Evaluation of the Repeatability and Reproducibility of Corneal Epithelial Thickness Mapping for a 9-mm Zone Using Optical Coherence Tomography

Jack, X; Wang, Li; Weikert, Mitchell P.; de, Ildamaris Montes; Koch, Douglas D.

doi:10.1097/ico.0000000000001806

Cited by 31 publications

(22 citation statements)

References 23 publications

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“…In a recent study evaluating long-term efficacy of PTK in treating EBMD, Lee et al reported that painful erosions and visual disturbance associated with EBMD respond positively to PTK [31]. In addition, the proposed screening by AS-OCT provides a very simple, highly repeatable, quantitative and accurate procedure [13]. The findings reported herein may also be very useful to identify PTK candidates and for their post-operative follow-up.…”

Section: Plos Onementioning

confidence: 63%

“…OCT has been used in several studies to evaluate the corneal epithelial thickness in ocular diseases [12,13]. Li et al [19] and Sandali et al [34] mapped the corneal epithelial thickness with Fourier-domain OCT in keratoconic eyes: keratoconus was characterised by apical epithelial thinning.…”

Section: Plos Onementioning

confidence: 99%

“…Fourier-domain OCT is a non-contact technique that enables measurement of corneal epithelial thickness [11] and an accurate assessment of the corneal layers [12] with great reliability and repeatability [12,13]. Given the implication of the epithelium in this corneal dystrophy, the study of the mapping of the corneal thickness seems to be interesting to characterize this pathology.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of corneal epithelial thickness mapping in epithelial basement membrane dystrophy

et al. 2020

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Purpose To investigate the corneal epithelial thickness topography with optical coherence tomography (OCT) and its relationship with vision quality in epithelial basement membrane dystrophy (EBMD). Methods 45 eyes of EBMD patients, 26 eyes of dry eye (DED) patients and 22 eyes of normal subjects were enrolled. All participants were subjected to 9-mm corneal epithelial mapping with OCT and vision quality was assessed with the optical quality analysis system using the objective scatter index (OSI). Central, superior, inferior, minimum, maximum, and standard deviation of epithelium thickness (Irregularity), were analysed and correlations with the OSI were calculated. Results The mean (±SD) central, inferior and maximum epithelial thicknesses of the EBMD patients (respectively, 56.4 (±8.1) μm, 58.9 (±6.4) μm, and 67.1 (±8.3) μm) were thicker compared to DED patients (P<0.05) and normal subjects (P<0.05). We found greater irregularity of epithelial thickness in EBMD (5.1±2.5 μm) compared to DED patients (2.6±1.0 μm) (P = 4.4.10−6) and normal subjects (2.1±0.7 μm) (P = 7.6.10−7). The mean OSI was worse in EBMD patients than in DED patients (P = 0.01) and compared to normal subjects (P = 0.02). The OSI correlated with the epithelial thickness irregularity (Spearman coefficient = 0.54; P = 2.65.10−5). Conclusions The OCT pachymetry map demonstrated that EBMD patients had thicker corneal epithelium in the central and inferior region. These changes were correlated with objective measurements of vision quality. This OCT characterisation of the EMBD provides a better understanding of the epithelial behaviour in this dystrophy and its role in vision quality.

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Section: Plos Onementioning

confidence: 63%

Section: Plos Onementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of corneal epithelial thickness mapping in epithelial basement membrane dystrophy

et al. 2020

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“…Initially designed to characterize epithelial thickness in a 6-mm zone, a recent upgrade allows expansion up to 9 mm, equivalent to an area that is approximately two and a quarter times larger than the former. 2 Using a custom-designed polarization-sensitive OCT, Pircher and colleagues 3 were able to map the thickness of the Bowman’s layer in addition to the epithelium from limbus-to-limbus and noted a highly irregular “moth-like” damage pattern in the Bowman’s layer in keratoconic eyes. Another group employed a commercially available swept-source OCT and by postprocessing, delineation of the air–epithelium edge and epithelium–Bowman’s layer interface was made possible.…”

Section: Advances In Diagnosismentioning

confidence: 99%

Advances in the diagnosis and treatment of keratoconus

2021

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Keratoconus had traditionally been considered a rare disease at a time when the imaging technology was inept in detecting subtle manifestations, resulting in more severe disease at presentation. The increased demand for refractive surgery in recent years also made it essential to more effectively detect keratoconus before attempting any ablative procedure. Consequently, the armamentarium of tools that can be used to diagnose and treat keratoconus has significantly expanded. The advances in imaging technology have allowed clinicians and researchers alike to visualize the cornea layer by layer looking for any early changes that might be indicative of keratoconus. In addition to the conventional geometrical evaluation, efforts are also underway to enable spatially resolved corneal biomechanical evaluation. Artificial intelligence has been exploited in a multitude of ways to enhance diagnostic efficiency and to guide treatment. As for treatment, corneal cross-linking treatment remains the mainstay preventive approach, yet the current main focus of research is on increasing oxygen availability and developing new strategies to improve riboflavin permeability during the procedure. Some new combined protocols are being proposed to simultaneously halt keratoconus progression and correct refractive error. Bowman layer transplantation and additive keratoplasty are newly emerging alternatives to conventional keratoplasty techniques that are used in keratoconus surgery. Advances in tissue engineering and regenerative therapy might bring new perspectives for treatment at the cellular level and hence obviate the need for invasive surgeries. In this review, we describe the advances in the diagnosis and treatment of keratoconus primarily focusing on newly emerging approaches and strategies.

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“…In addition, corneal SD-OCT can provide useful information for surgical and postoperative monitoring [6]. The RTVue-XR (Optovue Inc., Fremont, CA, USA) is a SD-OCT device that is routinely used in clinical practice, and capable of 9 mm wide cornea scans [7,8]. Using this device for CT and ET measurements, previous studies were able to show excellent reliability for central corneal measurements as well as the central 6-mm zone area in relatively small groups of healthy eyes [9 -11].…”

Section: Introductionmentioning

confidence: 99%

Reliability of Corneal, Epithelial, and Stromal Thickness Mapping for a 9-mm Zone Using Spectral-Domain Optical Coherence Tomography

Krause

Mohr

Shajari

et al. 2021

Klin Monbl Augenheilkd

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Purpose To evaluate the reliability of spectral-domain optical coherence tomography (SD-OCT; RTVue XR; Optovue, Inc., Fremont, CA, USA) for thickness mapping of the entire cornea (CT), corneal epithelium (ET). and corneal stroma (ST) over a 9-mm zone in healthy eyes. We sought to develop reference values for different age groups and elucidate potential sex- and age-dependent characteristics of corneal sublayer pachymetry maps. Methods Three consecutive SD-OCT scans were obtained in 166 healthy right eyes (mean age = 50 ± 20 years). The thickness maps contain 25 sectors over a 9-mm diameter zone. To test measurement reliability, intraclass correlation coefficients (ICC), coefficients of variation (CoV), and within-subject standard deviations (WSSD) were calculated. Results CT, ET, and ST ICCs ranged from 0.961 to 0.998, 0.896 to 0.945, and 0.955 to 0.998, respectively. CoV values for CT, ET, and ST ranged between 0.3 and 1.5%, 1.6 and 4.2%, and 0.4 and 1.7%, respectively. WSSD ranged from 6 to 41, 4 to 8, and 7 to 46 µm, respectively. A negative correlation was found between age and ET (p < 0.05) but not between age and ST or CT. No gender-related differences in CT, ET, or ST were detected. CoV of CT, ET, and ST measurements showed a positive correlation with age in 28, 64, and 28% of the sectors, respectively. Conclusion SD-OCT is a rapid and noninvasive technique that provides excellent reliability for corneal sublayer thickness measurements over a 9-mm zone. The reliability of the ET measurement seems to be negatively affected by age. Peripheral CT and global ET thin with age.

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Evaluation of the Repeatability and Reproducibility of Corneal Epithelial Thickness Mapping for a 9-mm Zone Using Optical Coherence Tomography

Cited by 31 publications

References 23 publications

Assessment of corneal epithelial thickness mapping in epithelial basement membrane dystrophy

Assessment of corneal epithelial thickness mapping in epithelial basement membrane dystrophy

Advances in the diagnosis and treatment of keratoconus

Reliability of Corneal, Epithelial, and Stromal Thickness Mapping for a 9-mm Zone Using Spectral-Domain Optical Coherence Tomography

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