顿挫伤性睫状体脱离的眼前节相干光断层扫描观察

目的探讨眼前节相干光断层扫描（OCT）在挫伤性睫状体脱离诊断中的应用价值。方法应用德国Ze iss公司的V isante OCT对2010年10月至2011年4月门诊或急诊就诊的10例（10只眼）因顿挫伤而怀疑睫状体脱离的病例进行检查,所有患者同时也进行眼超声生物显微镜（UBM）检查进行对照分析。结果 10例确诊为360°的睫状体脱离,与UBM结果一致。结论眼前节OCT为非接触式检查,结合临床资料,对顿挫伤性睫状体脱离可提供有用的诊断价值。     

Identification of peripheral anterior synechia with anterior segment optical coherence tomography

Graefe's Archive for Clinical and Experimental Ophthalmology - To generate a model that evaluates the presence and extent of peripheral anterior synechia (PAS) based on anterior segment optical...     

Slit-lamp-adapted optical coherence tomography of the anterior segment

· Purpose: To evaluate the diagnostic potential of a slit-lamp-adapted optical coherence tomography (OCT) system as an in vivo imaging device for routine clinical examination of the anterior segment of the eye. · Patients and methods: In a pilot study, healthy volunteers and patients with different pathologies of the anterior segment were examined with a slit-lamp-adapted OCT system using 100–200 axial scans with 100-Hz line-scan frequency. The scan length is variable up to 7 mm, and the axial depth is 1.5 mm in tissue. · Results: The slit-lamp-adapted OCT system allowed direct biomicroscopic imaging of the measured area. Anatomic structures and morphological changes anterior to the attenuating iris pigment epithelium could be visualized with high accuracy. Biometric analyses of the cornea, the chamber angle, the iris and secondary cataract were possible. Complete demonstration of the chamber angle was difficult due to the backscattering properties of the anterior part of the sclera and the consequent shadowing of the most peripheral part of the iris. · Conclusions: Slit-lamp-adapted OCT is a useful diagnostic tool which allows in vivo microscopic cross-sectional imaging of the anterior segment and precise measurement of ocular structures. Received: 11 February 1999 Revised version received: 28 April 1999 Accepted: 17 May 1999     

Comparative study of anterior segment measurement with Pentacam and anterior segment optical coherence tomography

Objective: To evaluate the repeatability of central corneal thickness (CCT), anterior chamber volume (ACV), and central anterior chamber depth (CACD) measurements obtained using a Pentacam rotating Scheimpflug camera, and to examine their agreement with measurements obtained using an anterior segment optical coherence tomography (AS-OCT) imaging system.Design: Observational cross-sectional study.Participants: Fifty eyes from 50 healthy subjects were recruited.Methods: CCT, CACD, and ACV were measured. Subjects were re-examined twice within a week of the first measurements. Intrasession and intersession within-subject SD (S_w), precision (1.96 × S_w), coefficient of variation (CV_w: 100 × S_w/ overall mean), and intraclass correlation coefficient (ICC) were calculated to evaluate repeatability and reproducibility. Bland-Altman plots were used to assess agreements between Pentacam and AS-OCT measurements.Results: For intrasession repeatability, CVwand ICC values were 0.78 and 0.98 for CCT, 0.92 and 0.99 for CACD, and 3.52 and 0.98 for ACV, respectively. For intersession repeatability, CV_w and ICC values were 1.19 and 0.96 for CCT, 1.25 and 0.99 for CACD, and 3.96 and 0.96 for ACV, respectively. The AS-OCT CCT measurement (519.23 [SD 34.37] μm) was 18.53 μm less than the Pentacam measurement (537.76 [SD 31.84] μm). The Pentacam CACD measurement (3.03 [SD 0.32] mm) was 0.08 less than the AS-OCT measurement (3.11 [SD 0.31] mm). The Pentacam ACV measurement (165.56 [SD 34.86] μL) was 14.21 μL less than the AS-OCT measurement (179.77 [SD 34.57] μL).Conclusions: Although the Pentacam measurements of the anterior segment parameters were reliable, their agreement with the AS-OCT measurements was not sufficient.     

Intraoperative optical coherence tomography in anterior segment surgery

Intraoperative optical coherence tomography (iOCT) enables real-time visualization of ocular structures during surgery and enhances our understanding of intraoperative dynamics. iOCT aids in decision-making during various anterior segment surgeries, and its efficacy and feasibility in anterior lamellar keratoplasty and endothelial keratoplasty is well established. The landmark DISCOVER study observed that iOCT altered the surgeon decision in 38% of cases undergoing lamellar keratoplasty and provided guidance regarding the need for secondary surgical intervention. iOCT also finds an application in phacoemulsification wherein it helps to assess corneal incisions, intralenticular pressure, and posterior capsule integrity during nuclear emulsification. iOCT aids in the visualization of angle structures during placement of tubes and shunts in glaucoma surgeries and allows precise creation of partial thickness scleral flaps. In addition, iOCT helps in establishing a diagnosis, as well as provide intraoperative guidance, in pediatric patients who are not cooperative for examination. The role of iOCT in refractive surgeries and ocular surface disorders is increasingly being evaluated. The limitations of present-day iOCT systems are related to instrument compatibility, automated tracking of the surgical field, and on-table volumetric analysis of the real-time images. Technological advances may facilitate complete integration of OCT in the surgical microscopes for all surgical procedures.     

采用AS-OCT测量房角开放度数的一致性分析

目的 探讨采用眼前段光学相干断层扫描仪(AS-OCT)定量测量房角,并分析其测量一致性.方法 采用AS-OCT对23例受试者(30只眼)的房角进行扫描,分别由测量者甲和乙,以及测量者甲在两个不同的时间点对颞侧房角500μm(AA-500μm)和750μm(AA-750μm)的房角开放度数进行定量测量.采用类内相关系数ICC和95%LoA(95%Limts of Agreement,95% LoA)评价测量的一致性.结果 甲两次测量的AA-500μm和AA-750μm值比较差异均无统计学意义(均P＞0.05);甲与乙测量的AA-500μm和AA-750μm值比较差异均无统计学意义(均P＞0.05).AA-500μm和AA-750μm测量者内的95%LoA分别为(-5.441,5.281弧度和-7.313、6.020弧度);ICC分别为:0.933,0.907.AA-500μm和AA-750μm测量者间的95%LoA分别为:(-6.098,5.098弧度和-7.877、5.423弧度);ICC分别为0.925,0.887.结论 AS-OCT测量房角开放度数的一致性较好,可以用于定量测量房角开放度数.     

眼前段相干光断层成像术在眼科的应用

本文介绍了眼前段相干光断层成像术(OCT)产生的背景、技术特点及测量方法,并对其在眼科的应用进行综述.初步的研究结果显示眼前段OCT在角膜成像和分析、前房成像和活体测量、前房角成像和定量分析、有晶状体眼人工晶状体成像和位置测量、小梁切除术后滤过泡的成像和分析以及眼的调节观察等方面均具有良好的应用前景.     

前节光学相干断层扫描在青光眼研究中的应用

前节光学相干断层扫描(anterior segment opticalcoherence tomography,OCT)技术因为快速、非接触、分辨率高等优点在眼科应用广泛,对眼前节形态学包括角膜厚度、前房角结构、虹膜形态等方面有重要价值。现就前节OCT在青光眼研究中的应用综述如下。     

Applications of optical coherence tomography in the anterior segment

Optical coherence tomography provides high-resolution images of the anterior segment (AS-OCT). When used as a measuring tool, corneal thickness, anterior and posterior chamber depths, anterior chamber diameter and chamber angle configuration are defined reproducibly. In terms of an optical biopsy by cellular imaging, tissue infiltration, deformation and deposits can be analysed microstructurally. A comparison of pre- and post-operative, as well as long-term follow-up of pathological findings are possible. Examination with AS-OCT is a no-contact procedure, and is well tolerated by the patient. The following instruments were used: Visante-OCT and Cirrus HD-OCT (Carl Zeiss Meditec GmbH, Germany) and SS100 CASIA (Tomey Europe, Erlangen).     

Application of anterior segment optical coherence tomography in glaucoma

Optical coherence tomography (OCT) is a cross-sectional, three-dimensional, high-resolution imaging modality that uses low coherence interferometry to achieve axial resolution in the range of 3–20 μm. Two OCT platforms have been developed: time domain (TD-OCT) and spectral (or Fourier) domain (SD/FD-OCT). Visante anterior segment OCT (Carl Zeiss Meditec) is a TD-OCT widely used for anterior segment imaging. The SD-OCT systems with both posterior and anterior segment imaging capabilities include the RTVue, iVue (Optovue), the Cirrus (Carl Zeiss Meditec), and the Spectralis (Heidelberg Engineering, Inc.). Each of the SD-OCTs has a wavelength in the range of 820–879 nm. Anterior segment OCT is a non-contact method providing high resolution tomographic cross-sectional imaging of anterior segment structures. Anterior segment OCT provides qualitative and quantitative assessment of the anterior segment structures important to the pathogenesis and the anatomical variations of glaucoma, and the approach to and success of treatment. We summarize the clinical applications of anterior segment OCT in glaucoma.     

前节光学相干断层扫描在眼科领域的应用

眼前节光学相干断层扫描（anterior segment optical coherence tomography,AS-OCT）是眼科最新应用的扫描技术。它利用相干光断层扫描获取全方位高分辨率的眼前节图像及准确的眼前节数据,包括角膜厚度数据、前房参数、晶状体和人工晶状体数据,临床应用领域于屈光不正、角膜病、青光眼和白内障等疾病中。此技术已逐渐成为眼前节疾病最主要的临床检查和治疗疗效评价方法之一。     

Assessment of capsular block syndrome with anterior segment optical coherence tomography

A 59-year-old woman developed progressive, moderate myopia 1 year after routine phacoemulsification and insertion of a soft posterior chamber intraocular lens (IOL). After biomicroscopy, late capsular block was diagnosed and treated with a neodymium:YAG laser posterior capsulotomy. The myopia disappeared immediately. This case was illustrated using optical coherence tomography developed for the anterior segment. After capsulotomy, the IOL moved backward by 448 microm, corresponding to -0.75 diopter of induced myopia.     

Reproducibility of anterior chamber angle measurements obtained with anterior segment optical coherence tomography

PURPOSE: To evaluate the reproducibility of anterior chamber (AC) angle measurements obtained using anterior segment optical coherence tomography (AS-OCT). METHODS: Patients with suspected glaucoma and those with glaucoma, ocular hypertension, or anatomically narrow angles were recruited from the glaucoma service at the National University Hospital, Singapore. All subjects underwent imaging of the nasal, temporal, and inferior AC angles with an AS-OCT prototype under standardized dark and light conditions. For short-term reproducibility analysis, a single observer acquired two sets of images followed by a third set of images acquired by a second observer. The interval between sessions was 10 minutes. For long-term reproducibility analysis, a single observer acquired two sets of images at least 24 hours apart. Images were measured using custom software to determine the AC depth (ACD), angle opening distance at 500 microm (AOD(500)), angle recess area at 500 microm (ARA(500)), and trabecular-iris space area at 500 microm (TISA(500)). The intraclass correlation coefficient (ICC) was calculated as a measure of intraobserver and interobserver reproducibility. RESULTS: Twenty eyes of 20 patients were analyzed for short-term reproducibility, and 23 eyes of 23 patients were analyzed for long-term reproducibility. AC depth measurement demonstrated excellent reproducibility (ICC 0.93-1.00) in both dark and light conditions. For the nasal and temporal quadrants, all AC angle parameters demonstrated good to excellent short-term (ICC 0.67-0.90) and long-term (ICC 0.56-0.93) reproducibility in both dark and light conditions. In the inferior quadrant, reproducibility was lower in all categories of analysis and varied from poor to good (ICC 0.31-0.73). CONCLUSIONS: AS-OCT allows quantitative assessment of the AC angle. The reproducibility of AC angle measurements was good to excellent for the nasal and temporal quadrants. The lower reproducibility of measurements in the inferior quadrant may be unique to this prototype due to difficulty in acquiring high-quality images of the inferior angle. Further assessment of the commercially available AS-OCT is needed to clarify this finding.