during pregnancy, distinguish them from pathological changes, and avoid unnecessary treatment. We consider that it's also important to guide the timing of anterior segment surgeries such as cataract and refractive surgery and to prescribe glasses/contact lenses.
Assuntos
Pressão Intraocular , Período Pós-Parto , Trimestres da Gravidez , Humanos , Feminino , Estudos Prospectivos , Gravidez , Adulto , Período Pós-Parto/fisiologia , Trimestres da Gravidez/fisiologia , Pressão Intraocular/fisiologia , Segmento Anterior do Olho/diagnóstico por imagem , Adulto Jovem , Acuidade Visual/fisiologia , Biometria/métodos , Córnea/diagnóstico por imagem , Córnea/anatomia & histologia , Câmara Anterior/diagnóstico por imagemRESUMO
This case report aims to present the findings of in vivo confocal microscopy (IVCM) and anterior segment optical coherence tomography (AS-OCT) in three patients with iridocorneal endothelial (ICE) syndrome. Three female patients 37, 50, and 57 years of age presented with complaints of unilateral visual impairment and elevated intraocular pressure (IOP). Biomicroscopy revealed unilateral pupil irregularities and anterior synechiae, and gonioscopy demonstrated synechiae in the iridocorneal angle. IOP was within normal limits with medical treatment in two patients, while one patient had an IOP of 44 mmHg despite maximal antiglaucomatous treatment. IVCM revealed large, polymorphic, and hyperreflective cells in the corneal endothelial layer of the affected eyes and normal corneal epithelium, stroma, and endothelium in the fellow eyes. AS-OCT findings were normal in healthy eyes, while the affected eye showed synechiae in the iridocorneal angle and a hyperreflective, thickened endothelial layer. The patient with refractory glaucoma underwent trabeculectomy surgery with 5-fluorouracil. In conclusion, IVCM and AS-OCT allow a detailed examination of endothelial cell abnormalities and iridocorneal membranes in ICE syndrome, which is characterized by unilateral pupil and iris irregularities and anterior synechiae mainly in women.
Assuntos
Segmento Anterior do Olho , Pressão Intraocular , Síndrome Endotelial Iridocorneana , Microscopia Confocal , Tomografia de Coerência Óptica , Humanos , Feminino , Tomografia de Coerência Óptica/métodos , Síndrome Endotelial Iridocorneana/diagnóstico , Microscopia Confocal/métodos , Pessoa de Meia-Idade , Adulto , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/patologia , Pressão Intraocular/fisiologia , Endotélio Corneano/patologia , GonioscopiaRESUMO
PURPOSE: Evaluation of anterior segment parameters using the Scheimpflug corneal topography 1 year after surgery in patients who underwent sutureless scleral fixation intraocular lens (SFIOL) implantation using the modified Yamane technique and retropupillary iris-claw intraocular lens (RPIOL) implantation. METHODS: A total of 60 eyes from 57 patients who underwent sutureless SFIOL implantation and 57 eyes from 52 patients who underwent RPIOL implantation were included. Anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), anterior-posterior corneal astigmatism, and keratometric values were assessed using the Scheimpflug corneal topography (Pentacam HR, Germany). RESULTS: There was no statistically significant difference in postoperative UCVA and BCVA between the sutureless SFIOL and the RPIOL group (p = 0.236, p = 0.293, respectively). While there was no statistically significant difference in postoperative IOP between the two groups (p = 0.223), a statistically significant decrease in IOP was observed in both groups (p < 0.001). While there was no statistical difference between the sutureless SFIOL group and the RPIOL group in terms of spherical value (p = 0.441) and spherical equivalence (p = 0.237), there was a statistically significant difference in cylindrical value (p < 0.001). While there was a statistical difference in anterior astigmatism (p < 0.001), there was no statistical difference in posterior astigmatism (p = 0.405). There was no statistical difference in terms of ACV, ACD, and ACA between the sutureless SFIOL and the RPIOL group (p = 0.812, p = 0.770, p = 0.401, respectively). CONCLUSION: In this study, although there was a statistical difference in cylindrical value and anterior corneal astigmatism between the sutureless SFIOL and RPIOL groups, vision was not affected. According to this study, sutureless SFIOL and RPIOL are two successful methods in terms of visual acuity, anterior segment, and keratometry outcomes in aphakic patients after phacoemulsification.
Assuntos
Topografia da Córnea , Iris , Implante de Lente Intraocular , Esclera , Procedimentos Cirúrgicos sem Sutura , Acuidade Visual , Humanos , Masculino , Feminino , Esclera/cirurgia , Implante de Lente Intraocular/métodos , Pessoa de Meia-Idade , Idoso , Iris/cirurgia , Procedimentos Cirúrgicos sem Sutura/métodos , Lentes Intraoculares , Estudos Retrospectivos , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/cirurgia , Adulto , Resultado do Tratamento , Desenho de Prótese , Afacia Pós-Catarata/cirurgia , Afacia Pós-Catarata/fisiopatologia , Seguimentos , Afacia/cirurgia , Afacia/fisiopatologia , Afacia/diagnósticoRESUMO
We describe 3 cases of ocular trauma that presented with strabismus. Anterior segment optical coherence tomography was used to delineate the morphology of extraocular muscle insertions and proved helpful in diagnosis and management.
Assuntos
Segmento Anterior do Olho , Traumatismos Oculares , Músculos Oculomotores , Estrabismo , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/patologia , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/lesões , Masculino , Estrabismo/etiologia , Feminino , Traumatismos Oculares/complicações , Traumatismos Oculares/diagnóstico por imagem , AdultoAssuntos
Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Biópsia/métodos , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/patologia , Neoplasias Oculares/diagnóstico , Neoplasias Oculares/patologia , Neoplasias Oculares/diagnóstico por imagem , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/diagnóstico por imagem , Neoplasias da Túnica Conjuntiva/diagnósticoRESUMO
Congenital corneal staphyloma is a rare congenital malformation with guarded visual potential. The cornea is opaque, markedly ectatic, and lined by uveal tissue with a variety of associated anterior segment abnormalities. In this case report, the detailed histopathology of this condition is highlighted with an unusual finding of the malformed lens. [J Pediatr Ophthalmol Strabismus. 2024;61(3):e28-e32.].
Assuntos
Segmento Anterior do Olho , Córnea , Doenças da Córnea , Humanos , Lactente , Segmento Anterior do Olho/anormalidades , Segmento Anterior do Olho/diagnóstico por imagem , Córnea/patologia , Córnea/anormalidades , Doenças da Córnea/diagnóstico , Doenças da Córnea/congênito , Anormalidades do Olho/diagnósticoRESUMO
Optical coherence tomography of the anterior segment of the eye (AS-OCT) is a non-invasive method based on the principles of optical reflectometry (measurement of the degree of backscattering of light passing through transparent or translucent media). Limitations of the first devices of this type were associated with insufficient image quality of the details of the anterior chamber angle and the posterior parts of the lens, primarily due to the "working" level of the scanning wavelength (within 800 µm). Fundamentally new possibilities in the structural and functional assessment of the anterior segment of the eye are associated with the introduction into clinical practice of swept-source AS-OCT device - the CASIA2 anterior optical coherence tomograph (Tomey Corporation, Japan). Its high scanning speed (50 000 A-scans per second) with a wavelength of 1310 µm allows high-quality visualization by building a scan at a depth of 13 mm. The previous model (CASIA SS-1000, Tomey Corporation, Japan) supported scan depth of only 6 mm. This review summarizes the results of research on the clinical use of CASIA2 tomograph.
Assuntos
Segmento Anterior do Olho , Tomografia de Coerência Óptica , Tomografia de Coerência Óptica/métodos , Humanos , Segmento Anterior do Olho/diagnóstico por imagemRESUMO
PURPOSE: This study compares the changes in the parameters of the anterior chamber of the eye using anterior segment optical coherence tomography (AS-OCT) in patients with a natural and artificial lens after treatment of neovascular age-related macular degeneration (nAMD) by multiple intravitreal injections (IVI) of anti-VEGF drugs. MATERIAL AND METHODS: The patients were divided into 2 groups: group 1 (control) included 30 patients (30 eyes) with a natural lens, group 2 - 30 patients (30 eyes) with an intraocular lens (IOL). AS-OCT was performed using the Revo NX tomograph (Optopol, Poland) to analyze anterior chamber depth (ACD) and the parameters of anterior chamber angle (ACA). Intraocular pressure (IOP) was measured with a contact tonometer ICare Pro. RESULTS: In patients with an IOL, the IOP level 1 minute after intravitreal injection (IVI) of an anti-VEGF drug was statistically lower than in the control group, on average by 17.8% during the first IVI and by 28.7% after 1 year of observation (p<0.001). ACD before treatment was statistically significantly higher in patients with IOL compared to patients of group 1 by an average of 39.3% (p<0.001). ACA from the nasal and temporal sides in the meridian 0°-180° before the start of treatment was statistically significantly wider in phakic patients than in the control group, by an average of 15.9±9.3° (p<0.001) and 16.9±8.2° (p<0.001), respectively. According to AS-OCT, there was no shift of the iris-lens diaphragm in patients with an IOL after multiple IVI of an anti-VEGF drug, in contrast to the control group. CONCLUSIONS: AS-OCT was used to determine for the first time the changes in the parameters of the anterior chamber of the eye in patients with a natural and artificial lens after multiple injections of an anti-VEGF drug in the treatment of nAMD.
Assuntos
Inibidores da Angiogênese , Segmento Anterior do Olho , Pressão Intraocular , Cristalino , Lentes Intraoculares , Degeneração Macular , Receptores de Fatores de Crescimento do Endotélio Vascular , Proteínas Recombinantes de Fusão , Fator A de Crescimento do Endotélio Vascular , Pressão Intraocular/efeitos dos fármacos , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/efeitos dos fármacos , Injeções Intravítreas , Tomografia de Coerência Óptica , Degeneração Macular/tratamento farmacológico , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Proteínas Recombinantes de Fusão/administração & dosagem , Proteínas Recombinantes de Fusão/efeitos adversos , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Inibidores da Angiogênese/administração & dosagem , Inibidores da Angiogênese/efeitos adversos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidoresRESUMO
OBJECTIVE: This study aimed to develop and evaluate a deep learning-based model that could automatically measure anterior segment (AS) parameters on preoperative ultrasound biomicroscopy (UBM) images of implantable Collamer lens (ICL) surgery candidates. METHODS: A total of 1164 panoramic UBM images were preoperatively obtained from 321 patients who received ICL surgery in the Eye Center of Renmin Hospital of Wuhan University (Wuhan, China) to develop an imaging database. First, the UNet++ network was utilized to segment AS tissues automatically, such as corneal lens and iris. In addition, image processing techniques and geometric localization algorithms were developed to automatically identify the anatomical landmarks (ALs) of pupil diameter (PD), anterior chamber depth (ACD), angle-to-angle distance (ATA), and sulcus-to-sulcus distance (STS). Based on the results of the latter two processes, PD, ACD, ATA, and STS can be measured. Meanwhile, an external dataset of 294 images from Huangshi Aier Eye Hospital was employed to further assess the model's performance in other center. Lastly, a subset of 100 random images from the external test set was chosen to compare the performance of the model with senior experts. RESULTS: Whether in the internal test dataset or external test dataset, using manual labeling as the reference standard, the models achieved a mean Dice coefficient exceeding 0.880. Additionally, the intra-class correlation coefficients (ICCs) of ALs' coordinates were all greater than 0.947, and the percentage of Euclidean distance distribution of ALs within 250 µm was over 95.24%.While the ICCs for PD, ACD, ATA, and STS were greater than 0.957, furthermore, the average relative error (ARE) of PD, ACD, ATA, and STS were below 2.41%. In terms of human versus machine performance, the ICCs between the measurements performed by the model and those by senior experts were all greater than 0.931. CONCLUSION: A deep learning-based model could measure AS parameters using UBM images of ICL candidates, and exhibited a performance similar to that of a senior ophthalmologist.
Assuntos
Segmento Anterior do Olho , Aprendizado Profundo , Microscopia Acústica , Humanos , Microscopia Acústica/métodos , Segmento Anterior do Olho/diagnóstico por imagem , Masculino , Feminino , Adulto , Lentes Intraoculares Fácicas , Implante de Lente Intraocular , Adulto Jovem , Pessoa de Meia-Idade , Processamento de Imagem Assistida por Computador/métodosRESUMO
OBJECTIVES: Differentiation of iris and ciliary body lesions as benign or malignant and cystic or solid is important. The aim of this study was to compare anterior segment swept-source optical coherence tomography (AS SS-OCT) and ultrasound biomicroscopy (UBM) findings in iris and ciliary body tumors. RESEARCH DESIGN AND METHODS: Forty-two eyes of 38 cases with iris and ciliary body tumors imaged with UBM and AS SS-OCT between September 2018 and September 2023 were evaluated retrospectively. RESULTS: Of 42 eyes, 14 had melanoma, 14 iris pigment epithelial (IPE) cysts, 7 nevi, 3 Lisch nodules, 2 iris stromal cysts, 1 pars plana cysts, and 1 iris mammillations. An equivalent (100%) visualization of the anterior tumor margin was obtained with both techniques. Compared to AS SS-OCT, UBM was superior for posterior margin visualization in melanocytic tumors and IPE cysts. Bland-Altman plots demonstrated good agreement between UBM and AS SS-OCT for melanocytic tumors < 2.5 mm in base diameter and < 2 mm in thickness. CONCLUSIONS: Although, UBM is the gold standard for ciliary body and iridociliary tumors. AS SS-OCT should be considered as an excellent alternative to UBM, especially in minimally elevated iris lesions.
Assuntos
Corpo Ciliar , Microscopia Acústica , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Microscopia Acústica/métodos , Corpo Ciliar/diagnóstico por imagem , Corpo Ciliar/patologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Idoso , Neoplasias Uveais/diagnóstico por imagem , Neoplasias Uveais/patologia , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/patologia , Neoplasias da Íris/diagnóstico por imagem , Adulto Jovem , Doenças da Íris/diagnóstico por imagem , Iris/diagnóstico por imagem , Iris/patologia , AdolescenteRESUMO
BACKGROUND: To compare results from different corneal astigmatism measurement instruments; to reconstruct corneal astigmatism from the postimplantation spectacle refraction and toric intraocular lens (IOL) power; and to derive models for mapping measured corneal astigmatism to reconstructed corneal astigmatism. METHODS: Retrospective single centre study involving 150 eyes treated with a toric IOL (Alcon SN6AT, DFT or TFNT). Measurements included IOLMaster 700 keratometry (IOLMK) and total keratometry (IOLMTK), Pentacam keratometry (PK) and total corneal refractive power in 3 and 4 mm zones (PTCRP3 and PTCRP4), and Aladdin keratometry (AK). Regression-based models mapping the measured C0 and C45 components (Alpin's method) to reconstructed corneal astigmatism were derived. RESULTS: Mean C0 components were 0.50/0.59/0.51 dioptres (D) for IOLMK/PK/AK; 0.2/0.26/0.31 D for IOLMTK/PTCRP3/PTCRP4; and 0.26 D for reconstructed corneal astigmatism. All corresponding C45 components ranged around 0. The prediction models had main diagonal elements lower than 1 with some crosstalk between C0 and C45 (nonzero off-diagonal elements). Root-mean-squared residuals were 0.44/0.45/0.48/0.51/0.50/0.47 D for IOLMK/IOLMTK/PK/PTCRP3/PTCRP4/AK. CONCLUSIONS: Results from the different modalities are not consistent. On average IOLMTK/PTCRP3/PTCRP4 match reconstructed corneal astigmatism, whereas IOLMK/PK/AK show systematic C0 offsets of around 0.25 D. IOLMTK/PTCRP3/PTCRP4. Prediction models can reduce but not fully eliminate residual astigmatism after toric IOL implantation.
Assuntos
Astigmatismo , Biometria , Córnea , Topografia da Córnea , Implante de Lente Intraocular , Refração Ocular , Humanos , Astigmatismo/fisiopatologia , Astigmatismo/diagnóstico , Astigmatismo/cirurgia , Estudos Retrospectivos , Masculino , Biometria/métodos , Refração Ocular/fisiologia , Feminino , Córnea/diagnóstico por imagem , Córnea/patologia , Idoso , Pessoa de Meia-Idade , Topografia da Córnea/métodos , Lentes Intraoculares , Segmento Anterior do Olho/diagnóstico por imagem , Acuidade Visual/fisiologia , Idoso de 80 Anos ou mais , Facoemulsificação , AdultoRESUMO
PURPOSE: To investigate and compare the morphological features and differences among Gaussian, Sagittal, and Tangential anterior corneal curvature maps obtained with an anterior segment optical coherence tomographer combined with a Placido disc MS-39 device in keratoconus (KC) and normal eyes. METHODS: Prospective, cross-sectional study including 37 KC and 51 healthy eyes. The pattern of astigmatism and maximum keratometry (Kmax), keratometry at the thinnest point (Ktp) and 2 mm diameter (K 2mm ), and inferior-superior dioptric asymmetry values were obtained and calculated from Gaussian, Tangential, and Sagittal curvature maps using the MS-39 (CSO). RESULTS: In KC eyes, an asymmetric bowtie pattern was observed in 64.86% (24/37), 64.86% (24/37), and 0% in the Sagittal, Tangential, and Gaussian maps, respectively. In normal eyes, 51.0% (26/51), 51.0% (26/51), and 0% showed a symmetric bowtie pattern in the Sagittal, Tangential, and Gaussian maps, respectively. There was a significant difference for the variables Kmax, Ktp, and K 2mm inferior among the Gaussian, Tangential, and Sagittal maps in both normal and KC groups. Sensitivity discriminating between normal and KC eyes was 100%, 97.3%, and 90.9% and specificity was 94.1%, 100%, and 100% for Kmax coming from the Tangential, Gaussian, and Sagittal maps, respectively. CONCLUSIONS: Gaussian maps displayed significantly different morphological features when compared with Sagittal and Tangential maps in normal and KC eyes. Anterior curvature maps from Gaussian maps do not show the morphological pattern of symmetric bowtie in normal eyes nor asymmetric bowtie in KC eyes. Kmax from Gaussian maps are more specific, however less sensitive than Tangential maps in discriminating KC from normal eyes.
Assuntos
Topografia da Córnea , Ceratocone , Tomografia de Coerência Óptica , Humanos , Ceratocone/diagnóstico , Ceratocone/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Estudos Prospectivos , Masculino , Estudos Transversais , Feminino , Adulto , Adulto Jovem , Topografia da Córnea/métodos , Córnea/patologia , Córnea/diagnóstico por imagem , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/patologia , Pessoa de Meia-Idade , Distribuição NormalRESUMO
The aim of the study was to compare the anterior segment parameters after cataract surgery in pseudoexfoliation syndrome (PEX) and control eyes. We conducted a prospective comparative study of 36 eyes (PEX group), 16 eyes (PEXG group) and 46 eyes (control group) of 98 patients after phacoemulsification with intraocular lens implantation. Before surgery, 1 week, 1 month and 3 months postoperatively, anterior chamber parameters were evaluated by swept source anterior segment optical coherence tomography (AS-OCT). Anterior chamber depth (ACD), angle opening distance (AOD500/750), trabecular-iris space area (TISA500/750), trabecular-iris angle (TIA500/750) and lens vault (LV) were assessed at each study visit. Preoperatively, ACD, AOD500/750 and TISA500/750 were significantly smaller, while LV was significantly greater in PEX and PEXG eyes than in controls. 3 months postoperatively all irido-corneal parameters and ACD were significantly greater in all study groups without intergroup differences. ACD and LV significantly increased in PEX group between 1 and 3 months after surgery while being stable in control group. Relative increases in ACD, AOD500, TISA750, TIA500/750 were significantly higher in PEX and PEXG groups than in controls. Our study finds that ACD and iridocorneal parameters in AS-OCT demonstrated significantly greater relative increases 3 months after phacoemulsification in PEX and PEXG groups than in control eyes. Significantly greater deepening of anterior chamber and opening of the irido-corneal angle may be a reason for different refractive outcomes and IOP control in patients with PEX and PEXG after routine cataract surgery.
Assuntos
Catarata , Síndrome de Exfoliação , Humanos , Tomografia de Coerência Óptica/métodos , Síndrome de Exfoliação/diagnóstico por imagem , Estudos Prospectivos , Pressão Intraocular , Câmara Anterior , Segmento Anterior do Olho/diagnóstico por imagemRESUMO
A 71-year-old woman had 2 months of worsening vision and pain in her right eye. Examination revealed retrocorneal plaque, peaking of the pupil, and temporal prominent scleral vessels with inferotemporal scleral thinning. What would you do next?