Comparison of optical coherence tomography and ultrasound biomicroscopy for detection of narrow anterior chamber angles

Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States
Archives of Ophthalmology (Impact Factor: 4.4). 08/2005; 123(8):1053-9. DOI: 10.1001/archopht.123.8.1053
Source: PubMed


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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    • "Currently, most of the knowledge on features of anterior segment OCT imaging is based on the studies using time-domain OCT.16171819202122 Information about imaging features of common corneal and conjunctival pathologies with Fourier-domain OCT technology is limited. Rosas Salaroli et al.10 reported that Fourier-domain OCT gave highly repeatable flap-thickness measurements in LASIK patients. "
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    ABSTRACT: Purpose: To describe the limitations of Fourier-domain optical coherence tomography (OCT) in imaging common conjunctival and corneal pathology. Materials and Methods: Retrospective, single-center case series of 40 patients with conjunctival and cornea pathology. Results: Fourier-domain OCT imaged laser in situ keratomileusis (LASIK) flaps in detail, including its relation to other corneal structures and abnormalities. Similarly, in infectious or degenerative corneal disorders, Fourier-domain OCT successfully showed the extent of infiltration or material deposition, which appeared as hyper-reflective areas. In cases with pterygium, the underlying cornea could not be imaged. All cases of common conjunctival pathologies, such as nevus or pinguecula, were successfully imaged in detail. Nevi, scleritis, pterygium, pinguecula, and subconjunctival hemorrhage were hyper-reflective lesions, while cysts and lymphangiectasia were hyporeflective. The details of the underlying sclera were not uniformly imaged in conjunctival pathologies. Fourier-domain OCT imaged the trabeculectomy bleb in detail, whereas the details of structures of the anterior chamber angle were not routinely visualized in all cases. Conclusions: Light scatter through vascularized, densely inflamed, or thick lesions limits the imaging capabilities of Fourier-domain anterior segment OCT.
    Middle East African journal of ophthalmology 07/2014; 21(3):220-4. DOI:10.4103/0974-9233.134673
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    • "Quantitative, in vivo data of the anterior segment became available with the creation of ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (ASOCT). Many studies were performed to compare the accuracy and reproducibility of these 2 imaging modalities when measuring the anterior segment parameters [3] [4] [5] [6] [7]. As the imaging capability continues to improve, the TM [8] and its individual surrounding structures are now visible , including the scleral spur [9], Schlemm's canal [10– 12], and Schwalbe's line [13]. "
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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.
    09/2013; 2013:295204. DOI:10.1155/2013/295204
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    • "It provides easier detection of scleral incisions and better image interpretation. However, the Spectralis SD-OCT, originally designed for the exploration of the retina, has a shorter wavelength than the Visante OCT (820 nm versus 1310 nm), and its penetration through tissues is lower (Radhakrishnan et al. 2005; Taban et al. 2009); nevertheless, this did not prevent us from obtaining high-quality images. "
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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 · 2.84 Impact Factor
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