Distinguishing Keratoconic Eyes and Healthy Eyes Using Ultrahigh-Resolution Optical Coherence Tomography–Based Corneal Epithelium Thickness Mapping

Pircher, Niklas; Schwarzhans, Florian; Stephan, Holger; Lammer, Jan; Schmidl, Doreen; Bata, Ahmed M.; Werkmeister, René M.; Seidel, Gerald; Garhöfer, Gerhard; Gschließer, Andreas; Schmetterer, Leopold; Schmidinger, Gerald

doi:10.1016/j.ajo.2018.02.006

Cited by 29 publications

(23 citation statements)

References 24 publications

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“…Previous studies using various imaging modalities, like confocal microscopy, 34 VHF ultrasound, 35 and OCT, 12,15 found ET values varying from approximately 50 to 60 lm and an increase in thickness from superior to inferior, for which three possible reasons were described in the literature. First, friction forces due to blinking might ablate the epithelium.…”

Section: Discussionmentioning

confidence: 95%

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Mapping of Corneal Layer Thicknesses With Polarization-Sensitive Optical Coherence Tomography Using a Conical Scan Pattern

Beer

Wartak

Pircher

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We demonstrate segmentation and mapping of corneal layers (epithelium, Bowman's layer, and stroma) across the entire cornea (limbus to limbus), using additional contrast provided by polarization-sensitive optical coherence tomography (PS-OCT) and analyze the reproducibility of the procedure. METHODS. A custom built PS-OCT system operating at 1045 nm central wavelength with conical scanning was used for image acquisition. Conical scanning allows for almost perpendicular beam incidence on the corneal surface and provides good signal quality over the entire field of view. Epithelium, Bowman's layer, and stroma were segmented using the additional contrast provided by PS-OCT. Thickness maps were computed and analyzed in sectors. Both eyes of 20 healthy volunteers were imaged at least three times to test this method and to quantify reproducibility. RESULTS. Thickness maps of the epithelium show significant (P < 0.001) superior thinning and an inferior thickening. Bowman's layer appears homogeneous within the central 7 to 8 mm diameter of the cornea and gets thinner toward the periphery until this layer disappears between 4 and 5.5 mm eccentricity from the center. Intersubject variations of the measured thicknesses of epithelium (coefficient of variation [CV]~8%), Bowman's layer (CV~25%), and stroma (CV~10%) were observed. Very good reproducibility of thickness measurements of epithelium (CV < 3%), Bowman's layer (CV < 5%), and stroma (CV < 2%) was found. Furthermore, a significant correlation (P < 0.001) between layer thicknesses of the right and left eyes of the same subject was found. CONCLUSIONS. PS-OCT with conical scanning is a feasible approach for determining thickness maps of corneal layers on a large field of view with high reproducibility.

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Section: Discussionmentioning

confidence: 95%

“…6 For more detailed studies on corneal diseases, measurement and imaging of individual corneal layers is required. Epithelial thickness (ET) measurements were described by various studies using custom built OCT 12,13 or commercial 14,15 devices. Most of these studies report an ET between 50 and 60 lm measured in a field of view (FoV) of up to 9 mm diameter.…”

mentioning

confidence: 99%

Mapping of Corneal Layer Thicknesses With Polarization-Sensitive Optical Coherence Tomography Using a Conical Scan Pattern

Beer

Wartak

Pircher

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…UHR-OCT can be used for the diagnosis of ocular surface squamous neoplasia (OSSN) and detection of sub-clinical disease [16, 56,57]. OSSN has several classical features on anterior segment OCT, including thickened, hyper-reflective epithelium with an abrupt transition from normal to abnormal epithelium [16, 57,58].…”

Section: Ocular Surface Pathologymentioning

confidence: 99%

Corneal Microlayer Optical Tomography Review

Roongpoovapatr¹,

Cook²,

Eleiwa³

et al. 2019

A Practical Guide to Clinical Application of OCT in Ophthalmology

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Anterior segment ultra-high resolution OCT (UHR-OCT) uses a resolution of 1-4 μm to provide non-invasive imaging of the tear film and cornea. This new high definition imaging technology increases our understanding of normal structure and pathological changes in the cornea, and resolution has continued to improve over time. UHR-OCT is useful in the treatment of disease such as dry eye, subclinical keratoconus, keratoconus, and ocular surface pathology. It also aids clinicians in fitting contact lenses and screening tissue for corneal transplantation. In this review, we summarize applications of imaging the normal and pathologic ocular surface and cornea. Novel developments, such as the new-generation micro-OCT, Anterior segment OCT angiography and artificial intelligence have the potential to continue to increase our knowledge.

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“…Bei alleiniger Messung der Hornhauttopografie kann dann eine verzögerten Diagnose und damit auch Behandlung des Keratokonus die Folge sein. In einer rezenten Studie erlaubte der Vergleich von 3-dimensionalen UHR-OCT-Datensätzen und die Extraktion von Epitheldickenkarten die Unterscheidung zwischen gesunden Augen und Augen mit frühem Keratokonus [35]. Dabei zeigte sich, dass vor allem Unregelmäßigkeiten im Dickenprofil und Asymmetrien in der Dickenkarte diagnostischen Wert haben.…”

Section: Ultrahoch Aufgelöste Optische Kohärenztomografieunclassified

Bildgebung in der Kornea mittels optischer Kohärenztomografie – historische Entwicklung und neueste technische Fortschritte

Werkmeister

Stegmann

Santos

et al. 2018

Klin Monatsbl Augenheilkd

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ZusammenfassungDie optische Kohärenztomografie (OCT) hat seit ihrer Einführung für die retinale Bildgebung in den 90er-Jahren eine rasante Entwicklung genommen und die Ophthalmologie revolutioniert. Während sie zu Beginn nur zur Untersuchung der Retina zum Einsatz kam, wurden in der Zwischenzeit auch zahlreiche Systeme zur Beurteilung des vorderen Augenabschnitts entwickelt. Basierend auf der Detektion und Verarbeitung des vom Gewebe zurückreflektierten und gestreuten Lichts, eröffnete sie dem Ophthalmologen völlig neue Möglichkeiten zur Untersuchung der Strukturen des vorderen Augenabschnitts. Je nach technischer Umsetzung erlauben OCT-Systeme für den vorderen Augenabschnitt die präzise Vermessung einzelner Schichten der Kornea und des Kammerwinkels oder – in Form von ultrahoch auflösender OCT – die detailreiche Darstellung der Hornhautmorphologie mit nahezu histologischer Auflösung. Letztere könnte durch weitere technische Entwicklungen vor allem hinsichtlich der Erhöhung der Aufnahmegeschwindigkeit zu einem wesentlichen Werkzeug in der Differenzialdiagnose und Verlaufsbeobachtung verschiedenster Erkrankungen der Hornhaut werden, das auch neue Einsichten in die Pathophysiologie dieser Erkrankungen liefert.

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Distinguishing Keratoconic Eyes and Healthy Eyes Using Ultrahigh-Resolution Optical Coherence Tomography–Based Corneal Epithelium Thickness Mapping

Cited by 29 publications

References 24 publications

Mapping of Corneal Layer Thicknesses With Polarization-Sensitive Optical Coherence Tomography Using a Conical Scan Pattern

Mapping of Corneal Layer Thicknesses With Polarization-Sensitive Optical Coherence Tomography Using a Conical Scan Pattern

Corneal Microlayer Optical Tomography Review

Bildgebung in der Kornea mittels optischer Kohärenztomografie – historische Entwicklung und neueste technische Fortschritte

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