Evaluación del músculo ciliar y del grosor escleral anterior en miopes altos mediante tomografía de coherencia óptica / Assessment of the ciliary muscle and scleral anterior thickness in high myopia by optical coherence tomography

Propósito: Evaluar las dimensiones del músculo ciliar (MC) y del grosor escleral anterior (AST) in vivo en miopes altos mediante tomografía de coherencia óptica de fuente de barrido (SS-OCT) y comparar con sujetos emétropes e hipermétropes.MétodosEstudio transversal en el que se incluyeron 34 miopes altos (≥−6dioptrías [D]), 90 emétropes (−1 a +1D) y 38 hipermétropes (≥+3,5D). Se midieron el grosor del MC (CMT) y el AST en los cuadrantes temporal y nasal a 1, 2 y 3mm del espolón escleral utilizando la SS-OCT. Además, se evaluó la longitud del MC (CML).ResultadosLas dimensiones tanto del CML como del CMT en cualquiera de sus puntos de medida fueron mayores en miopes altos y en emétropes que en hipermétropes, tanto en el cuadrante nasal como en el temporal (p<0,001). Sin embargo, no existieron diferencias entre miopes magnos y emétropes para ninguno de los parámetros (p≥0,076), salvo para el CMT a 3mm en temporal (p<0,001). No existieron diferencias en el AST entre miopes altos, emétropes e hipermétropes, en ninguno de los puntos de medida ni cuadrantes estudiados (p>0,05).ConclusionesLa SS-OCT permite medir el MC in vivo, no observándose diferencias en sus dimensiones entre miopes altos y emétropes, pero sí que fueron menores en hipermétropes. En la medida de la esclera anterior no se observaron diferencias entre los tres grupos analizados según la refracción. (AU)

Purpose: To assess ciliary muscle (CM) and anterior scleral thickness (AST) dimensions in vivo in high myopia using swept-source optical coherence tomography (SS-OCT) and to compare with emmetropic and hyperopic subjects.MethodsCross-sectional study that included 34 high myopic patients (≥−6 diopters [D]), 90 emmetropes (−1 to +1D) and 38 hyperopic patients (≥+3.5D). CM thickness (CMT) and AST were measured in the temporal and nasal quadrants at 1, 2, and 3mm from the scleral spur using SS-OCT. In addition, the length of the CM (CML) was evaluated.ResultsThe dimensions of the CML and the CMT at any of their measurement points were greater in high myopes and emmetropes than in hyperopes, both in the nasal and temporal quadrants (P<.001). However, there were no differences between high myopes and emmetropes for any of the parameters (P≥.076) except for the CMT at 3mm in the temporal quadrant (P<.001). There were no differences in the AST between high myopes, emmetropes and hyperopes, in any of the measurement points or quadrants studied (P>.05).ConclusionsThe SS-OCT allows to measure the CM in vivo, not observing differences in its dimensions between high myopes and emmetropes, but they were smaller in hyperopes. In the measurement of the anterior sclera, no differences were observed between the three groups analyzed according to refraction. (AU)

Comparison in conjunctival-Tenon's capsule thickness, anterior scleral thickness and ciliary muscle dimensions between Caucasians and Hispanic by optical coherence tomography.

PURPOSE: To investigate the differences in the dimensions of the anterior ocular segment, and specifically in conjunctival-Tenon's capsule thickness (CTT), anterior scleral thickness (AST) and ciliary muscle thickness (CMT), between Caucasian and Hispanic subjects using swept-source optical coherence tomography (SS-OCT). METHODS: Cross-sectional study including 53 Hispanic and 60 Caucasian healthy participants, matched by age, sex and refractive error, who underwent a complete ophthalmological examination. CTT, AST and CMT were manually measured in the temporal and nasal quadrants at 0, 1, 2 and 3 mm from the scleral spur using SS-OCT. RESULTS: Mean age and refractive error were 38.7 ± 12.3 years and -1.05 ± 2.6 diopters, and 41.8 ± 11.7 years and -0.50 ± 2.6 diopters for the Hispanic and Caucasians, respectively (p = 0.165 and p = 0.244). The CTT was increased in the temporal quadrant in the Hispanic group in the three studied regions (CTT1, CTT2 and CTT3; being the means 223.0 ± 68.4, 215.3 ± 66.4 and 203.8 ± 67.1 µm versus 190.8 ± 51.0, 189.4 ± 53.2 and 187.4 ± 55.3 µm respectively; p < 0.001). Larger AST values were observed in the temporal quadrant in the Hispanic group (AST2: 559.8 ± 80.8 µm and AST3: 591.6 ± 83.0 µm) compared to the Caucasian group (520.7 ± 50.1 and 558.9 ± 54.7 respectively; p ≤ 0.022). No differences were observed in the nasal quadrant for CTT, AST1 and AST3 (p ≥ 0.076). No differences emerged in the CM dimensions (p ≥ 0.055). CONCLUSION: CTT and AST measurements were thicker in the temporal quadrant of Hispanic patients compared to Caucasians. This could have implications for the pathogenesis of different ocular diseases.

Normative Topographic Anterior and Posterior Corneal Astigmatism: Axis Distribution and Its Relations with Ocular and Biometric Parameters.

Corneal astigmatism correction is a key factor when planning refractive treatment for ametropies with intraocular lenses. We aim to obtain normative anterior and posterior corneal astigmatism (ACA and PCA, respectively) data in a local population and to describe their axis distribution and their association with other parameters. A total of 795 patients with no ocular diseases were evaluated with corneal tomography and optical biometry. Only data of the right eye were included. Mean ACA and PCA were 1.01 ± 0.79 and 0.34 ± 0.17 D, respectively. Vertical steep axis distribution was 73.5% for ACA and 93.3% for PCA. Axis orientation between ACA and PCA matched best for vertical orientation (especially 90° to 120°). Vertical ACA orientation frequency decreased with age, with a more positive sphere and less ACA. Vertical PCA orientation frequency increased with higher PCA. Eyes with vertical ACA orientation were younger and showed a greater white-to-white (WTW) measurement, anterior corneal elevations, ACA and PCA. Eyes with vertical PCA orientation were younger and showed greater anterior corneal elevations and PCA. Normative ACA and PCA data in a Spanish population were presented. Steep axis orientations presented differences with age, WTW, anterior corneal elevations and astigmatism.

Reply to Stanojcic et al. Comment on "Fernández-Vigo et al. Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System. J. Clin. Med. 2023, 12, 2351".

We appreciate the comments made by Stanojcic et al. [...].

Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System.

PURPOSE: To propose a classification of the glistening in intraocular lenses (IOL) using swept-source optical coherence tomography (SS-OCT) by means of a simple, objective and reproducible method that allows the quantification of the presence and severity of glistening. METHODS: A cross-sectional study on a sample of 150 eyes of 150 patients who underwent cataract surgery in at least 600 days before the exam and attended a routine examination. Each subject was examined by SS-OCT after pupil dilation, identifying the presence of glistening or hyperreflective foci (HRF) in the central area of the IOL. The degree of glistening was classified into four categories: 0: ≤5 HRF; 1: 6 to 15 HRF; 2: 16 to 30 HRF; and 3: >30 HRF. The intra and interobserver reproducibility (intraclass correlation coefficient, ICC) in the quantification and classification of the glistening were calculated. The correlation between the horizontal and vertical scan of the IOL was also assessed. RESULTS: Glistening was present in the IOL in 42.7% of the patients. The mean number of HRF or glistening microvacuoles was 10.4 ± 26.2 (range 0 to 239). In total, 63.3% of the IOLs had a grade 0, 20% grade a 1, 6.7% grade a 2 and 10% a grade 3. The intraobserver and interobserver reproducibility were very high, both for the absolute quantification of the glistening (ICC ≥ 0.994) and for the severity scale (ICC ≥ 0.967). There was an excellent correlation in the quantification of the IOL glistening between the horizontal and vertical scans (R ≥ 0.834; p < 0.001). CONCLUSIONS: The use of SS-OCT makes it possible to identify, quantify and classify IOL glistening in a simple, objective and reproducible way. This technique could provide relevant information for the study of the glistening on IOLs.

Association between macular and papillary vessel density by optical coherence tomography angiography in a large healthy population.

PURPOSE: To provide a normative data set of the relationship between macular and papillary vessel density (VD) using swept-source optical coherence tomography angiography (SS-OCTA) in a large healthy population. METHODS: Cross-sectional study conducted on 346 right eyes of healthy subjects. Macular and papillary SS-OCTA VD measurements of the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) in the central area and the four quadrants were obtained. Correlations between macular and papillary VD among different quadrants were assessed. RESULTS: The mean participant age was 37.7 ± 19.8 years (range 5-83); 59% were women. No correlation was detected neither for the global SCP (R = 0.050; P = 0.040), DCP (R = -0.056; P = 0.038) nor CC (R = 0.102; P < 0.001) between macular and papillary VD. In a subanalysis, there was also no correlation in any of the quadrants studied (R ≤ 0.180; P < 0.001). In a subgroup of 45 left eyes, there was no correlation in the different plexus and layers studied between macular and papillary vasculature. No differences in SCP, DCP and CC were found according to gender, age or axial length in the relationship between macular and papillary VD. CONCLUSION: There is no association between macular and papillary VD neither in the SCP, DCP or CC in any of the regions studied. Hence, macular and optic nerve head vascularization should be investigated separately to identify which structure is more relevant in each disease.

Diagnostic imaging of the ciliary body: Technologies, outcomes, and future perspectives.

The ciliary body (CB) is part of the uvea and is a complex, highly specialized structure with multiple functions and significant relationships with nearby structures. Its functions include the aqueous humor (AH) production in the ciliary processes, the regulation of the AH output through the uveoscleral pathway, and accommodation, which depends on the ciliary muscle. Also, the CB is an important determinant of angle width as it forms part of the ciliary sulcus. Until recently, knowledge of the CB was based on histological studies. However, this structure can currently be assessed in vivo using imaging techniques such as ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT). Both techniques have shown good reproducibility of their measurements allowing for quantification of CB dimensions and their localization. In effect, studies have shown a larger CB in myopia and its diminishing size with age. Swept-source OCT devices offer fast, non-invasive high-resolution imaging allowing the identification of multiple structures. UBM requires contact and is uncomfortable for the patient. However, this technique offers deeper imaging and therefore remains the gold standard for assessing the posterior chamber, ciliary processes, or zonula. The clinical utility of CB imaging includes its assessment in different types of glaucoma such as angle-closure, malignant or plateau iris. Diagnostic CB imaging is also invaluable for the assessment of ciliochoroidal detachment when suspected, the position after the implantation of a pre-crystalline or sulcus-sutured lenses, diagnosis or monitoring of cysts or tumors, sclerotomies after retinal surgery, intermediate uveitis, or accommodation.

Anterior scleral thickness dimensions by swept-source optical coherence tomography.

Clinical relevance: Given the association of scleral characteristics with many ophthalmological diseases, there is an important need to measure the anterior scleral thickness (AST).Background: This study examined the AST by swept-source optical coherence tomography (SS-OCT) in a large healthy population, assessing also the reproducibility of AST measurements and the correlation with different parameters.Methods: Cross-sectional study in 605 eyes of 605 subjects. AST measurements were made in the temporal and nasal quadrants at 1 (AST1) and 3 mm (AST3) from the scleral spur using SS-OCT. These dimensions were then assessed for associations in a multivariate model with the factors age, sex, refractive error, conjunctival-Tenon capsule thickness (CTT), anterior chamber angle (ACA), intraocular pressure (IOP), iris thickness (IT), limbus-sulcus distance (LSD), and ciliary muscle thickness (CMT). The reproducibility of the AST measurements was determined in 30 of the participants.Results: The mean age was 42.6 ± 17.3 years (range 5 to 86 years). The following means were recorded: AST1 was 522.3 ± 65.7 µm (355 to 761) and 558.4 ± 71.5 µm (357 to 889); AST2 was 513.3 ± 67.3 µm (343 to 732) and 574.4 ± 71.6 µm (389 to 789), and AST3 548.8 ± 71.9 µm (356 to 762) and 590.1 ± 76.6 µm (414 to 873) in the temporal and nasal quadrants respectively, being thicker the nasal quadrant (all p < 0.001). A positive correlation was detected between AST and age, sex, temporal ACA and LSD (all p ≤ 0.043), being negative the correlation with CMT (p ≤ 0.044). No correlation was observed between AST measurements and refractive error, CTT and IT (p ≥ 0.064). The reproducibility of AST measurements was excellent (intraclass correlation coefficient ≥0.951).Conclusions: SS-OCT allows for in vivo AST measurements. Our data contained a wide range of measurements, showing an association between AST and age, sex, ACA, LSD and CMT.

Dimensions of the limbus-ciliary sulcus region by OCT and correlation study in a large population.

PURPOSE: To assess the dimensions of the limbus-ciliary sulcus region measured by swept-source optical coherence tomography (SS-OCT) and conduct a correlation study in a large healthy population. SETTING: Centro Internacional de Oftalmología Avanzada, Madrid, Spain. DESIGN: Cross-sectional study. METHODS: The dimensions of the limbus-ciliary sulcus region were measured in the temporal and nasal quadrants using a SS-OCT. The limbus-sulcus distance (LSD), the posterior iris line-ocular surface to limbus distance (PIOLD), and the angle-to-sulcus distance (ASD) were measured. These distances were then assessed for correlations with factors such as age, sex, refractive error, anterior chamber angle (ACA), ciliary muscle thickness (CMT), conjunctival-Tenon capsule thickness (CTT), and anterior scleral thickness (AST). RESULTS: The mean age of the participants was 41.0 ± 18.2 years (range 5 to 86) and the mean refractive error -0.75 ± 3.3 diopters (range -10 to 7). The LSD could be measured in 93.2% of the participants (625 eyes out of 670 eyes), with a mean of 1.35 ± 0.12 mm (range 0.96 to 1.75) and 1.33 ± 0.12 mm (range 1.05 to 1.68) in the temporal and nasal quadrants, respectively, and a correlation of R = 0.616 (P < .001) between them. PIOLD measured 2.22 ± 0.31 mm (1.42 to 2.98), and ASD was 0.21 ± 0.05 mm (0.01 to 0.40). No correlation was observed between LSD with age, spherical error, sex, or ACA (P ≥ .247). However, LSD exhibited the highest correlation with AST (R = 0.466), followed by CTT (R = 0.309) and CMT (R = 0.259). CONCLUSIONS: The SS-OCT allowed for an accurate in vivo measurement of the dimensions of the limbus-ciliary sulcus region.

Impact of age, sex and refractive error on conjunctival and Tenon's capsule thickness dimensions by swept-source optical coherence tomography in a large population.

PURPOSE: To evaluate conjunctival and Tenon's capsule thickness (CTT) in a large healthy population using swept-source optical coherence tomography (SS-OCT), investigating the impact of age, sex and refractive error. METHODS: 630 healthy participants underwent a complete ophthalmological examination. CTT was manually measured in the temporal and nasal quadrants at 0, 1, 2 and 3 mm from the scleral spur using SS-OCT (CTT0, CTT1, CTT2 and CTT3, respectively). These dimensions were then assessed for associations in a multivariate regression model with age, sex, refractive error and anterior scleral thickness (AST). The reproducibility of the CTT measurements was determined in 30 individuals. RESULTS: CTT dimensions could be measured in 596 cases (94.6%); mean age was 42.6 ± 17.2 years (range 5-86). Mean CTT0 was 199.2 ± 33.8 and 192.9 ± 33.9 µm, mean CTT1 195.4 ± 38.0 µm and 199.9 ± 50.9 µm, mean CTT2 187.0 ± 38.4 and 194.8 ± 48.9 µm, and CTT3 180.5 ± 35.6 µm and 191.8 ± 43.7 µm, for the temporal and nasal quadrants, respectively. No difference in CTT was observed in the nasal versus temporal quadrant (p ≥ 0.106) except for the CTT0 and CTT3 (p = 0.001). Moderate correlation was observed between nasal and temporal CTT (R = 0.472, p < 0.001). In the multivariate model, no influence was observed by sex, refractive error and AST on CTT measurements (p ≥ 0.065). Negative association was observed between age and CTT (p < 0.005). The reproducibility was excellent (intraclass correlation coefficient ≥ 0.908). CONCLUSIONS: SS-OCT allows for in vivo CTT evaluation. Our data document a wide range of measurements, showing negative association between CTT and age.

Ciliary muscle dimensions measured by swept-source optical coherence tomography in eyes with primary open-angle glaucoma and healthy eyes.

PURPOSE: To compare in vivo swept-source optical coherence tomography (SS-OCT) measurements of the ciliary muscle (CM) in patients with primary open-angle glaucoma (POAG) and healthy subjects, and examine correlations between CM dimensions and several covariates. METHODS: This was a cross-sectional study of the right eyes of 181 subjects: 89 POAG patients and 92 healthy subjects. Using the Triton SS-OCT device (Topcon, Tokyo, Japan), CM length (CML), area (CMA) and thickness measured 1000 µm (CMT1), 2000 µm (CMT2) and 3000 µm (CMT3) from the scleral spur were determined in the temporal and nasal quadrants. POAG patients were subjected to visual field (VF) and peripapillary retinal nerve fiber layer (RNFL) assessment. CM dimensions were then assessed for correlation with VF mean defect (MD), mean RNFL thickness and intraocular pressure (IOP). RESULTS: Mean CMLs were 4325 ± 340 µm and 4195 ± 843 µm for the healthy subjects and POAG patients, respectively (p = 0.17). Mean CM thicknesses were CMT1 = 546 ± 56 µm, CMT2 = 326 ± 44 µm and CMT3 = 174 ± 16 µm in the healthy eyes versus CMT1 = 534 ± 108, CMT2 = 332 ± 99 and CMT3 = 183 ± 74 in the POAG eyes, with no significant differences detected (all p ≥ 0.25). In the temporal quadrant, mean CMA was 1.12 ± 0.29 mm2 and 1.15 ± 0.24 mm2 for the healthy and POAG subjects, respectively (p = 0.45). No correlations were observed between CM measurements and RNFL thickness (p ≥ 0.15), IOP or VF MD (p ≥ 0.14) in POAG subjects irrespective of glaucoma severity (p ≥ 0.19). CONCLUSIONS: While SS-OCT proved useful to measure CM dimensions in vivo, these dimensions did not differ between healthy individuals and POAG subjects. In the patients with POAG, no correlations were detected between CM dimensions and VF, RNFL or IOP.

Normative Database of Peripapillary Vessel Density Measured by Optical Coherence Tomography Angiography and Correlation Study.

Purpose: To provide a normative data set of swept-source optical coherence tomography angiography (SS-OCTA) peripapillary vessel density (VD) measurements and assess correlations with age, gender, disc area and axial length (AL). Material and Methods: This was an observational cross-sectional study conducted on 346 right eyes of healthy subjects. Peripapillary SS-OCTA VD measurements were obtained in the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) in all four quadrants using the Triton device (Topcon, Nagoya, Japan). AL measurements were made by optical biometry. Results: Mean participant age was 37.7 ± 19.8 years (range 5- 83), AL was 23.9 ± 1.3 mm (21-27), and 59% were women. Mean VDs for all quadrants were 57.2 ± 5.7% for SCP (52.4 ± 4.0% - 62.1 ± 4.2%), 46.3 ± 6.5% for DCP (41.9 ± 5.8% - 49.7 ± 4.8%) and 60.8 ± 7.4% for CC (53.4 ± 5.8% - 65.7 ± 5.5%). Negative correlation was detected between SCP VD and age (R = -0.264; P < .001), while correlation between DCP densities and age was positive (R = 0.202; P = .002). No associations were detected between peripapillary VD and gender (P ≥ 0.087) and negative correlation was found with AL and disc area only in the CC (P ≤ 0.004). In a subgroup analysis of 33 individuals, we noted no differences in VD between fellow eyes (P ≥ 0.139). Conclusion: Peripapillary VD showed wide individual variation when measured with the Triton SS-OCTA in the different retinal plexuses and CC. While correlations were observed with age, no relationships emerged with gender and only CC showed negative correlation with AL and disc area.

Ciliary muscle dimensions by swept-source optical coherence tomography and correlation study in a large population.

PURPOSE: To examine ciliary muscle (CM) dimensions in vivo by swept-source optical coherence tomography (SS-OCT) in a large healthy population. To assess the reproducibility of CM measurements and correlations with different parameters. METHODS: In this cross-sectional study, the following CM measurements were made in 495 eyes of 495 subjects in the temporal and nasal quadrants: length (CML), area (CMA) and thickness at distances of 1000 µm (CMT1), 2000 µm (CMT2) and 3000 µm (CMT3) from the scleral spur using the SS-OCT DRI-Triton® (Topcon, Tokyo, Japan). These dimensions were then assessed for correlations with the factors age, gender, refractive error, anterior chamber angle (ACA) and intraocular pressure (IOP). The reproducibility of CM measurements was determined in 85 of the participants. RESULTS: Mean age was 41.4 ± 17.5 years (range 5-83). The following means were recorded as follows: CML = 4.57 ± 0.73 mm (range 2.16-6.97), CMA = 1.35 ± 0.31 mm2 (2.04-5.45), CMT1 = 558 ± 98 µm (299-891), CMT2 = 366 ± 100 µm (89-629) and CMT3 = 210 ± 75 µm (36-655). Negative correlation was detected between CML/CMA and age (R = -0.516/R = -0.404; p < 0.001) and refractive error (R = -0.519/R = -0.538; p < 0.001). No gender differences were observed (p ≥ 0.150). Both CML and CMA were correlated with ACA (R = 0.498 and 0.546; p < 0.001) and slightly with IOP (R = -0.175; p < 0.001). The reproducibility of the CM measurements was excellent (intraclass correlation coefficient ≥0.878). CONCLUSIONS: Swept-source optical coherence tomography is a valid tool for in vivo CM measurements. Our data indicate a larger CM in myopes and its diminishing size with age.

Correlation Between Optical Coherence Tomography and Magnetic Resonance Imaging of Rectus Muscle Thickness Measurements in Graves' Ophthalmopathy.

PURPOSE: To assess the correlation between optical coherence tomography (OCT) and magnetic resonance imaging (MRI) measurements of extraocular rectus muscle thickness in patients with Graves' ophthalmopathy. METHODS: This was a cross-sectional observational study conducted in 62 eyes of 31 patients with Graves' ophthalmopathy. The disease phase was inactive in 20 patients and active in the remaining 11. The OCT measurements obtained were: medial rectus thickness at 7.2 and 9.2 mm from the limbus and lateral rectus thickness at 8.5 mm from the limbus. MRI measurements were maximum transversal diameter (T-MRI), craniocaudal diameter (CC-MRI), and muscle area (A-MRI). RESULTS: For the whole patient cohort, correlation emerged between the OCT-MR and T-MRI measurements (R = 0.428 to 0.576; P ≤ .002), A-MRI (R = 0.562 to 0.674; P < .001), and CC-MRI (R = 0.286 to 0.293; P ≤ .046). In patients with clinically active Graves' ophthalmopathy, correlations with T-MRI (R = 0.576 to 0.604; P ≤ .010) and A-MRI (R = 0.678 to 0.706; P < .001) were higher. No correlations were detected between OCT and MRI measurements of lateral rectus thickness (P ≥ .177), regardless of disease phase. CONCLUSIONS: The correlations observed suggest OCT could be a complementary assessment or screening method to detect thickening of the anterior portion of the medial rectus muscle in patients with Graves' ophthalmopathy, which may be especially useful when MRI is not available. [J Pediatr Ophthalmol Strabismus. 2019;56(5):319-326.].

Schlemm's canal measured by optical coherence tomography and correlation study in a healthy Caucasian child population.

PURPOSE: To measure the Schlemm's canal (SC) in vivo by Fourier-domain optical coherence tomography (FD-OCT) in a Caucasian paediatric population. METHODS: Participants of this cross-sectional study were 290 healthy children. In the right eye of each child, SC cross-sectional diameter and area measurements were made with the FD-OCT instrument RTVue® (Optovue Inc, Fremont, CA, USA) in the nasal and temporal quadrants. These SC variables were then assessed for correlation with the factors age, gender, refractive error, anterior chamber angle and trabecular meshwork (TM) metrics. Finally, the reproducibility of the SC measurements was assessed in 30 of the participants. RESULTS: Mean participant age was 10.7 ± 3.4 years (range 3-18). SC diameters could be measured in both quadrants in 70.6% and 70.4% of subjects, respectively. Mean SC diameters were similar (p = 0.125) for the temporal and nasal quadrants: 266.7 ± 84.1 µm (range 131-509) and 273.2 ± 77.3 µm (range 124-486), respectively. Mean SC areas were also similar (p = 0.167) for the two quadrants: 9975 ± 3514 µm2 (range 4000-23 000) versus 9688 ± 3297 µm2 (range 3000-24 000). No differences were detected in SC measurements according to gender, refractive error or angle and TM measurements (R ≤ 0.116; p ≥ 0.125). The exception was age which was directly correlated with SC size (p ≤ 0.041). The reproducibility of the SC measurements was excellent (intraclass correlation coefficients ≥0.936). CONCLUSION: FD-OCT allows the identification of the SC in children. Our data indicate an increase in SC size produced with age.

Optical Coherence Tomography Thickness Measurements of the Extraocular Rectus Muscle Tendons in Graves' Ophthalmopathy.

PURPOSE: To examine extraocular rectus muscle tendons in patients with Graves' ophthalmopathy using optical coherence tomography (OCT). METHODS: This was a cross-sectional observational study conducted with 55 healthy controls, 45 patients with clinically inactive Graves' ophthalmopathy, and 12 patients with clinically active Graves' ophthalmopathy. Scanning was performed at the 3- and 9-o'clock positions. The medial rectus tendon thickness was measured at 7.2 and 9.2 mm from the limbus and the lateral rectus tendon thickness was measured at 8.5 and 10.5 mm from the limbus. RESULTS: The 9.2-mm medial rectus, 8.5-mm lateral rectus, and 10.5-mm lateral rectus tendons were thicker in the inactive Graves' ophthalmopathy group than the control group (240 ± 70, 231 ± 63, and 228 ± 54 µm vs 201 ± 71, 199 ± 53, and 200 ± 32 µm, respectively; P ≤ .011), whereas the 8.5-mm lateral rectus and 9.2-mm medial rectus tendons were thicker in patients with active Graves' ophthalmopathy than patients with inactive Graves' ophthalmopathy (274 ± 77 and 283 ± 68 µm vs 231 ± 63 and 240 ± 70 µm, respectively; P ≤ .048). A correlation was detected between lateral rectus and medial rectus tendon thicknesses and the Graves' ophthalmopathy clinical activity score (R = 0.252, P = .035; and R = 0.291, P = .013, respectively). CONCLUSIONS: OCT emerged as an accurate method for measuring medial rectus and lateral rectus tendon thicknesses in patients with Graves' ophthalmopathy. The imaging tool was able to detect thicker horizontal rectus tendons in patients with inactive Graves' ophthalmopathy than in controls, and in patients with active compared to inactive disease. [J Pediatr Ophthalmol Strabismus. 2018;55(6):356-362.].

Anterior Chamber Angle Tissue as an Incidental Optical Coherence Tomography Finding in a Large Healthy Caucasian Child Population.

PURPOSE: The aim of this study was to describe the presence of anterior chamber angle (ACA) tissue as an incidental optical coherence tomography (OCT) finding in healthy children. METHODS: For this cross-sectional study, we reviewed Fourier-domain OCT images obtained in 422 children, who were chosen as candidates for inclusion in a prior study, and who visited our clinic for a routine vision test. The presence of angle tissue was assessed in the nasal and temporal quadrants. On tomographies showing angle tissue, several measurements were made, including ACA width and trabecular meshwork length and size. RESULTS: Hyperreflective tissue was observed in the ACA recess in 14 eyes of 13 children subjected to OCT (3.3%). This tissue was only present in 1 quadrant. The mean age of the affected children was 10.1±2.5 years (range, 7 to 14); 69% were female patients. Spherical refractive error was -0.5 to +1.75 D. ACA width was 45.9±9.1 (24.8 to 57.9) in the nasal quadrant and 44.3±10.1 (23.9 to 60.1) in the temporal quadrant. Trabecular meshwork length and size were 494±94 µm (322 to 732) and 0.064±0.018 mm (0.03 to 0.11), respectively. In all 13 children, intraocular pressure was ≤18 mm Hg, the appearance of the optic nerve head was normal, and none had a family history of glaucoma. CONCLUSIONS: We, here, report the incidental observation of angle tissue in a small percentage of healthy Caucasian children. The follow-up of these children in future work could clarify the possible clinical implications of this observation.