Comparison of optical coherence tomography and ultrasound biomicroscopy for detection of narrow anterior chamber angles
ABSTRACT To assess the accuracy of classification of narrow anterior chamber (AC) angles using quantitative imaging by optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM).
Observational comparative study.
A high-speed (4000 axial scans/s) anterior segment OCT prototype was developed using a 1.3-microm light source. Seventeen normal subjects (17 eyes) and 7 subjects (14 eyes) with narrow angle glaucoma were enrolled. All subjects underwent gonioscopy, OCT, and UBM. Quantitative AC angle parameters (angle opening distance, angle recess area, and the trabecular-iris space area [a new parameter we have defined]) were measured from OCT and UBM images using proprietary processing software.
Specificity and sensitivity in identifying narrow angles with image-derived AC angle parameters.
Eight of 31 eyes were classified as having narrow angles (Shaffer grade < or =1 in all quadrants). The AC angle parameters measured by both OCT and UBM had similar mean values, reproducibility, and sensitivity-specificity profiles. Both OCT and UBM showed excellent performance in identifying eyes with narrow angles. Areas under the receiver operating characteristic curves for these parameters were all in the range of 0.96 to 0.98.
Optical coherence tomography was similar to UBM in quantitative AC angle measurement and detection of narrow angles. In addition, it was easier to use and did not require contact with the eye. Optical coherence tomography is a promising method for screening individuals at risk for narrow angle glaucoma.
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ABSTRACT: Purpose. To evaluate the normal aging effects on trabecular meshwork (TM) parameters using Fourier domain anterior segment optical coherence tomography (ASOCT) images. Patients and Methods. One eye from 45 participants with open angles was imaged. Two independent readers measured TM area, TM length, and area and length of the TM interface shadow from 3 age groups (18-40, 41-60, and 61-80). Measurements were compared using stepwise regression analysis. Results. The average TM parameters were 0.0487 (±0.0092) mm(2) for TM area, 0.5502 (±0.1033) mm for TM length, 0.1623 (±0.341) mm(2) for TM interface shadow area, and 0.7755 (±0.1574) mm for TM interface shadow length. Interobserver reproducibility coefficients ranged from 0.45 (TM length) to 0.82 (TM area). TM area and length were not correlated with age. While the TM interface shadow length did not correlate with age, the TM interface shadow area increased with age. Race, sex, intraocular pressure, and gonioscopy score were not correlated with any TM parameters. Conclusion. Although the TM measurements were not correlated with age, the TM interface shadow area increased with age. Further study is required to determine whether there is any relationship between the age-related ASOCT findings of the TM interface shadow area and physiologic function.01/2013; 2013:295204. DOI:10.1155/2013/295204
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ABSTRACT: Purpose: To compare the 23-gauge (23-G) sutureless vitrectomy incision architecture in macular and non-macular surgery, using anterior segment spectral-domain optical coherence tomography (SD-OCT), and to evaluated its influence on clinical outcomes. Methods: A prospective, observational case series of 43 patients who underwent primary transconjunctival 23-G pars plana vitrectomy (PPV) for macular and non-macular diseases. All sclerotomy wounds were imaged 1 day after surgery using the anterior segment module of SD-OCT (OCT Spectralis; Heidelberg Engineering, Heidelberg, Germany). Sclerotomy architecture, including good wound apposition, presence of gaping and misalignment of the roof and floor of the incisions were evaluated. Preoperative, intraoperative and postoperative medical record data were also prospectively collected. Results: Incision gaping and misalignment of the roof and floor occurred more frequently in the superotemporal and superonasal quadrants than in the inferotemporal quadrant (p < 0.05) and was more frequent in the non-macular group than in the macular group (p < 0.05). The incidence of incision gaping increased significantly as the incision angle increased. In the macular group, the mean postoperative intraocular pressure (IOP) did not change from the preoperative value, whereas in the non-macular group, the mean IOP decreased significantly from 15.09 ± 2.58 mmHg preoperatively to 12.18 ± 3.25 mmHg on the first postoperative day (p < 0.005). The mean IOP did not differ significantly between the two groups of surgery at 1 week, and at 1 month postoperatively. Conclusions: In 23-G PPV, non-macular surgery is associated with a significant postoperative IOP decrease in comparison with macular surgery, which could be explained by the most remodelled wound architecture.Acta ophthalmologica 12/2012; 91(3). DOI:10.1111/aos.12015 · 2.51 Impact Factor
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ABSTRACT: Angle-closure glaucoma is a major cause of blindness in Asia and could be detected by measuring the anterior chamber angle (ACA) using gonioscopy, ultrasound biomicroscopy or anterior segment (AS) optical coherence tomography (OCT). The current software in the VisanteTM OCT system by Zeiss is based on manual labeling of the scleral spur, cornea and iris and is a tedious process for ophthalmologists. Furthermore, the scleral spur can not be identified in about 20% to 30% of OCT images and thus measurements of the ACA are not reliable. However, high definition (HD) OCT has identified a more consistent landmark: Schwalbe's line. This paper presents a novel algorithm which automatically detects Schwalbe's line in HD-OCT scans. The average deviation between the values detected using our algorithm and those labeled by the ophthalmologist is less than 0.5% and 0.35% in the horizontal and vertical image dimension, respectively. Furthermore, we propose a new measurement to quantify ACA which is defined as Schwalbe's line bounded area (SLBA).Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 01/2010; 2010:3013-6. DOI:10.1109/IEMBS.2010.5626167