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      Clinical Applications of Anterior Segment Optical Coherence Tomography

      review-article
      1 , 2 , *
      Journal of Ophthalmology
      Hindawi Publishing Corporation

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          Abstract

          Anterior segment optical coherence tomography (AS-OCT) was recently developed and has become a crucial tool in clinical practice. AS-OCT is a noncontact imaging device that provides the detailed structure of the anterior part of the eyes. In this review, the author will discuss the various clinical applications of AS-OCT, such as the normal findings, tear meniscus measurement, ocular surface disease (e.g., pterygium, pinguecula, and scleromalacia), architectural analysis after cataract surgery, post-LASIK keratectasia, Descemet's membrane detachment, evaluation of corneal graft after keratoplasty, corneal deposits (corneal dystrophies and corneal verticillata), keratitis, anterior segment tumors, and glaucoma evaluation (angle assessment, morphological analysis of the filtering bleb after trabeculectomy, or glaucoma drainage device implantation surgery). The author also presents some interesting cases demonstrated via AS-OCT.

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          Most cited references70

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          Micrometer-scale resolution imaging of the anterior eye in vivo with optical coherence tomography.

          To demonstrate a new diagnostic technique, optical coherence tomography, for high-resolution cross-sectional imaging of structures in the anterior segment of the human eye in vivo. Optical coherence tomography is a new, noninvasive, noncontact optical imaging modality that has spatial resolution superior to that of conventional clinical ultrasonography ( 90 dB). Survey of intraocular structure and dimension measurements. Laboratory. Convenience sample. Correlation with range of accepted normal intraocular structure profiles and dimensions. Direct in vivo measurements with micrometer-scale resolution were performed of corneal thickness and surface profile (including visualization of the corneal epithelium), anterior chamber depth and angle, and iris thickness and surface profile. Dense nuclear cataracts were successfully imaged through their full thickness in a cold cataract model in calf eyes in vitro. Optical coherence tomography has potential as a diagnostic tool for applications in noncontact biometry, anterior chamber angle assessment, identification and monitoring of intraocular masses and tumors, and elucidation of abnormalities of the cornea, iris, and crystalline lens.
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            Risk assessment for ectasia after corneal refractive surgery.

            To analyze the epidemiologic features of ectasia after excimer laser corneal refractive surgery, to identify risk factors for its development, and to devise a screening strategy to minimize its occurrence. Retrospective comparative and case-control study. All cases of ectasia after excimer laser corneal refractive surgery published in the English language with adequate information available through December 2005, unpublished cases seeking treatment at the authors' institution from 1998 through 2005, and a contemporaneous control group who underwent uneventful LASIK and experienced a normal postoperative course. Evaluation of preoperative characteristics, including patient age, gender, spherical equivalent refraction, pachymetry, and topographic patterns; perioperative characteristics, including type of surgery performed, flap thickness, ablation depth, and residual stromal bed (RSB) thickness; and postoperative characteristics including time to onset of ectasia. Development of postoperative corneal ectasia. There were 171 ectasia cases, including 158 published cases and 13 unpublished cases evaluated at the authors' institution. Ectasia occurred after LASIK in 164 cases (95.9%) and after photorefractive keratectomy (PRK) in 7 cases (4.1%). Compared with controls, more ectasia cases had abnormal preoperative topographies (35.7% vs. 0%; P<1.0x10(-15)), were significantly younger (34.4 vs. 40.0 years; P<1.0x10(-7)), were more myopic (-8.53 vs. -5.09 diopters; P<1.0x10(-7)), had thinner corneas before surgery (521.0 vs. 546.5 microm; P<1.0x10(-7)), and had less RSB thickness (256.3 vs. 317.3 microm; P<1.0x10(-10)). Based on subgroup logistic regression analysis, abnormal topography was the most significant factor that discriminated cases from controls, followed by RSB thickness, age, and preoperative corneal thickness, in that order. A risk factor stratification scale was created, taking all recognized risk factors into account in a weighted fashion. This model had a specificity of 91% and a sensitivity of 96% in this series. A quantitative method can be used to identify eyes at risk for developing ectasia after LASIK that, if validated, represents a significant improvement over current screening strategies.
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              Clinical and research applications of anterior segment optical coherence tomography - a review.

              Optical coherence tomography (OCT) is being employed more and more often to image pathologies and surgical anatomy within the anterior segment, specifically in anterior chamber biometry, corneal pachymetric mapping, angle evaluation and high-resolution cross-sectional imaging. The cross-sectional imaging capability of OCT is similar to ultrasound, but its higher resolution allows OCT to measure and visualize very fine anatomic structures. No contact is required. In this review, we describe the utility and limitations of anterior segment OCT.
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                Author and article information

                Journal
                J Ophthalmol
                J Ophthalmol
                JOPH
                Journal of Ophthalmology
                Hindawi Publishing Corporation
                2090-004X
                2090-0058
                2015
                3 March 2015
                : 2015
                : 605729
                Affiliations
                1Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Republic of Korea
                2Department of Ophthalmology, Daegu Veterans Health Service Medical Center, 60 Wolgok-ro, Dalseo-Gu, Daegu 704-802, Republic of Korea
                Author notes

                Academic Editor: Edward Manche

                Article
                10.1155/2015/605729
                4363581
                25821589
                1cf0d36e-184b-489b-a909-04cb77c53fb0
                Copyright © 2015 Su-Ho Lim.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 December 2014
                : 21 February 2015
                Categories
                Review Article

                Ophthalmology & Optometry
                Ophthalmology & Optometry

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