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Chauhan P, Kamalakannan P, Upadhyay AD, Sinha R, Titiyal JS, Sharma N. Comparative Evaluation of Topographic Parameters Using Three Different Topographers in Keratoconic and Cross-linked Keratoconic Corneas. J Refract Surg 2024; 40:e260-e269. [PMID: 38593263 DOI: 10.3928/1081597x-20240311-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
PURPOSE To compare the parameters of three different topographic devices (Pentacam HR, Oculus Optikgeräte GmbH; Sirius, Costruzione Strumenti Oftalmici; and Cassini, i-Optics) in grading the severity of keratoconus in cross-linked and non-cross-linked eyes. METHODS This was a prospective comparative interventional study done in a tertiary eye care center, wherein 114 eyes of 68 patients with keratoconus were divided into two groups: 62 eyes that were observed and 52 eyes that were cross-linked. All eyes were evaluated on all three topographers at baseline, 3-month follow-up, and 6-month follow-up. RESULTS The Sirius showed significantly lower values of mean flat keratometry in comparison to the Pentacam HR (limits of agreement [LoA]: 1.75 to 3.51%) and Cassini (LoA: 1.75 to 3.51%). The mean steep keratometry values were higher for the Cassini in comparison to the Pentacam HR (LoA: 4.39 to 7.02%) and Sirius (LoA: 3.51 to 6.14%). The mean steep keratometry values of the Sirius were significantly lower than those of the Pentacam HR and in both the cross-linked and observation groups (LoA: 3.51 to 6.14%). The mean keratometry values were significantly higher in the Cassini compared to the Pentacam HR (LoA: 3.51 to 8.77%) and significantly lower in the Sirius in comparison to the Pentacam HR (LoA: 3.51 to 6.14%). The mean difference in astigmatism was also statistically significant between the three tomographers in both groups, with the Cassini showing higher values (LoA: 3.51 to 5.26%) and the Sirius lower values than the Pentacam HR (LoA: 5.26 to 6.14%). CONCLUSIONS The authors conclude the three devices cannot be used interchangeably. The Cassini showed better agreement and correlation with the Pentacam HR in the staging of keratoconus, whereas the Sirius tended to underdiagnose and under-stage the disease. [J Refract Surg. 2024;40(4):e260-e269.].
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Hashemi H, Doroodgar F, Niazi S, Khabazkhoob M, Heidari Z. Comparison of different corneal imaging modalities using artificial intelligence for diagnosis of keratoconus: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2024; 262:1017-1039. [PMID: 37418053 DOI: 10.1007/s00417-023-06154-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 04/18/2023] [Accepted: 06/16/2023] [Indexed: 07/08/2023] Open
Abstract
PURPOSE This review was designed to compare different corneal imaging modalities using artificial intelligence (AI) for the diagnosis of keratoconus (KCN), subclinical KCN (SKCN), and forme fruste KCN (FFKCN). METHODS A comprehensive systematic search was conducted in scientific databases, including Web of Science, PubMed, Scopus, and Google Scholar based on the PRISMA statement. Two independent reviewers assessed all potential publications on AI and KCN up to March 2022. The Critical Appraisal Skills Program (CASP) 11-item checklist was used to evaluate the validity of the studies. Eligible articles were categorized into three groups (KCN, SKCN, and FFKCN) and included in the meta-analysis. The pooled estimate of accuracy (PEA) was calculated for all selected articles. RESULTS The initial search yielded 575 relevant publications, of which 36 met the CASP quality criteria and were included in the analysis. Qualitative assessment showed that Scheimpflug and Placido combined with biomechanical and wavefront evaluations improved KCN detection (PEA, 99.2, and 99.0, respectively). The Scheimpflug system (92.25 PEA, 95% CI, 94.76-97.51) and a combination of Scheimpflug and Placido (96.44 PEA, 95% CI, 93.13-98.19) had the highest diagnostic accuracy for the detection of SKCN and FFKCN, respectively. The meta-analysis outcomes showed no significant difference between the CASP score and accuracy of the publications (all P > 0.05). CONCLUSIONS Simultaneous Scheimpflug and Placido corneal imaging methods provide high diagnostic accuracy for early detection of keratoconus. The use of AI models improves the discrimination of keratoconic eyes from normal corneas.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Negah Eye Hospital Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sana Niazi
- Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Heidari
- Department of Ophthalmology, Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
- Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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Barrio AR, Antona B, Morago-Villanueva S, Martínez-Arribas V, González-Pérez M. Intrasession repeatability and agreement of the anterior corneal assessment provided by a multidiagnostic device. Clin Exp Optom 2024:1-7. [PMID: 38494447 DOI: 10.1080/08164622.2024.2324978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Abstract
CLINICAL RELEVANCE Multidiagnostic systems have recently appeared on the market. Knowledge of the repeatability and validity of any instrument is mandatory before its introduction in clinical practice. BACKGROUND The aim of this work is to examine the intrasession repeatability of anterior pole measurements provided by the multidiagnostic device Wave Analyzer Medica 700 (WAM700) and agreement with Pentacam measurements in normal eyes. METHODS In the right eyes of 113 participants, three repeat measurements of central keratometry, central corneal thickness, anterior chamber depth and corneal eccentricity were made with the WAM700 and Pentacam in random order. Intrasession repeatability and agreement were determined. RESULTS Employing WAM700, intrasession repeatability for keratometry, central corneal thickness and anterior chamber depth was good (ICCs ≥ 0.992; CV 0.48-0.98%), yet worse than the values obtained for the Pentacam (ICCs ≥ 0.998; CV 0-0.33%). WAM700 showed excellent intrasession repeatability when used to measure the anterior chamber depth (Sw 0.03 mm). However, the repeatability of this device was inferior for central corneal thickness (Sw 4.24 μm) and keratometry measurements (Sw < 0.21 D) and was poor for corneal eccentricity (Sw 0.07; ICC 0.908; CV 14.58%). Agreement between WAM700 and Pentacam showed a high ICC for the keratometry measurements, central corneal thickness and anterior chamber depth (>0.972) but lower for corneal eccentricity (ICC 0.762). CONCLUSIONS In healthy eyes, the WAM700 multidiagnostic device showed good intrasession repeatability for keratometry, central corneal thickness and anterior chamber depth measurements. Agreement between WAM700 and Pentacam was good for the anterior chamber depth measurement. However, these instruments cannot be considered interchangeable for keratometry, central corneal thickness and eccentricity readings.
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Affiliation(s)
- Ana Rosa Barrio
- Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - Beatriz Antona
- Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | | | | | - Mariano González-Pérez
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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Telek HH, Bilen RBA, Özdemir YA, Dinç DN, Çelikay O. Comparison of keratometric values and anterior segment parameters measured using Scheimpflug Sirius topography and Lenstar biometry. Int Ophthalmol 2024; 44:103. [PMID: 38376696 DOI: 10.1007/s10792-024-03046-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE This study aimed to evaluate the consistency of preoperative keratometric values, anterior segment, and intraocular lens (IOL) power measurements in patients with cataract and no comorbidities using the Sirius topography device (CSO, Italy) and Lenstar LS 900 (Haag-Streit AG, Köeniz, Switzerland). METHODS Patients with grade 2 and 3 cataracts who applied to Ophthalmology Clinic of Dışkapı Yıldırım Beyazıt Education and Research Hospital, University of Health Sciences and planned for cataract surgery were included the study. Forty eyes with cataract from 40 patients were taken in the study. All patients underwent preoperative assessment using a combined Scheimpflug-Placido disc-based tomography device (Sirius) and Lenstar before cataract surgery. Keratometric measurements, such as flat keratometry (K1), steep keratometry (K2), and maximum keratometry (Kmax), and anterior segment parameters, white-to-white (WTW) distance, IOL power, astigmatism (AST), anterior chamber depth (ACD), aqueous depth (AD), and central cornea thickness (CCT), were recorded. RESULTS There were significant differences between K1Lenstar and K1Sirius, K2Lenstar and K2Sirius, KmaxLenstar and KmaxSirius, WTWLenstar and WTWSirius, and IOL powerLenstar versus IOL powerSirius. However, there were insignificant differences between ASTLenstar and ASTSirius, ACDLenstar versus ACDSirius, ADLenstar and ADSirius, and CCTLenstar and CCTSirius variables. Furthermore, it was found that Sirius measured significantly higher than Lenstar, especially in terms of IOL power. CONCLUSION Significant differences were observed between Lenstar and Sirius in terms of keratometric values, WTW distance, and IOL power. The IOL power value measured with Sirius was found to be higher than the IOL power value measured with Lenstar.
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Niazi S, Jiménez-García M, Findl O, Gatzioufas Z, Doroodgar F, Shahriari MH, Javadi MA. Keratoconus Diagnosis: From Fundamentals to Artificial Intelligence: A Systematic Narrative Review. Diagnostics (Basel) 2023; 13:2715. [PMID: 37627975 PMCID: PMC10453081 DOI: 10.3390/diagnostics13162715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
The remarkable recent advances in managing keratoconus, the most common corneal ectasia, encouraged researchers to conduct further studies on the disease. Despite the abundance of information about keratoconus, debates persist regarding the detection of mild cases. Early detection plays a crucial role in facilitating less invasive treatments. This review encompasses corneal data ranging from the basic sciences to the application of artificial intelligence in keratoconus patients. Diagnostic systems utilize automated decision trees, support vector machines, and various types of neural networks, incorporating input from various corneal imaging equipment. Although the integration of artificial intelligence techniques into corneal imaging devices may take time, their popularity in clinical practice is increasing. Most of the studies reviewed herein demonstrate a high discriminatory power between normal and keratoconus cases, with a relatively lower discriminatory power for subclinical keratoconus.
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Affiliation(s)
- Sana Niazi
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran P.O. Box 1336616351, Iran;
| | - Marta Jiménez-García
- Department of Ophthalmology, Antwerp University Hospital (UZA), 2650 Edegem, Belgium
- Department of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium
| | - Oliver Findl
- Department of Ophthalmology, Vienna Institute for Research in Ocular Surgery (VIROS), Hanusch Hospital, 1140 Vienna, Austria
| | - Zisis Gatzioufas
- Department of Ophthalmology, University Hospital Basel, 4031 Basel, Switzerland;
| | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran P.O. Box 1336616351, Iran;
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran P.O. Box 1544914599, Iran
| | - Mohammad Hasan Shahriari
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran P.O. Box 1971653313, Iran
| | - Mohammad Ali Javadi
- Ophthalmic Research Center, Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran P.O. Box 19395-4741, Iran
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Ning R, Gao R, Piñero DP, Zhang J, Gao Q, Jin Y, Wang Y, Wang C, Huang J. Repeatability and reproducibility of corneal higher-order aberrations measurements after small incision lenticule extraction using the Scheimpflug-Placido topographer. EYE AND VISION 2022; 9:1. [PMID: 34983674 PMCID: PMC8728949 DOI: 10.1186/s40662-021-00274-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 11/24/2021] [Indexed: 11/18/2022]
Abstract
Background To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction (SMILE) using the Sirius Scheimpflug-Placido topographer (CSO, Italy). Methods Seventy-five eyes from 75 postoperative subjects were included in this prospective study. Three consecutive corneal aberrometric measurements were obtained with the Scheimpflug-Placido topographer by two experienced operators to assess intra- and inter-observer reproducibility. The within-subject standard deviation (Sw), test-retest repeatability (TRT) and the intraclass correlation coefficient (ICC) were calculated. Results For intraobserver repeatability of anterior and total corneal aberrations, all ICCs were more than 0.922, except for trefoil (0.722 to 0.768). The ICCs of total root mean square (RMS), coma Z (3, ± 1), and spherical aberration Z (4, 0) were over 0.810 while higher-order RMS, trefoil Z (3, ± 3), and astigmatism II Z (4, ± 2) were below 0.634 for posterior corneal surface aberrations. All Sw values for all types of aberrations were equal to or below 0.07 μm. Regarding interobserver reproducibility, all TRT values were no more than 0.12 μm, 0.05 μm, and 0.11 μm for anterior, posterior, and total corneal aberrations, respectively. The ICC values ranged from 0.875 to 0.989, from 0.686 to 0.976 and over 0.834 for anterior, posterior, and total corneal aberrations, respectively. Conclusions The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high, except for trefoil. There was some variability in posterior corneal aberrometric measurements. High reproducibility of corneal aberrometric measurements was observed between measurements of both examiners, except for trefoil, with poor to moderate reproducibility.
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Kim BY, Jun I. Comparison of Anterior Segment Measurements with a New Multifunctional Unit and Five Other Devices. KOREAN JOURNAL OF OPHTHALMOLOGY 2022; 36:338-349. [PMID: 35766048 PMCID: PMC9388890 DOI: 10.3341/kjo.2022.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/06/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose To evaluate the clinical availability of a multifunctional ocular biometric unit, MR-6000, for simultaneous keratometry, tonometry, topography, and pachymetry evaluation, and compare anterior segment measurements with five other devices: autokeratometer (KR-1), Scheimpflug camera (Pentacam HR), swept-source optical coherence tomography (IOLMaster 700), Placido disk scanning-slit topography (Orbscan II), and noncontact tonometry (FT-1000). Methods Thirty eyes from thirty patients who visited Severance Hospital for cataract surgery were examined using MR-6000 and the other devices. The mean keratometry, central corneal thickness (CCT), white-to-white (WTW) distance, and intraocular pressure (IOP) values were compared. Repeated measures analysis of variance, Wilcoxon signed-rank test, intraclass correlation coefficient (ICC), and Bland-Altman plot were used to assess the correlation and agreement between devices. Results Thirty eyes of thirty patients were evaluated. Statistically significant differences in mean keratometry between MR-6000, KR-1, Pentacam HR, and IOLMaster 700 were not observed (p > 0.05). All five devices, including Orbscan II, had almost perfect agreement in measuring keratometry (ICC > 0.80, p < 0.05). CCT measured by MR-6000 was significantly different from that of Pentacam HR and Orbscan II measurements (p < 0.05) but correlated with that of Pentacam HR and Orbscan II measurements (ICC > 0.60, p < 0.05). The WTW distance measured by MR-6000 was not significantly different from that measured by IOLMaster 700 but was different from that measured by Orbscan II. IOP measured by MR-6000 was not correlated with FT-1000. Conclusions Keratometric values obtained through MR-6000 can be used interchangeably with other devices based on good correlation and agreement. However, the CCT, WTW, and IOP values were not interchangeable with a single multifunctional unit for cataract surgery preoperative examination.
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Affiliation(s)
- Bo Yi Kim
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ikhyun Jun
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Placide J, Neves Da Silva HV, McCabe SE, Ronquillo YC, Moshirfar M. Agreement of anterior segment measurements between four diagnostic imaging devices in myopic patients. Expert Rev Med Devices 2021; 18:1235-1243. [PMID: 34846974 DOI: 10.1080/17434440.2021.2012153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the inter-device agreement of anterior chamber depth (ACD), central corneal thickness (CCT), flat keratometry (K1), steep keratometry (K2), corneal astigmatism (ΔK), and white-to-white (WTW) measurements. METHODS This is a retrospective study with 73 myopic patients (142 eyes). We extracted and compared anterior segment measurements (ACD, CCT, K1, K2, ΔK, and WTW) of four devices (OPD-Scan III, Pentacam HR, Lenstar LS 900, and Galilei G4), and performed pairwise agreement comparisons between them. RESULTS Agreement analyses revealed that the most agreement occurred: in Pentacam HR and Galilei G4 for ACD measurements, in Pentacam HR and Lenstar LS 900 for CCT measurements, in OPD-Scan III and Galilei G4 for WTW measurements, in OPD-Scan III and Pentacam HR for K1 and K2 measurements, and OPD-Scan III and Galilei G4 for ΔK measurements. CONCLUSION OPD-Scan III is interchangeable with both Galilei G4 and Lenstar LS 900 for WTW measurements. OPD-Scan III and the Pentacam-HR are interchangeable in K1, K2, and ΔK measurements. OPD-Scan III and Lenstar LS 900, and OPD-Scan III and Galilei G4 are interchangeable in K1 and ΔK measurements, respectively.
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Affiliation(s)
- John Placide
- McGovern Medical School, The University of Texas Health Science Center, Houston, TX, USA
| | | | - Shannon E McCabe
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,Mission Hills Eye Center, Pleasant Hill, CA, USA
| | | | - Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.,John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Ut, USA.,Utah Lions Eye Bank, Murray, Ut, USA
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Wang Q, Chen M, Ning R, Savini G, Wang Y, Zhang T, Lin X, Chen X, Huang J. The Precision of a New Anterior Segment Optical Coherence Tomographer and Its Comparison With a Swept-Source OCT-Based Optical Biometer in Patients With Cataract. J Refract Surg 2021; 37:616-622. [PMID: 34506238 DOI: 10.3928/1081597x-20210610-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To assess the precision of a new spectral-domain optical coherence tomographer (SD-OCT)/Placido topographer (MS-39; CSO) and its comparison with a swept-source OCT (SS-OCT) biometer (Argos; Movu, Inc) in patients with cataract. METHODS Fifty-three right eyes from 53 patients were examined by two experienced operators three times using both devices randomly. Employing the within-subject standard deviation (Sw), test-retest variability, coefficient of variation, and intraclass correlation coefficient to evaluate intraoperator repeatability and interoperator reproducibility; the double-angle plots to analyze astigmatism; and Bland-Altman plots and 95% limits of agreement to verify the agreement between devices. RESULTS The SD-OCT/Placido tomographer showed high precision, with coefficient of variation of 0.44% or less, intraclass correlation coefficient of 0.945 or greater for all parameters, test-retest variability of 4.21 µm or less for central corneal thickness (CCT), 0.03 mm or less for anterior chamber depth (ACD) and aqueous depth (AQD), and 0.25 diopters (D) or less for mean keratometry (Km), J0, and J45. The inter-device differences in Km, J0, and J45 were statistically insignificant, whereas the remaining were statistically but not clinically significant. The 95% limits of agreement of CCT, ACD, AQD, Km, J0, and J45 were -3.70 to 15.25 µm, -0.06 to 0.04 mm, -0.06 to 0.04 mm, -0.28 to 0.35 D, -0.27 to 0.26 D, and -0.27 to 0.21 D, respectively. The double-angle plot confirmed the high agreement in astigmatism. CONCLUSIONS For CCT, ACD, AQD, Km, and astigmatism measurements in patients with cataract, the new SD-OCT/Placido tomographer has excellent precision and high agreement with the Argos SS-OCT biometer, and can be used interchangeably. [J Refract Surg. 2021;37(9):616-622.].
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Yu AY, Ye J, Savini G, Wang Y, Zhang T, Chen M, Wang Q, Huang J. Reliability and agreement of the central and mid-peripheral corneal thickness measured by a new Scheimpflug based imaging. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1136. [PMID: 34430577 PMCID: PMC8350684 DOI: 10.21037/atm-20-7895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/24/2021] [Indexed: 11/06/2022]
Abstract
Background To assess the intra-observer repeatability and inter-observer reproducibility of central corneal thickness (CCT) and mid-peripheral corneal thickness (MPCT) measurements using a new Scheimpflug imaging instrument (Scansys) and compare the agreement with the rotating Scheimpflug corneal tomographer (Pentacam HR). Methods The same well-trained operator performed the measuring using the two devices, after which Scansys measurements were repeated by another operator. Both instruments required three consecutive measurements per subject. Corneal thickness measurements were obtained by each instrument, including CCT, thinnest corneal thickness (TCT), pupil corneal thickness (PCT), and MPCT. Test-retest repeatability (TRT), within-subject coefficient of variation (CoV), and intra-class correlation coefficient (ICC) were used to evaluate repeatability and reproducibility. A paired t-test was used to compare the differences between Scansys and Pentacam, and the agreement was compared with Bland-Altman plots. Results This study enrolled 112 healthy subjects. The CoV were <0.91% and 0.55% for repeatability and reproducibility, respectively. The ICC was close to 1 in all measurements. For intra-observer repeatability in the CT2mm region, TRT was <10.30 µm. Moreover, TRT was <15.26 µm within the CT5mm region. The paired t-test showed significant differences in all corneal thickness measurements (P<0.001). The central region and CT2mm agreement were high, but the largest range of 95% limits of agreement (LoA) appeared in the CTnasal-5mm. Conclusions The new Scheimpflug imaging instrument showed excellent intra-observer repeatability and inter-observer reproducibility for corneal thickness measurements. The agreement analysis suggested that Scansys and Pentacam could be interchangeably used between the central region and CT2mm, except CT5mm.
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Affiliation(s)
- A-Yong Yu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
| | - Junming Ye
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | | | - Yiran Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Tianjiao Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Min Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Qinmei Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
| | - Jinhai Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, China
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Tañá-Rivero P, Rodríguez-Carrillo MD, Ruíz-Santos M, García-Tomás B, Montés-Micó R. Agreement Between Angle-to-Angle Distance and Aqueous Depth Obtained With Two Different Optical Coherence Tomographers and a Scheimpflug Camera. J Refract Surg 2021; 37:133-140. [PMID: 33577700 DOI: 10.3928/1081597x-20201013-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/08/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare angle-to-angle (ATA) distance and aqueous depth (AQD) readings produced by two different optical coherence tomography (OCT) devices and a Scheimpflug camera. METHODS ATA distance and AQD were measured in 60 eyes using the Visante time-domain OCT (TD-OCT) (Carl Zeiss Meditec AG), the Anterion swept-source OCT (SS-OCT) (Heidelberg Engineering GmbH), and the Pentacam HR Scheimpflug camera (Oculus Optikgeräte GmbH). Moreover, ATA distance was measured along the horizontal and vertical meridians. Bland-Altman analysis was used to assess the agreement between devices. RESULTS All three devices did not yield similar horizontal ATA distance: 11.96 ± 0.47 mm (TD-OCT), 11.96 ± 0.42 mm (SS-OCT), and 11.05 ± 0.52 mm (Pentacam). More specifically, the Pentacam yielded significantly smaller values (approximately 0.9 mm, P < .001). Mean vertical ATA distance was 12.61 ± 0.65 and 12 ± 0.65 mm for the TD-OCT and SS-OCT, respectively (P = .983). Vertical ATA distance was significantly larger than horizontal ATA distance for both OCT devices (approximately 0.6 mm, P < .001). The lowest mean difference was found between both OCT devices (0.0068 and -0.0415 mm, for horizontal and vertical meridians, respectively) and the highest between the Pentacam and the two OCT devices (approximately 0.9 mm). As for AQD, inter-device mean values were also statistically significant: 2.89 ± 0.48, 2.82 ± 0.49, and 2.79 ± 0.50 mm, for the TD-OCT, SS-OCT, and Pentacam, respectively (P < .001). Mean differences were similar for the TD-OCT versus SS-OCT and SS-OCT versus Pentacam (approximately 0.02 mm), and larger between the TD-OCT and Pentacam (approximately 0.05 mm). CONCLUSIONS The results show that the TD-OCT and SS-OCT are interchangeable instruments for ATA distance measurement but the Pentacam is not with either of the two OCT devices. A clinical criterion should assess whether these three devices could be used interchangeably for AQD measurement. [J Refract Surg. 2021;37(2):133-140.].
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Jiang Y, Qin Y, Bu S, Zhang H, Zhang X, Tian F. Distribution and internal correlations of corneal astigmatism in cataract patients. Sci Rep 2021; 11:11514. [PMID: 34075156 PMCID: PMC8169901 DOI: 10.1038/s41598-021-91028-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 05/18/2021] [Indexed: 11/29/2022] Open
Abstract
The aim of the study is to explore the distribution patterns and internal correlations of the morphological parameters of the cornea in patients with age-related cataract. The Pentacam HR was used to measure anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), total corneal astigmatism (TCA) and keratometric corneal astigmatism (KCA). With age, the proportion of with-the-rule (WTR) ACA decreased from 65.31% to 23.63%, while the against-the-rule (ATR) ACA increased from 26.53% to 56.20%. PCA exceeded 0.50 D in 9.14% of eyes, while 76.35% of them were ATR. The magnitude of ACA was positively correlated with PCA in the whole sample, with a more significant correlation in WTR eyes (sr = 0.349, P < 0.001). The vector summation effect of PCA to ACA changed from compensation to augmentation with aging. In 57.53% of WTR eyes, KCA was overestimated by an average of 0.21 ± 0.17 D, while it was underestimated by 0.38 ± 0.27 D in 87.62% of ATR eyes. In conclusion, among age-related cataract patients, ACA and TCA gradually shifted from WTR to ATR with aging, while most PCA remained as ATR. Ignoring the age-related changes and real PCA might cause overestimation of WTR astigmatism and underestimation of ATR astigmatism.
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Affiliation(s)
- Yuanfeng Jiang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin Medical University, Tianjin, 300384, China
| | - Ying Qin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin Medical University, Tianjin, 300384, China
| | - Shaochong Bu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin Medical University, Tianjin, 300384, China
| | - Hong Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin Medical University, Tianjin, 300384, China
| | - Xiaomin Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin Medical University, Tianjin, 300384, China.
| | - Fang Tian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin Medical University, Tianjin, 300384, China.
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Corneal aberrations measured with a high-resolution Scheimpflug tomographer: repeatability and reproducibility. J Cataract Refract Surg 2021; 46:581-590. [PMID: 32050208 DOI: 10.1097/j.jcrs.0000000000000084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the precision of elevation and wavefront aberration measurements with the Pentacam HR (Oculus Optikgeräte GmbH). SETTING Flinders University, Australia. DESIGN Instrument evaluation study. METHODS A randomly selected eye of 100 participants was scanned twice with the Pentacam HR by 1 observer on the 3 measurement modes: 25-picture, 50-picture, and cornea fine. A second observer performed 2 scans on the same random eye with the 25-picture mode. Repeatability and reproducibility were assessed using the within-subject SD (Sw) statistic from a 1-way analysis of variance. RESULTS From the 100 scanned eyes, the higher-order aberration root mean square (RMS) repeatability limit for both elevation and wavefront, and anterior and posterior measurements was 0.03 μm for all 3 measurement modes. Anterior, posterior, and total corneal wavefront Zernike terms were highly precise, with most Zernike terms displaying a repeatability limit of 0.03 μm. The least repeatable measurement was the posterior elevation Zernike term with the 25-picture scan (repeatability limit 1.50 μm). The cornea fine measurement mode provided the most precise measurements. Reproducibility limits (second observer) were similar to repeatability limits with the 25-picture scan mode. CONCLUSIONS The Pentacam HR provided highly precise aberration outputs. The most precise measurements are achievable with the cornea fine measurement mode and wavefront aberrations. One should be cognizant of posterior elevation aberration precision, particularly for lower radial order and higher azimuthal frequency terms. Accounting for tilt and misalignment of aberrations, all RMS and Zernike aberrations were extremely precise (repeatability and reproducibility limit less than 0.000001 μm).
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Heidari Z, Hashemi H, Mohammadpour M, Amanzadeh K, Fotouhi A. Evaluation of corneal topographic, tomographic and biomechanical indices for detecting clinical and subclinical keratoconus: a comprehensive three-device study. Int J Ophthalmol 2021; 14:228-239. [PMID: 33614451 DOI: 10.18240/ijo.2021.02.08] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/16/2020] [Indexed: 12/26/2022] Open
Abstract
AIM To evaluate the diagnostic ability of topographic and tomographic indices with Pentacam and Sirius as well as biomechanical parameters with Corvis ST for the detection of clinical and subclinical forms of keratoconus (KCN). METHODS In this prospective diagnostic test study, 70 patients with clinical KCN, 79 patients with abnormal findings in topography and tomography maps with no evidence on clinical examination (subclinical KCN), and 68 normal control subjects were enrolled. The accuracy of topographic, tomographic, and biomechanical parameters was evaluated using the area under the receiver operating characteristic curve (AUC) and cross-validation analysis. The Delong method was used for comparing AUCs. RESULTS In distinguishing KCN from normal, all parameters showed statistically significant differences between the two groups (P<0.001). Indices with the perfect diagnostic ability (AUC≥0.999) were Sirius KCN vertex of back (KVb), Pentacam random forest index (PRFI), Pentacam index of height decentration (IHD), and Corvis integrated tomographic/biomechanical index (TBI). In distinguishing subclinical KCN from normal, Sirius symmetry index of back (SIb; AUC=0.908), Pentacam inferior-superior difference (IS) value (AUC=0.862), PRFI (AUC=0.847), and Corvis TBI (AUC=0.820) performed best. There were no significant differences between the highest AUCs within keratoconic groups (DeLong, P>0.05). CONCLUSION In clinical KCN, all topographic, tomographic, and biomechanical indices have acceptable outcomes in terms of sensitivity and specificity. However, in differentiating subclinical forms of KCN from normal corneas, curvature-based parameters (SIb and IS value) followed by integrated indices (PRFI and TBI) are the most powerful tools for early detection of KCN.
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Affiliation(s)
- Zahra Heidari
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran 1968653111, Iran.,School of Medicine, Tehran University of Medical Sciences, Tehran 1417613151, Iran
| | - Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran 1968653111, Iran
| | - Mehrdad Mohammadpour
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran 1968653111, Iran.,Department of Ophthalmology, Farabi Eye Hospital and Eye Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Kazem Amanzadeh
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran 1968653111, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 1417613151, Iran
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Repeatability of Zone Averages Compared to Single-Point Measurements of Maximal Curvature in Keratoconus. Am J Ophthalmol 2021; 221:226-234. [PMID: 32800828 DOI: 10.1016/j.ajo.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the repeatability of curvature zone averages centered on the point of maximum curvature (Kmax) compared to that of the single-point Kmax. DESIGN Comparative reliability analysis. METHODS Setting: American University of Beirut Medical Center, Beirut, Lebanon. STUDY POPULATION Sixty-five eyes of 65 adult keratoconus patients. Patients with other ocular disease, history of ocular surgery or trauma, and contact lens wear within 2 weeks of image acquisition were excluded. OBSERVATION PROCEDURES Eyes were evaluated with 3 consecutive scans using the Galilei dual Scheimpflug-Placido system. MAIN OUTCOME MEASURES Repeatability of axial and instantaneous Kmax single points, and zone averages with radii of 0.1-2.0 mm, centered on them. Repeatability was assessed by within-subject standard deviations, repeatability limits (r), and intraclass correlation coefficients. RESULTS Axial curvature zone averaging yielded clinically acceptable repeatability only in eyes with Kmax ≤50 diopters (D), for radii of 1.5 mm and 2.0 mm (r = 0.87 D and r = 0.76, respectively, vs r = 0.91 for the single-point axial Kmax). Compared to instantaneous Kmax, clinically acceptable repeatability was achieved with instantaneous zone averages of at least 1.5 mm radius in eyes with Kmax ≤50 D (r = 0.99 D and r = 0.70 D, respectively) and 2.0 mm radius in eyes with Kmax >50 D (r = 2.28 D and r = 0.87 D, respectively). For all eyes, the repeatability limit of the location of Kmax was 0.82 mm and 0.80 mm for axial and instantaneous curvature, respectively. CONCLUSIONS Instantaneous curvature zone averages centered on Kmax yielded a greater improvement in repeatability than axial zone averages and reached clinical adequacy with radii of at least 1.5 mm, for eyes with Kmax ≤50 D, and with a 2.0 mm radius for eyes with Kmax >50 D.
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Marques RE, Sousa DC, Vandewalle E, Somers A, Melamed S, Nardi M, Figus M, Stalmans I, Abegao Pinto L. The effect of glaucoma treatment using high-intensity focused ultrasound on total and corneal astigmatism: a prospective multicentre study. Acta Ophthalmol 2020; 98:833-840. [PMID: 32421229 DOI: 10.1111/aos.14467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/21/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Ultrasound cycloplasty (UCP) acts through the selective coagulation of the ciliary body using high-intensity focused ultrasound (HIFU) technology. The aim of this study was to investigate whether the application of ultrasound beams targeting the ciliary body using an external probe influences astigmatism. METHODS Multicentre, prospective, single-arm, open-label study in adult patients with primary open-angle glaucoma and moderately uncontrolled intraocular pressure (IOP) under glaucoma medication. The primary outcome was induced corneal astigmatism, calculated from topography, and assessed statistically through vector analysis. Secondary outcomes included induced total astigmatism and mean changes from baseline in best-corrected visual acuity (logMAR) and IOP. Subgroup analysis was performed to assess the impact of device centring on corneal and total induced astigmatism. RESULTS Fifty eyes were enrolled. Mean age was 69.6 ± 11.3 years. At 1, 3 and 6 months postprocedure, HIFU-induced corneal astigmatism was 0.88 D × 93°, 0.87 D × 106° and 1.16 D × 97°, respectively, while induced total astigmatism was 0.62 D × 103°, 0.42 × 106° and 0.39 × 107°. By the last follow-up, the percentage of patients with <0.50, <1.00, <1.50 and <2.00 D of induced corneal versus total astigmatism was 8.3% versus 46%, 29% versus 66%, 62.5% versus 88% and 79% versus 94%. Visual acuity was statistically significantly impaired at 1 month, but no difference remained by 3 and 6 months postprocedure. CONCLUSION Ultrasound cycloplasty procedure is associated with increased corneal astigmatism. However, its impact on total refractive astigmatism is less pronounced.
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Affiliation(s)
- Raquel Esteves Marques
- Department of Ophthalmology Hospital de Santa Maria Centro Hospitalar Universitário Lisboa Norte Lisboa Portugal
- Vision Sciences Study Centre CECV Faculdade de Medicina Universidade de Lisboa Lisboa Portugal
| | - David Cordeiro Sousa
- Department of Ophthalmology Hospital de Santa Maria Centro Hospitalar Universitário Lisboa Norte Lisboa Portugal
- Vision Sciences Study Centre CECV Faculdade de Medicina Universidade de Lisboa Lisboa Portugal
| | - Evelien Vandewalle
- Department of Neurosciences Research Group of Ophthalmology KU Leuven Leuven Belgium
- Department of Ophthalmology University Hospitals UZ Leuven Leuven Belgium
| | - Alix Somers
- Department of Neurosciences Research Group of Ophthalmology KU Leuven Leuven Belgium
- Department of Ophthalmology University Hospitals UZ Leuven Leuven Belgium
| | - Shlomo Melamed
- The Sam Rothberg Glaucoma Centre Goldschleger Eye Institute Sheba Medical Centre Tel‐Aviv University Tel‐Hashomer Israel
| | - Marco Nardi
- Department of Surgical Medical, Molecular Pathology and of Critical Area University of Pisa Pisa Italy
| | - Michele Figus
- Department of Surgical Medical, Molecular Pathology and of Critical Area University of Pisa Pisa Italy
| | - Ingeborg Stalmans
- Department of Neurosciences Research Group of Ophthalmology KU Leuven Leuven Belgium
- Department of Ophthalmology University Hospitals UZ Leuven Leuven Belgium
| | - Luis Abegao Pinto
- Department of Ophthalmology Hospital de Santa Maria Centro Hospitalar Universitário Lisboa Norte Lisboa Portugal
- Vision Sciences Study Centre CECV Faculdade de Medicina Universidade de Lisboa Lisboa Portugal
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Supiyaphun C, Rattanasiri S, Jongkhajornpong P. Comparison of Anterior Segment Parameters and Axial Length Using Two Scheimpflug Devices with Integrated Optical Biometers. Clin Ophthalmol 2020; 14:3487-3494. [PMID: 33122885 PMCID: PMC7590999 DOI: 10.2147/opth.s278701] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the repeatability of anterior segment parameters and axial length (AL) using Pentacam AXL and Galilei G6 and the agreement between both devices. Materials and Methods Eighty-four eyes of 84 participants were measured prospectively with two devices. Outcome measurements included corneal curvatures, anterior chamber depth (ACD), AL, pupil size, and white-to-white distance (WTW). Intra-device repeatability was assessed using intraclass correlation coefficient (ICC), within-subject standard deviation (Sw), test-re-test repeatability (TRT=2.77 Sw), and coefficient of variation (CoV). Agreement between two devices was analyzed using Bland-Altman plots. Results For each device, the Sw of corneal curvatures, ACD, and AL were lower than 0.25 D, 0.04 mm, and 0.04 mm, respectively. The ICC was higher than 0.90 in all parameters measured by Pentacam AXL, whereas three parameters measured by Galilei G6 (steep meridian at anterior and posterior cornea, and pupil size) were lower than 0.90. Comparing to Galilei G6, Pentacam AXL led to significantly lower mean anterior cornea curvatures (Km) with the mean difference (95% level of agreement; LoA) of -0.12 D (-0.36, 0.12, P<0.001). For ACD, there was no significant difference between the two devices. Pentacam AXL led to significantly lower AL, pupil size, and WTW, with the mean differences (95% LoA) of -0.04 mm (-0.35, 0.27), -0.18 mm (-0.71, 0.35), and -0.35 mm (-0.61, -0.10), respectively. Conclusion We found good repeatability of corneal curvature, ACD, and AL in both devices. Most parameters obtained from Pentacam AXL were statistically significantly different from those obtained from Galilei G6, except for steep meridians and ACD.
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Affiliation(s)
- Chantaka Supiyaphun
- Department of Ophthalmology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Passara Jongkhajornpong
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Analysis of related factors of optical quality in healthy Chinese adults: a community-based population study. Chin Med J (Engl) 2020; 133:2308-2314. [PMID: 32868501 PMCID: PMC7546838 DOI: 10.1097/cm9.0000000000000994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Zhao Y, Chen D, Savini G, Wang Q, Zhang H, Jin Y, Song B, Ning R, Huang J, Mei C. The precision and agreement of corneal thickness and keratometry measurements with SS-OCT versus Scheimpflug imaging. EYE AND VISION 2020; 7:32. [PMID: 32528997 PMCID: PMC7285531 DOI: 10.1186/s40662-020-00197-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/19/2020] [Indexed: 11/23/2022]
Abstract
Purpose To assess the repeatability and reproducibility of swept-source optical coherence tomography (SS-OCT) and Scheimpflug system and evaluate the agreement between the two systems in measuring multiple corneal regions in children. Methods Pachymetric and keratometric maps for both systems were evaluated. Central, midperipheral and peripheral corneal thickness (CT), keratometry and astigmatism power vectors were recorded. The three outcomes yielded by the same observer were used to assess intraobserver repeatability. The differences in the mean values provided by each observer were used to evaluate interobserver reproducibility. Within-subject standard deviation, test-retest repeatability (TRT) and coefficient of variation (CoV) were used to analyze the intraobserver repeatability and interobserver reproducibility. Paired T-test and Bland-Altman were used to appraise interdevice agreement. Results Seventy-eight eyes of 78 children were included. The CoV was ≤2.12 and 1.10%, respectively, for repeatability and reproducibility. TRT and CoV were lower for central and paracentral CT measurements than for peripheral measurements. The SS-OCT device generated higher precision when acquiring CT data, whereas Scheimpflug system showed higher reliability when measuring corneal keratometry. Although the CT readings measured using SS-OCT were significantly thinner than Scheimpflug device (P < 0.001), the central and thinnest CT values were still of high agreement. The interdevice agreement of keratometry measurement was high for the central corneal region and moderate for the paracentral and peripheral areas. Conclusions The precision of CT measurements by SS-OCT was higher, while the reliability of keratometry measurements by the Scheimpflug system was higher in children. Apart from the measured values in the central corneal region, the thickness and keratometry readings should not be considered interchangeable between the two systems.
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Affiliation(s)
- Yune Zhao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang China
| | - Ding Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | | | - Qing Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Hongfang Zhang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang China
| | - Yili Jin
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Benhao Song
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Rui Ning
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Jinhai Huang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang China.,Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027 Zhejiang China
| | - Chenyang Mei
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang China.,Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027 Zhejiang China
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Zhang XF, Li M, Shi Y, Wan XH, Wang HZ. Repeatability and agreement of two anterior segment OCT in myopic patients before implantable collamer lenses implantation. Int J Ophthalmol 2020; 13:625-631. [PMID: 32399415 DOI: 10.18240/ijo.2020.04.15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/11/2019] [Indexed: 12/27/2022] Open
Abstract
AIM To evaluate the intra-operator repeatability of time domain and swept-source Fourier domain anterior segment optical coherence tomography (AS-OCT), namely, Visante AS-OCT and Casia SS-1000 OCT, in measuring the preoperative parameters of implantable collamer lens (ICL) in myopic eyes, as well as the agreement between the two devices. METHODS A total of 97 eyes from 49 myopes were investigated in this prospective case series study. The anterior chamber depth (ACD), angle-to-angle distance (ATA), pupil diameter (PD) and crystalline lens rise (CLR) in all subjects were measured for three times during one session by the same operator. The repeatability was evaluated using the within-subject standard deviation (Sw), repeatability limits and intraclass correlation coefficients (ICC). The agreement between the two systems was evaluated using the Bland-Altman plots and 95% limits of agreement (LoA). RESULTS The repeatability limits of Visante AS-OCT in measuring ACD, ATA, PD and CLR were 0.099, 0.141, 0.304, and 0.079 mm, respectively. The repeatability limits of Casia SS-1000 OCT in measuring ACD, ATA, PD, and CLR were 0.105, 0.127, 0.357, and 0.082 mm, respectively. Excellent repeatability could be attained in both devices, with the ICC>0.8 for all the measured variables. The interdevice agreement was excellent (P>0.05) for ACD and ATA, but poor (P<0.05) for PD and CLR. CONCLUSION Good repeatability can be attained by time domain and swept-source Fourier-domain OCT for all the measured variables. Moreover, interdevice agreement analysis suggests that interchangeable measurements between two devices can be achieved for ACD and ATA, but not for PD and CLR; but the differences in measurements were not clinically significant.
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Affiliation(s)
- Xi-Fang Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China
| | - Meng Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China
| | - Yan Shi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China
| | - Xiu-Hua Wan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China
| | - Huai-Zhou Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China
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Abstract
PURPOSE To observe the distributions and changes in angle kappa and angle alpha preoperatively and postoperatively in patients with cataract who were implanted with a multifocal intraocular lens (mIOL). SETTING The First Affiliated Hospital of Northwest University, Shaanxi, China. DESIGN Prospective nonrandomized noncomparative case series. METHODS Eyes that underwent phacoemulsification were included. The magnitudes and orientations of angle kappa and angle alpha preoperatively and postoperatively were compared, respectively. RESULTS The study comprised 81 eyes of 70 patients. The magnitude of angle kappa significantly decreased after phacoemulsification. No significant differences were observed between preoperative and postoperative angle kappa in orientation, as well as between preoperative and postoperative angle alpha. The correlations between preoperative and postoperative angle kappa and angle alpha were significant. There were displacement vectors for angle kappa (0.15 ± 0.10) and angle alpha (0.12 ± 0.12) after phacoemulsification. Locations of angle kappa of right and left eyes were scattered mostly in the temporal side of corneal light reflection, whereas locations of angle alpha were well organized in the horizontal position on temporal sides of corneal light reflection. CONCLUSIONS The distribution of angle alpha was more organized compared with angle kappa. Angle kappa may change after phacoemulsification. During preoperative evaluation for patients with cataract planning for mIOLs implanted angle alpha may be a more reliable and stable factor compared with angle kappa.
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Correlation Between Anterior Corneal Elevation Differences in Main Meridians and Corneal Astigmatism. Eye Contact Lens 2020; 46:99-104. [DOI: 10.1097/icl.0000000000000613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhang QW, Zhai CB, Ma DL. Comparison of corneal curvature parameters obtained from two different instruments-Pentacam and VX120. Int J Ophthalmol 2019; 12:1311-1316. [PMID: 31456922 DOI: 10.18240/ijo.2019.08.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 07/29/2019] [Indexed: 01/02/2023] Open
Abstract
AIM To explore whether the same corneal curvature parameters and anterior chamber depth measured by Pentacam and VX120 have a good consistency and can replace each other. METHODS This study enrolled 140 eyes of 70 patients ranging in age from 19 to 53y. All eyes underwent a comprehensive ophthalmologic examination including an anterior segment analysis with the VX120 system (Visionix-Luneau Technologies, Chartres, France) and Pentacam (Oculus Optikgerate GmbH) respectively. The comparison on corneal curvature parameters was done between Pentacam and VX120 using clustered signed rank test; the interclass correlation coefficients (ICC) with 95% confidence intervals (CI) was calculated for each parameter between Pentacam and VX120; the Bland-Altman plot of each parameter was supplemented. RESULTS The anterior corneal curvature measured by VX120 was Ks: 44.00±1.78 D, KsAt: 89.45±22.18, Kf: 42.84±1.58 D, KfAt: 93.91±79.34; which measured by Pentacam was Ks: 43.80±1.82 D, KsAt: 91.17±21.40, Kf: 42.61±1.64 D, KfAt: 91.16±78.69. There was statistical difference between Pentacam and VX120 for anterior corneal curvature parameter (P<0.001). The posterior corneal curvature measured by VX120 was Ks: -6.42±1.23 D, KsAt: 91.00±23.45, Kf: -5.85±1.24 D, KfAt: 95.93±79.11; which measured by Pentacam was Ks: -6.44±0.32 D, KsAt: 92.24±11.75, Kf: -6.01±1.05 D, KfAt: 74.43±80.64. There was statistical difference between Pentacam and VX120 for posterior corneal curvature parameters (P<0.001). Anterior chamber depth (ACD) measured by Pentacam and VX120 was statistically different. Pentacam and VX120 achieved high consistency only on corneal anterior surface, including Ks and Kf. The ICCs were 0.96 (95%CI: 0.95, 0.97) and 0.95 (95%CI: 0.94, 0.97) respectively. For other corneal surface curvature parameters, all ICCs of between Pentacam and VX120 were below 0.87. Bland-Altman plots indicated of low consistency of corneal surface curvature parameters measured by Pentacam and VX120. CONCLUSION The corneal curvature parameters and anterior chamber depth measured by Pentacam and VX120 were statistically different. Data measured by Pentacam and VX120 is not suggested to replace each other, mixing data measured by Pentacam and VX120 together is not suggested either.
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Affiliation(s)
- Qing-Wei Zhang
- Beijing Institute of Ophthalmology; Beijing Tongren Eye Center; Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Chang-Bin Zhai
- Beijing Institute of Ophthalmology; Beijing Tongren Eye Center; Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Dong-Li Ma
- Beijing Institute of Ophthalmology; Beijing Tongren Eye Center; Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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Piñero DP, Camps VJ, de Fez D, García C, Caballero MT. Validation of posterior corneal curvature measurements with color light-emitting diode topography. Eur J Ophthalmol 2019; 30:1261-1267. [PMID: 31432704 DOI: 10.1177/1120672119870738] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the intrasession repeatability and validity of posterior corneal curvature and astigmatism measurements provided by a color light-emitting diode reflection topography system in healthy eyes. METHODS A total of 40 healthy eyes of 40 patients (age, 16-66 years) were enrolled. A complete eye examination was performed in all cases including posterior topographic analysis with two systems: the Scheimpflug-based system (Pentacam; Oculus Optikgeräte GmbH, Wetzlar, Germany) and the Cassini system (i-Optics; Ophthec, The Hague, The Netherlands). With this last system, three consecutive measurements were taken to assess the level of intrasession repeatability (within-subject standard deviation, Sw; intraclass correlation coefficient). The Bland & Altman analysis was used to evaluate the interchangeability of both devices. RESULTS The Sw was ⩽0.06 mm for all posterior corneal radius measurements, with intraclass correlation coefficient of ⩾0.960. The Sw for the magnitude of astigmatism, J0, and J45 were 0.15, 0.04, and 0.04 D, respectively, with intraclass correlation coefficient values of 0.876, 0.897, and 0.840, respectively. Statistically significant differences between devices were found in all parameters evaluated (p ⩽ 0.025). The interchangeability analysis revealed the presence of clinically relevant limits of agreement for the flattest (0.03 to 0.50 mm) and steepest posterior corneal radii (-0.01 to 0.39 mm). In contrast, limits of agreements were not clinically relevant for the magnitude of posterior astigmatism (-0.17 to 0.27 D) and their power vector components (-0.11 to 0.15 D). CONCLUSION The Cassini system provides consistent measures of posterior corneal curvature and astigmatism in healthy eyes, but only measures of posterior astigmatism can be considered as interchangeable with those provided by the Pentacam.
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Affiliation(s)
- David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Vicent J Camps
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Dolores de Fez
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Celia García
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
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Li C, Zhang J, Yin X, Li J, Cao Y, Lu P. Distribution and related factors of corneal regularity and posterior corneal astigmatism in cataract patients. Clin Ophthalmol 2019; 13:1341-1352. [PMID: 31440022 PMCID: PMC6664321 DOI: 10.2147/opth.s212946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 06/23/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To study the distribution of posterior corneal astigmatism (PCA) and its influencing factors in Chinese patients before cataract surgery. Patients and methods A retrospective study was conducted in the First Affiliated Hospital of Soochow University, Suzhou, China. In all, this study enrolled 121 eligible eyes of 121 cataract patients. The astigmatism, aberrations and Q value of anterior, posterior and total cornea and anterior segment parameters (ACD, CCT, WTW, ATA) were measured by the Sirius System, and AL was measured by Lenstar LS 900. Cataract was diagnosed using slit-lamp examination. Results The mean age of patients was 67.44±10.66 years old. Mean PCA was 0.31±0.17 (range 0.05–1.09) D and 85.9% eyes had PCA values <0.5 D. With-the-rule (WTR) astigmatism predominated the anterior cornea astigmatism (ACA) (48.8%) and total corneal astigmatism (TCA) (61.2%), while against-the-rule (ATR) astigmatism predominated posterior (86.0%). Significant positive correlation was found between the astigmatic power vector (APV) of ACA and PCA (Pearson correlation=0.318, P<0.001); TCA and PCA (Pearson correlation=0.204, P=0.025); keratometric astigmatism and PCA (Pearson correlation=0.356, P<0.001); this study also found a positive correlation between primary spherical aberration (Z4°) of the total cornea and PCA (Pearson correlation=0.266, P=0.003); primary spherical aberration (Z4°) of the corneal front surface and PCA (Pearson correlation=0.260, P=0.004); total corneal aberrations (Total cornea root mean square [RMS]) and PCA (Pearson correlation=0.327, P<0.001); total corneal higher-order
aberrations (Total HOA RMS) (Pearson correlation=0.232, P=0.011); total corneal lower-order aberrations (Total LOA RMS) (Pearson correlation=0.250, P=0.006). A positive linear correlation between Q value of corneal front surface and PCA, either 6 mm pupil diameter (Pearson correlation=0.264, P=0.003) or 8 mm pupil diameter (Pearson correlation=0.184, P=0.043) was found in this study. Conclusion Corneal aberration, Q value (front surface specifically) was essential that we need to take into consideration when we conduct PCA and intraocular
lens measurement in clinics.
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Affiliation(s)
- Chen Li
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Jiaju Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Xue Yin
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Jianqing Li
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Yihong Cao
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
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Comparison of anterior segment measurements obtained using a swept-source optical coherence tomography biometer and a Scheimpflug–Placido tomographer. J Cataract Refract Surg 2019; 45:298-304. [DOI: 10.1016/j.jcrs.2018.10.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/28/2018] [Accepted: 10/03/2018] [Indexed: 12/20/2022]
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Piccinini AL, Golan O, Hafezi F, Randleman JB. Higher-order aberration measurements: Comparison between Scheimpflug and dual Scheimpflug-Placido technology in normal eyes. J Cataract Refract Surg 2019; 45:490-494. [PMID: 30713018 DOI: 10.1016/j.jcrs.2018.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/25/2018] [Accepted: 11/19/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare higher order aberrations (HOAs) in normal eyes between a Scheimpflug imaging system (Pentacam HR) and dual Scheimpflug-Placido imaging system (Galilei G4). SETTING Emory University, Atlanta, Georgia, and the University of Southern California, Los Angeles, USA. DESIGN Retrospective case series. METHODS Eyes screened for refractive surgery were evaluated sequentially using a Scheimpflug device and a dual Scheimpflug-Placido device. Differences, correlations, and agreement between values for total root mean square (RMS), trefoil, coma, and spherical aberration were analyzed, and Bland-Altman plots were generated. RESULTS One hundred five eyes of 105 patients (44 men, 61 women) were evaluated. Total RMS, coma, and trefoil were significantly different between groups (all P < .001), while spherical aberration values were not. There was moderate correlation between devices for trefoil (r = 0.475 to 0.652), coma (r = 0.574 to 0.651), and spherical aberration (r = 0.483) and a strong correlation for total cornea RMS (r = 0.817). There was no directional bias between groups. The 95% limits of agreement for absolute values was 0.039 μm for trefoil at 30 degrees, 0.405 μm for trefoil at 0 degree, 0.553 μm for horizontal coma, 0.545 μm for vertical coma, 0.318 μm for spherical aberration, and 0.617 μm for RMS. CONCLUSIONS A Scheimpflug imaging device and dual Scheimpflug-Placido imaging device generated statistically different values for total cornea HOAs; however, the correlation between devices was moderate to strong and there was reasonable agreement in all measures for normal eyes. Based on these findings, the devices appear functionally equivalent for clinical use, although caution is warranted for outcomes-based research protocols that report HOAs.
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Affiliation(s)
- Andre L Piccinini
- Keck School of Medicine, University of Southern California, Los Angeles, USA; Sadalla Amin Ghanem Eye Hospital, Joinville, SC, Brazil
| | - Oren Golan
- Keck School of Medicine, University of Southern California, Los Angeles, USA; Department of Ophthalmology, Tel Aviv Souraski Medical Center, Tel Aviv, Israel; Tel Aviv University, Tel Aviv, Israel
| | - Farhad Hafezi
- Keck School of Medicine, University of Southern California, Los Angeles, USA; USC Roski Eye Institute, Los Angeles, USA; ELZA Institute, Dietikon/Zurich, Switzerland; Ocular Cell Biology Group, University of Zurich, Zurich, Switzerland; University of Wenzhou, Wenzhou, China
| | - J Bradley Randleman
- Keck School of Medicine, University of Southern California, Los Angeles, USA; USC Roski Eye Institute, Los Angeles, USA.
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Anterior Chamber Angle and Volume Do Not Change after Myopic Laser-Assisted In Situ Keratomileusis in Young Patients. J Ophthalmol 2019; 2018:8646275. [PMID: 30647966 PMCID: PMC6311827 DOI: 10.1155/2018/8646275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/07/2018] [Accepted: 11/19/2018] [Indexed: 12/05/2022] Open
Abstract
Purpose We aimed to investigate whether anterior chamber angle, depth, and volume change after myopic laser-assisted in situ keratomileusis (LASIK) in young patients. Methods This retrospective study included 29 eyes of 29 patients (15 females and 14 males) between the ages of 18 and 39 years who underwent LASIK for the treatment of myopia. In addition to complete ophthalmic examination, anterior chamber angle (ACA), central anterior chamber depth (ACD), and anterior chamber volume (ACV) were measured by using a Sirius rotating Scheimpflug camera combined with Placido disc corneal topography (CSO, Florence, Italy). Preoperative and postoperative values were compared using paired t-tests. Linear regression was used to evaluate the relationship between changes in refraction and changes in ACA, ACD, and ACV as well as between attempted maximum ablation depth and changes in ACA, ACD, and ACV. Results The mean age of the study population was 25.5 ± 6.2 years. The mean preoperative and postoperative spherical equivalent values were −3.30 ± 1.92 D and −0.18 ± 0.29 D, respectively. ACV and ACA were not significantly changed after surgery; however, central ACD was significantly decreased (preoperatively = 3.366 ± 0.316 mm vs postoperatively = 3.3 ± 0.298 mm) with a mean difference of 0.066 ± 1.121 mm. There were no significant relationships between changes in refraction and anterior segment dimensions or between attempted maximum ablation depth and anterior segment dimensions. Conclusion Measurements with Sirius showed that ACA and ACV did not change; however, central ACD significantly decreased after myopic LASIK in young patients, indicating that the preoperative central ACD value should not be used interchangeably with the postoperative central ACD value.
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Hsieh YH, Weng TH, Chou YC, Wu KL, Liang CM, Tai MC. Agreement of post-LASIK corneal power and corneal thickness measurements by pentacam and GALILEI corneal tomography systems. J Chin Med Assoc 2019; 82:72-77. [PMID: 30839408 DOI: 10.1016/j.jcma.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Post-LASIK corneal conditions cannot be accurately measured by traditional optometric approaches. Therefore, we aimed to analyze the agreement of two rotating Scheimpflug cameras in corneal assessment. METHODS Fifty otherwise healthy volunteers who had undergone LASIK were recruited in this study. The values of mean and central total corneal power (TCP), including TCP1, TCP2, and TCP-IOL, were measured by GALILEI Scheimpflug camera. The values of total corneal refractive power (TCRP) readings at both 2 mm ring and 3 and 4 mm zones were detected by Pentacam Scheimpflug camera. Central corneal thickness (CCT) and thinnest corneal thickness (TCT) were quantified by GALILEI and Pentacam respectively. Paired t-tests and Bland-Altman analyses were used to evaluate statistical differences between measurement results obtained by GALILEI and by Pentacam. RESULTS Among these 50 subjects, the mean and central TCP1 values (37.31 ± 2.61 and 37.27 ± 2.64) derived from GALILEI measurements were consistent with the TCRP values (37.08 ± 2.76, 37.11 ± 2.74, and 37.19 ± 2.68; p > 0.05) determined by Pentacam at the 2 mm ring apex, 3 mm zone apex, and 4 mm zone apex. There were no statistically significant differences in central corneal thickness (CCT) values measured by the two cameras (463.64 ± 55.67 μm for GALILEI and 470.69 ± 44.04 μm for Pentacam, respectively; p > 0.05). However, the limits of agreement were wide when comparing mean TCP1 (-1.4 to 1.8 D, -1.4 to 1.8 D, and -1.3 to 1.6 D), central TCP1 (-1.2 to 1.6 D, -1.2 to 1.6 D, and -1.2 to 1.4 D) and CCT (-77.2-63.0 μm). CONCLUSION Corneal power and corneal thickness are disparate post-LASIK evaluation parameters when comparing the utility of GALILEI with that of Pentacam.
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Affiliation(s)
- Yun-Hsiu Hsieh
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Tzu-Heng Weng
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Kuan-Liang Wu
- National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chang-Min Liang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
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Cavas-Martínez F, Fernández-Pacheco DG, Parras D, Cañavate FJF, Bataille L, Alió J. Study and characterization of morphogeometric parameters to assist diagnosis of keratoconus. Biomed Eng Online 2018; 17:161. [PMID: 30458789 PMCID: PMC6245489 DOI: 10.1186/s12938-018-0564-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background In case of significant imperfections on the cornea, data acquisition is difficult and a significant level of missing data could require the interpolation of important areas of the cornea, resulting in a very ambiguous model. The development of methods to define in vivo customised geometric properties of the cornea based only on real raw data is extremely useful to diagnose and assess the progression of diseases directly related to the corneal architecture. The present work tries to improve the prognostic of corneal ectasia creating a 3D customised model of the cornea and analysing different geometric variables from this model to determine which variables or combination of them could be defined as an indicator of susceptibility to develop keratoconus. Methods A corneal geometric reconstruction was performed using zonal functions and retrospective Scheimpflug tomography data from 187 eyes of 187 patients. Morphology of healthy and keratoconic corneas was characterized by means of geometric variables. The performance of these variables as predictors of a new geometric marker was assessed and their correlations were analysed. Results The more representative variable to classify the corneal anomalies related to keratoconus was posterior apex deviation (area under receiver operating characteristic curve > 0.899; p < 0.0001). However, the strongest correlations in both healthy and pathological corneas were provided by the metrics directly related to the thickness, as deviations of the anterior/posterior minimum thickness points. Conclusions The presented morphogeometric approach based on the analysis and custom geometric modelling of the cornea demonstrates to be useful for the characterization and diagnosis of keratoconus disease, stating that geometrical deformation is an effective marker of the ectatic disease’s progression.
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Affiliation(s)
- Francisco Cavas-Martínez
- Department of Graphical Expression, Technical University of Cartagena, C/Doctor Fleming s/n, 30202, Cartagena, Murcia, Spain.
| | - Daniel G Fernández-Pacheco
- Department of Graphical Expression, Technical University of Cartagena, C/Doctor Fleming s/n, 30202, Cartagena, Murcia, Spain
| | - Dolores Parras
- Department of Graphical Expression, Technical University of Cartagena, C/Doctor Fleming s/n, 30202, Cartagena, Murcia, Spain
| | - Francisco J F Cañavate
- Department of Graphical Expression, Technical University of Cartagena, C/Doctor Fleming s/n, 30202, Cartagena, Murcia, Spain
| | - Laurent Bataille
- Research and Development Department, Vissum Corporation Alicante, Alicante, Spain
| | - Jorge Alió
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.,Keratoconus Unit of Vissum Corporation Alicante, Alicante, Spain.,Department of Refractive Surgery, Vissum Corporation Alicante, Alicante, Spain
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Domínguez-Vicent A, Brautaset R. Agreement and Repeatability of Two Biometers to Measure Anterior Segment Components: Refractive Error Effect. Med Sci Monit 2018; 24:8056-8063. [PMID: 30414377 PMCID: PMC6240168 DOI: 10.12659/msm.907683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To assess the repeatability and agreement between a new high-resolution optical coherence tomographer (OCT) and a Scheimpflug topographer. MATERIAL AND METHODS Sixty phakic and healthy participants were measured in this study, and one eye per participant was analyzed. Depending on their refractive error, each participant was allocated into a myopic, hyperopic, or emmetropic group. The Cirrus HD-OCT 5000 (Carl Zeiss Meditec, Jena, Germany), and the Sirius Scheimpflug topographer (Costruzione Strumenti Oftalmici, Florence, Italy) were used to take all measurements. RESULTS The repeatability of these instruments to measure the anterior chamber depth, angle-to-angle, thinnest pachymetry, and both nasal and temporal angles was smaller than 0.15 mm, 0.40 mm, 10 µm, and 10 degrees, respectively. However, the repeatability of the Scheimpflug instrument to measure the apex pachymetry was about 15 µm, and for the OCT, it was about 4 µm for all groups. On average, the Sirius Scheimpflug instrument measured shallower anterior chamber depth (about 0.10 mm), shorter angle-to-angle (about 0.5 mm), thinner corneas (approximately 10 µm), and narrower angles (around 5 degrees) for all refractive groups. CONCLUSIONS The repeatability of the Cirrus OCT and Sirius Scheimpflug instrument was good and independent of the refractive error. Nevertheless, to judge whether these instruments could be used interchangeable, clinical criteria are needed.
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Affiliation(s)
- Alberto Domínguez-Vicent
- Unit of Optometry, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Rune Brautaset
- Unit of Optometry, Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
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Özkan Aksoy N, Çakır B, Doğan E, Alagöz G. Evaluation of Anterior Segment Parameters in Pseudoexfoliative Glaucoma, Primary Angle-Closure Glaucoma, and Healthy Eyes. Turk J Ophthalmol 2018; 48:227-231. [PMID: 30405943 PMCID: PMC6216528 DOI: 10.4274/tjo.03271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/30/2018] [Indexed: 12/01/2022] Open
Abstract
Objectives: To evaluate anterior segment parameters measured by dual Scheimpflug corneal topography in pseudoexfoliative glaucoma (PEXG), primary angle-closure glaucoma (PACG), and healthy eyes. Materials and Methods: One hundred forty-three eyes of 86 patients were included in this study. Forty-seven eyes of 38 patients with PEXG, 30 eyes of 15 patients with PACG, and 66 eyes of 33 healthy subjects were evaluated. Patients who underwent previous ophthalmic surgery and contact lens wearers were excluded. After full ophthalmological examination, mean central corneal thickness (CCT), white-to-white horizontal corneal diameter (WTW), pupillary diameter (PD), anterior chamber volume (ACV), anterior chamber depth (ACD), and mean anterior chamber angle were measured by dual Scheimpflug corneal topography and compared between the three groups. Statistical analyses were done using Statistical Package for Social Sciences for Windows 18.0 program. Results: No statistical difference was found in mean age or gender among the study groups (p>0.05). There were also no statistical differences in CCT, WTW, or PD among the groups (p=0.568, p=0.064, p=0.321, respectively). ACV, ACD, and mean anterior chamber angle values were significantly lower in the PACG group compared to the other groups (p=0.000 for all). There was no statistically significant difference in these measurements between the PEXG and normal eyes. Conclusion: ACV and depth and mean anterior chamber angle were statistically different (lower) in PACG when compared with PEXG and healthy eyes. Dual Scheimpflug corneal topography can be used as an objective method for the measurement of anterior segment parameters in glaucoma.
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Affiliation(s)
- Nilgün Özkan Aksoy
- Sakarya University Training and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
| | - Burçin Çakır
- Sakarya University Training and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
| | - Emine Doğan
- Sakarya University Training and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
| | - Gürsoy Alagöz
- Sakarya University Training and Research Hospital, Department of Ophthalmology, Sakarya, Turkey
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Kemraz D, Cheng XY, Shao X, Zhou KJ, Pan AP, Lu F, Yu AY. Age-Related Changes in Corneal Spherical Aberration. J Refract Surg 2018; 34:760-767. [PMID: 30428096 DOI: 10.3928/1081597x-20181011-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 10/10/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze the age-related changes in corneal spherical aberration (CSA) and higher order aberrations (HOAs) and to develop a novel model to estimate the change in CSA with age. METHODS This was a cross-sectional study of the right eyes of 3,769 patients. Anterior corneal spherical aberration (ASA), posterior corneal spherical aberration (PSA), total corneal spherical aberration (TSA), and the root mean square of corneal HOAs were measured using a Scheimpflug tomographer. Smoothed fitting curves were plotted as a function of age and the average change in spherical aberration was calculated for different ages. RESULTS The mean magnitude of ASA, PSA, TSA, and HOAs (6 and 4 mm) were 0.270 ± 0.111, -0.144 ± 0.031, 0.228 ± 0.120, 0.453 ± 0.194, and 0.141 ± 0.075 µm, respectively. All parameters showed a statistically significant non-linear change with age. The age after which the aberrations increased at a faster rate, namely the turning points of age, were 39 years for ASA, PSA, TSA, and 6-mm HOAs (95% confidence interval [CI]: 35 to 42, 36 to 41, 36 to 42, and 35 to 56 years, respectively) and 46 years for 4-mm HOAs (95% CI: 36 to 56 years). There were significant increases in increment rates after the turning points. The average change of TSA was -0.013 µm/10 years from 18 to 39 years and 0.057 µm/10 years after 39 years. There were statistically significant correlations between ASA and TSA (r = 0.976, P < .001) and PSA and TSA (r = 0.192, P < .001), but not between ASA and PSA (r = -0.003, P = .835). CONCLUSIONS CSA and HOAs increased non-linearly with age and became more positive after 39 and 46 years of age, respectively. Based on the increment rates and turning points of age, a novel model is provided to help calculate the value required to compensate for the increasing CSA associated with the aging cornea. [J Refract Surg. 2018;34(11):760-767.].
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Assessment of Pattern and Shape Symmetry of Bilateral Normal Corneas by Scheimpflug Technology. Symmetry (Basel) 2018. [DOI: 10.3390/sym10100453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose: The aim of this study was to assess bilateral symmetry in normal fellow eyes by using optical and geometric morphometric parameters. Methods: All participants underwent complete biocular examinations. Scheimpflug tomography data from 66 eyes of 33 patients were registered. The interocular symmetry was based on five patterns: morphogeometric symmetry, axial symmetry at the corneal vertex, angular-spatial symmetry, direct symmetry (equal octants), and enantiomorphism (mirror octants). Results: No statistically significant differences were found between right and left eyes in corneal morphogeometric (p ≥ 0.488) and aberrometric parameters (p ≥ 0.102). Likewise, no statistically significant differences were found in any of the axial symmetry parameters analyzed (p ≥ 0.229), except in the surface rotation angle beta (p = 0.102) and translation coordinates X0 and Y0 (p < 0.001) for the anterior corneal surface, and the rotation angle gamma (p < 0.001) for the posterior surface. Similarly, no statistically significant differences were identified for direct symmetry (p ≥ 0.20) and enantiomorphism (p ≥ 0.75), except for some elevation data in the posterior surface (p < 0.01). Conclusions: The level of symmetry of both corneas of a healthy individual is high, with only some level of disparity between fellow corneas in rotation and translation references. Abnormalities in this pattern of interocular asymmetry may be useful as a diagnostic tool.
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Almorín-Fernández-Vigo I, Sánchez-Guillén I, Fernández-Vigo JI, Macarro-Merino A, Kudsieh B, Fernández-Vigo C, Fernández-Vigo JA. Normative Pentacam anterior and posterior corneal elevation measurements: effects of age, sex, axial length and white-to-white. Int Ophthalmol 2018; 39:1955-1963. [PMID: 30276510 DOI: 10.1007/s10792-018-1028-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 09/21/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To provide normal corneal elevation data for a large Caucasian population and to determine the impacts on these data of age, sex, axial length (AXL) and horizontal white-to-white (WW). SETTING Centro Internacional de Oftalmología Avanzada, Madrid, Spain. DESIGN Retrospective, cross-sectional, observational. METHODS In this retrospective, cross-sectional, observational study, anterior and posterior corneal elevations were measured in 789 right eyes of subjects with no ocular disease at the thinnest corneal location in relation to a fixed 8-mm best-fit sphere using the Pentacam, and AXL and WW were measured with the IOLMaster. A multiple linear regression model was used to assess the effects of age, sex, AXL and WW on the elevation data. RESULTS Mean subject age was 50.5 ± 15 years (range 17-93 years); 64% were women. Mean anterior and posterior corneal elevations were 1.99 ± 1.75 µm (- 7 to 10 µm) and 7.70 ± 5.7 µm (- 6 to 28 µm). Anterior corneal elevations were higher by 0.165 μm and 0.033 μm for every mm reduction in AXL and every year reduction in age, respectively. Sex and WW were not significant predictors of anterior elevations (R2 = 7.7%). Posterior corneal elevation increased by 0.186 μm/year of age, 0.707 μm/mm reduction in WW and 0.819 μm/mm reduction in AXL. This variable was also 0.866 μm greater in men (R2 = 34.4%). CONCLUSION Anterior corneal elevations decrease with age and are higher for shorter AXL but are not influenced by sex or WW. Posterior corneal elevations increase with age, decreasing AXL, decreasing WW and are higher in men.
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Affiliation(s)
| | - Inés Sánchez-Guillén
- Centro Internacional de Oftalmología Avanzada, c/Godofredo Ortega y Muñoz 22, 06011, Badajoz, Spain
| | - José I Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain.,Department of Ophthalmology, Hospital Clínico San Carlos, Madrid, Spain
| | - Ana Macarro-Merino
- Centro Internacional de Oftalmología Avanzada, c/Godofredo Ortega y Muñoz 22, 06011, Badajoz, Spain.,Centro Internacional de Oftalmología Avanzada, Madrid, Spain
| | - Bachar Kudsieh
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain.,Department of Ophthalmology, Hospital Puerta de Hierro, Madrid, Spain
| | | | - José A Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain.,School of Medicine, Universidad de Extremadura, Badajoz, Spain
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36
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Jabbarvand M, Askarizadeh F, Sedaghat MR, Ghadimi H, Khosravi B, Amiri MA, Narooie-Noori F. Author's Reply. J Ophthalmic Vis Res 2018; 13:366-367. [PMID: 30090200 PMCID: PMC6058557 DOI: 10.4103/jovr.jovr_97_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Mahmoud Jabbarvand
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Askarizadeh
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohamad Reza Sedaghat
- Cornea Research Center, Khatam-Al-Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ghadimi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Khosravi
- Department of Optometry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Foroozan Narooie-Noori
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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Study of Morpho-Geometric Variables to Improve the Diagnosis in Keratoconus with Mild Visual Limitation. Symmetry (Basel) 2018. [DOI: 10.3390/sym10080306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The validation of new methods for the diagnosis of incipient cases of Keratoconus (KC) with mild visual limitation is of great interest in the field of ophthalmology. During the asymmetric progression of the disease, the current diagnostic indexes do not record the geometric decompensation of the corneal curvature nor the variation of the spatial profile that occurs in singular points of the cornea. The purpose of this work is to determine the structural characterization of the asymmetry of the disease by using morpho-geometric parameters in KC eyes with mild visual limitation including using an analysis of a patient-specific virtual model with the aid of computer-aided design (CAD) tools. This comparative study included 80 eyes of patients classified as mild KC according to the degree of visual limitation and a control group of 122 eyes of normal patients. The metric with the highest area under the receiver operating characteristic (ROC) curve was the posterior apex deviation. The most prominent correlation was found between the anterior and posterior deviations of the thinnest point for the mild keratoconic cases. This new custom computational approach provides the clinician with a three-dimensional view of the corneal architecture when the visual loss starts to impair.
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38
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Baghdasaryan E, Huang X, Marion KM, Tepelus TC, Bagherinia H, Sadda SR, Hsu HY. Reproducibility of Central Corneal Thickness Measurements in Normal Eyes Using the Zeiss Cirrus 5000 HD-OCT and Pentacam HR. Open Ophthalmol J 2018; 12:72-83. [PMID: 29872486 PMCID: PMC5960748 DOI: 10.2174/1874364101812010072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/20/2018] [Accepted: 04/23/2018] [Indexed: 11/22/2022] Open
Abstract
Objectives: To determine the repeatability and reproducibility of Central Corneal Thickness (CCT) measurements using two different anterior segment imaging modalities, including those obtained with the new anterior segment lens attachments for the Cirrus 5000 HD-OCT. Methods: A total of 32 eyes from 16 normal volunteers (8 male, 8 female) were enrolled in this prospective study. CCT was measured by the same examiner using the Cirrus 5000 HD-OCT and Pentacam HR. The results of CCT obtained by each method were averaged and compared using t-test analysis. The agreement between the measurement methods was evaluated. Coefficient of Repeatability (CoR) and Intra-Class Correlation Coefficient (ICC) were computed. Results: The mean measurements taken with the Cirrus OCT anterior chamber lens (CCTAC), HD cornea lens (CCTHDC) and pachymetry scans (CCTPach) were 545.35 ± 31.02, 537.87 ± 26.82, and 532.04 ± 29.82 µm, respectively. The mean CCT obtained with the Pentacam (CCTPent) was 545.51 ± 30.71 µm. CCTPent were significantly higher than CCTHDC and CCTPach (p< 0.0001). In contrast, the CCTPent and CCTAC were similar (p=0.87). CCT, as evaluated by the two different instruments, showed excellent correlation (r > 0.98, p< 0.0001) with an ICC > 0.99 (95% CI, 0.97 – 0.99). CoR was the highest for CCTPach (3.7 ± 1.4, 95% CI (3.0- 4.6)). Conclusion: CCT measurements from the Cirrus OCT using the new anterior segment lens attachments and the Pentacam HR are highly correlated. This should allow the use of a standardized correction factor if necessary to inter-relate the measurements between the two devices.
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Affiliation(s)
| | | | | | | | | | - SriniVas R Sadda
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Hugo Y Hsu
- Doheny Eye Institute, Los Angeles, CA, USA.,Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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Repeated Same-Day Versus Single Tomography Measurements of Keratoconic Eyes for Analysis of Disease Progression. Cornea 2018; 37:474-479. [PMID: 29319597 PMCID: PMC5844585 DOI: 10.1097/ico.0000000000001513] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose: Corneal tomography is used to assess progression of keratoconus and to direct clinical decisions regarding corneal cross-linking. The purpose of this study was to analyze the variability of repeated Scheimpflug-tomography (Pentacam Classic; Oculus, Wetzlar, Germany) measurements of keratoconic eyes in a clinical setting and to assess the validity of such measurements as a clinical decision-making tool. Methods: Eighty keratoconic eyes of 45 patients (age range 16–32 years) were examined at baseline and after follow-up periods of 3 to 6 months using 3 consecutive tomography measurements at each visit. Minimum corneal thickness and anterior sagittal curvature map parameters were studied [simulated keratometry (K) astigmatism (SimKast); maximum simulated K-reading (SimKmax); average SimK (SimKave); maximum K-readings on the 3-mm (Kmax3) and 5-mm (Kmax5) rings; and maximum K-reading (Kmax)]. Results: When comparing the first measurements at the first and second visits, respectively, 9% to 20% of eyes were classified as progressive depending on which parameter was chosen. Using the average of 3 consecutive measurements at each visit, 5% to 19% of eyes were classified as progressive. An increase in the SD of 3 consecutive measurements of SimKast (SD_SimKast) at the first visit of 1 diopter makes true progression of keratoconus 3.6 times more likely (odds ratio = 3.6; 95% confidence interval: 0.846–16.027; area under the curve = 0.70). Conclusions: The approach used to analyze progression in keratoconus, that is, single versus repeated measurements, may confer a great impact on the decision to perform corneal cross-linking treatment or not.
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Mülhaupt M, Dietzko S, Wolffsohn J, Bandlitz S. Corneal topography with an aberrometry-topography system. Cont Lens Anterior Eye 2018; 41:436-441. [PMID: 29748095 DOI: 10.1016/j.clae.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE To investigate the agreement between the central corneal radii and corneal eccentricity measurements generated by the new Wave Analyzer 700 Medica (WAV) compared to the Keratograph 4 (KER) and to test the repeatability of the instruments. METHODS 20 subjects (10 male, mean age 29.1 years, range 21-50 years) were recruited from the students and staff of the Cologne School of Optometry. Central corneal radii for the flat (rc/fl) and steep (rc/st) meridian as well as corneal eccentricity for the nasal (enas), temporal (etemp), inferior (einf) and superior (esup) directions were measured using WAV and KER by one examiner in a randomized order. RESULTS Central radii of the flat (rc/fl) and steep (rc/st) meridian measured with both instruments were statically significantly correlated (r = 0.945 and r = 0.951; p < 0.001). Comparison between the WAV and KER showed that rc/fl and rc/st measured with WAV were significantly steeper than those measured with KER (p < 0.001). Corneal eccentricities were statistically significantly correlated in all meridians (p < 0.05). Compared to KER, etemp and esup measured with WAV were greater (p < 0.05), while there were no statistically significant differences for enas and einf (p = 0.350 and p = 0.083). For the central radii, repeated measurements were not significantly different for the KER or WAV (p > 0.05). Limits of agreement (LoA) indicate a better repeatability for the KER compared to WAV. CONCLUSIONS Corneal topography measurements captured with the WAV were strongly correlated with the KER. However, due to the differences in measured corneal radii and eccentricities, the devices cannot be used interchangeably. For corneal topography the KER demonstrated better repeatability.
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Affiliation(s)
- Michael Mülhaupt
- Höhere Fachschule für Augenoptik Köln (Cologne School of Optometry), Cologne, Germany
| | - Sven Dietzko
- Höhere Fachschule für Augenoptik Köln (Cologne School of Optometry), Cologne, Germany
| | - James Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
| | - Stefan Bandlitz
- Höhere Fachschule für Augenoptik Köln (Cologne School of Optometry), Cologne, Germany; Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK.
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41
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Fan R, Chan TCY, Prakash G, Jhanji V. Applications of corneal topography and tomography: a review. Clin Exp Ophthalmol 2018; 46:133-146. [DOI: 10.1111/ceo.13136] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/10/2017] [Accepted: 12/14/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Rachel Fan
- Faculty of Medicine; The University of Hong Kong; Hong Kong
| | - Tommy CY Chan
- Department of Ophthalmology & Visual Sciences; The Chinese University of Hong Kong; Hong Kong
| | - Gaurav Prakash
- NMC Eye Care; NMC Specialty Hospital; Abu Dhabi United Arab Emirates
| | - Vishal Jhanji
- Department of Ophthalmology & Visual Sciences; The Chinese University of Hong Kong; Hong Kong
- Department of Ophthalmology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania USA
- Centre for Eye Research Australia; University of Melbourne; Melbourne Victoria Australia
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42
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A Study for Parametric Morphogeometric Operators to Assist the Detection of Keratoconus. Symmetry (Basel) 2017. [DOI: 10.3390/sym9120302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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43
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Jabbarvand M, Askarizadeh F, Sedaghat MR, Ghadimi H, Khosravi B, Amiri MA, Narooie-Noori F. Comparison between Pentacam HR and Orbscan II after Hyperopic Photorefractive Keratectomy. J Ophthalmic Vis Res 2017; 12:374-379. [PMID: 29090045 PMCID: PMC5644402 DOI: 10.4103/jovr.jovr_47_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: The aim of this study was to determine the agreement between Pentacam HR (Scheimpflug imaging, Oculus) and Orbscan II (scanning slit topography, Bausch and Lomb) in measuring corneal parameters after photorefractive keratectomy (PRK) for hyperopia. Methods: In this prospective cross-sectional study, 38 hyperopic eyes undergoing PRK were examined before refractive surgery and 8 to 10 months postoperatively using Pentacam HR and Orbscan II. Ultrasound (US) pachymetry was also used to measure central corneal thickness (CCT). The radius of anterior (A-) and posterior (P-) best-fit sphere size (BFS), central elevation (CE), and anterior maximum tangential power in 3 mm (TG3) and 3-5 mm (TG5) zones, anterior chamber depth (ACD), and central corneal thickness (CCT) were collected and used in the analyses. To study the agreement between the measurements made by the two devices, the method described by Bland and Altman was used and the 95% limits of agreement were calculated. Results: The 95% limits of agreement show reasonable agreement between the measurements by Pentacam HR and Orbscan II for A-BFS, P-BFS, A-TG3, and CCT, but not for A-CE, P-CE, A-TG5, or ACD. CCT values obtained by both Pentacam HR and Orbscan II correlated well with the values determined by US pachymetry. Conclusion: Pentacam HR and Orbscan II after PRK for hyperopia show reasonable agreement for determining A-BFS, P-BFS, A-TG3, and CCT, but not for A-CE, P-CE, A-TG5, or ACD. CCT measurements with Pentacam HR have reasonable agreement with US pachymetry.
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Affiliation(s)
- Mahmoud Jabbarvand
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Askarizadeh
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohamad Reza Sedaghat
- Cornea Research Center, Khatam-Al-Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Ghadimi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Khosravi
- Department of Optometry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Foroozan Narooie-Noori
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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Piñero DP, Cabezos I, López-Navarro A, de Fez D, Caballero MT, Camps VJ. Intrasession repeatability of ocular anatomical measurements obtained with a multidiagnostic device in healthy eyes. BMC Ophthalmol 2017; 17:193. [PMID: 29047369 PMCID: PMC5648429 DOI: 10.1186/s12886-017-0589-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 10/16/2017] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate the intrasession repeatability of anterior chamber depth (ACD), central (CCT) and peripheral corneal thickness (PCT), white-to-white diameter (WTW), and irido-corneal angle (IA) measurements obtained with a multidiagnostic device in healthy eyes. Methods A total of 107 eyes of 107 patients ranging in age from 23 to 65 years were examined with the VX120 system (Visionix-Luneau Technologies). Three consecutive measurements were obtained with this device to assess the intrasession repeatability of ACD, CCT, PCT at different nasal and temporal locations, WTW, and nasal and temporal IA. Data analysis included the calculation of within-subject standard deviation (Sw), intrasubject precision (1.96xSw), coefficient of variation (CV) and intraclass correlation coefficient (ICC). Results The Sw and CV for ACD was 0.03 mm and 1.16%, respectively, with an ICC of 0.992. The Sw values for central and peripheral pachymetric measurements were below 9 μm, with CV of less than 1.6% and ICC of 0.976 or higher. For IA measurements, Sw values of 0.84 or lower were found, with a CV between 1 and 2%, and an ICC of more than 0.970. The Sw for WTW was 0.24 mm and the CV was 1.95%. No statistically significant correlations were found between any anatomical parameter evaluated and their Sw and CV values associated (−0.220 ≤ r ≤ 0.204, p ≥ 0.125). Conclusions The VX120 system is able to provide repeatable measurements of anatomical parameters in healthy eyes. Inter-observer repeatability should be evaluated in future studies.
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Affiliation(s)
- David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain.
| | - Inmaculada Cabezos
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain
| | | | - Dolores de Fez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain
| | - María T Caballero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain
| | - Vicente J Camps
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig s/n 03016, San Vicente del Raspeig, Alicante, Spain
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Abstract
PURPOSE To investigate agreement between rotating Scheimpflug camera (Pentacam HR, Oculus) and rotating Scheimpflug camera combined with Placido disc corneal topography (Sirius, CSO) in measuring total corneal astigmatism (TCA). METHODS In this observational study, all patients undergoing cataract surgery with preoperative measurement of TCA by both devices and a validated corneal topographer (Keratron, Optikon 2000) were retrospectively evaluated. Astigmatism analysis was performed with and without vector analysis separately in eyes with with-the-rule, against-the-rule, and oblique astigmatism. Vector analysis was performed using the Næser polar system. RESULTS In 130 eyes of 130 subjects, nonvectorial analysis revealed that the mean TCA values obtained with the Sirius were higher than the corresponding values given by the Pentacam HR in all subgroups, although the difference was statistically significant only in eyes with against-the-rule astigmatism (P = 0.0009). This finding was confirmed by vector analysis. A TCA magnitude difference greater than 0.5 diopters was observed in 20.8% of cases, and a TCA axis difference greater than 10 degrees was observed in 45.4% of cases. Axis differences dropped to 18.5% when only eyes with astigmatism >0.75 diopters were analyzed and 3 measurements were averaged. The mean difference in the meridional and torsional power of TCA was close to zero in all subgroups, but with relatively large standard deviations (approximately 0.5 D). CONCLUSIONS Agreement between both devices in measuring TCA is only moderate with respect to both magnitude and axis orientation.
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46
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Sideroudi H, Labiris G, Ditzel F, Tsaragli E, Georgatzoglou K, Siganos H, Kozobolis V. Validation of Fourier analysis of videokeratographic data. Int Ophthalmol 2017; 38:1433-1440. [PMID: 28620708 DOI: 10.1007/s10792-017-0602-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim was to assess the repeatability of Fourier transfom analysis of videokeratographic data using Pentacam in normal (CG), keratoconic (KC) and post-CXL (CXL) corneas. METHODS This was a prospective, clinic-based, observational study. One randomly selected eye from all study participants was included in the analysis: 62 normal eyes (CG group), 33 keratoconus eyes (KC group), while 34 eyes, which had already received CXL treatment, formed the CXL group. Fourier analysis of keratometric data were obtained using Pentacam, by two different operators within each of two sessions. Precision, repeatability and Intraclass Correlation Coefficient (ICC), were calculated for evaluating intrassesion and intersession repeatability for the following parameters: Spherical Component (SphRmin, SphEcc), Maximum Decentration (Max Dec), Regular Astigmatism, and Irregularitiy (Irr). Bland-Altman analysis was used for assessing interobserver repeatability. RESULTS All parameters were presented to be repeatable, reliable and reproductible in all groups. Best intrasession and intersession repeatability and reliability were detected for parameters SphRmin, SphEcc and Max Dec parameters for both operators using ICC (intrasession: ICC > 98%, intersession: ICC > 94.7%) and within subject standard deviation. Best precision and lowest range of agreement was found for the SphRmin parameter (CG: 0.05, KC: 0.16, and CXL: 0.2) in all groups, while the lowest repeatability, reliability and reproducibility was detected for the Irr parameter. CONCLUSIONS The Pentacam system provides accurate measurements of Fourier tranform keratometric data. A single Pentacam scan will be sufficient for most clinical applications.
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Affiliation(s)
- Haris Sideroudi
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece. .,Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
| | - Georgios Labiris
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece.,Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Fienke Ditzel
- Medical Center, Universtity of Groningen (RuG), Groningen, The Netherlands
| | - Efi Tsaragli
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece
| | | | | | - Vassilios Kozobolis
- Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece.,Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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Yeo JH, Moon NJ, Lee JK. Measurement of Angle Kappa Using Ultrasound Biomicroscopy and Corneal Topography. KOREAN JOURNAL OF OPHTHALMOLOGY 2017; 31:257-262. [PMID: 28471103 PMCID: PMC5469929 DOI: 10.3341/kjo.2016.0021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/08/2016] [Indexed: 11/23/2022] Open
Abstract
Purpose To introduce a new convenient and accurate method to measure the angle kappa using ultrasound biomicroscopy (UBM) and corneal topography. Methods Data from 42 eyes (13 males and 29 females) were analyzed in this study. The angle kappa was measured using Orbscan II and calculated with UBM and corneal topography. The angle kappa of the dominant eye was compared with measurements by Orbscan II. Results The mean patient age was 36.4 ± 13.8 years. The average angle kappa measured by Orbscan II was 3.98° ± 1.12°, while the average angle kappa calculated with UBM and corneal topography was 3.19° ± 1.15°. The difference in angle kappa measured by the two methods was statistically significant (p < 0.001). The two methods showed good reliability (intraclass correlation coefficient, 0.671; p < 0.001). Bland-Altman plots were used to demonstrate the agreement between the two methods. Conclusions We designed a new method using UBM and corneal topography to calculate the angle kappa. This method is convenient to use and allows for measurement of the angle kappa without an expensive device.
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Affiliation(s)
- Joon Hyung Yeo
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Nam Ju Moon
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jeong Kyu Lee
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea.
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Corneal Topographic and Aberrometric Measurements Obtained with a Multidiagnostic Device in Healthy Eyes: Intrasession Repeatability. J Ophthalmol 2017; 2017:2149145. [PMID: 28133542 PMCID: PMC5241482 DOI: 10.1155/2017/2149145] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/10/2016] [Accepted: 12/05/2016] [Indexed: 12/12/2022] Open
Abstract
Purpose. To evaluate the intrasession repeatability of corneal curvature, eccentricity, and aberrometric measurements obtained with a multidiagnostic device in healthy eyes. Methods. This study enrolled 107 eyes of 107 patients ranging in age from 23 to 65 years. All of them underwent a complete anterior segment examination with the VX120 system (Visionix-Luneau Technologies, Chartres, France). Three consecutive measurements were obtained. The within-subject standard deviation (Sw), intrasubject precision (1.96 × Sw), and intraclass correlation coefficient (ICC) were calculated. Results. All Sw for corneal power measurements were below 0.26 D, with ICC above 0.982. The Sw for corneal astigmatism at different areas (3, 5, and 7 mm) was below 0.21 D, with ICC above 0.913. Concerning the axis of astigmatism, its Sw was below 11.27°, with ICC above 0.975. The Sw and ICC for corneal eccentricity were 0.067 and 0.957, respectively. The Sw and ICC for high-order aberration root mean square (RMS) were 0.048 µm and 0.901, respectively. For 3rd- and 4th-order aberrometric parameters, all Sw were below 0.037 µm and all ICC were higher than 0.84, except for quadrafoil RMS (ICC: 0.689). Conclusions. The multidiagnostic device evaluated is able to provide consistent measurements of corneal power, eccentricity, and third- and fourth-order aberrations in healthy eyes.
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Noncontact Evaluation of Corneal Grafts: Swept-Source Fourier Domain OCT Versus High-Resolution Scheimpflug Imaging. Cornea 2017; 36:434-439. [DOI: 10.1097/ico.0000000000001133] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Comparación de la medición del grosor corneal central medido con el paquímetro incluido en el Wavelight® Ex500 Excimer Laser y el tomógrafo de cámara de Scheimpflug Pentacam® en sujetos sanos. REVISTA MEXICANA DE OFTALMOLOGÍA 2017. [DOI: 10.1016/j.mexoft.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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