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Elena Yingqiu Zhu, Alexandros Ioannidis, Peter Harrington, Robert Symons; Use of a novel ocular contact lens to aid fundal optical coherence tomography (OCT) imaging in severe keratoconus. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3128.
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© ARVO (1962-2015); The Authors (2016-present)
OCT images of the ocular fundus can be degraded by uncorrected refractive errors. This can be a problem in severe keratoconus. We sought to improve the OCT quality in such a patient using a specially designed contact lens.
A single element quartz (n=1.46) ocular contact lens (Symons Image Enhancing Lens, Ocular Instruments, Bellevue, WA) was used to minimize the optic aberrations of the keratoconic cornea. This lens has a central thickness of 1.0mm and a net dioptric power of zero. The lens' anterior surface has a high-performance anti-reflection coating with minimal reflection intensity at 830nm. The patient’s eyes were anesthetized with topical oxybuprocaine and hypromellose 0.3% was used as an optical medium. Spectral domain OCT was performed using Spectralis (Heidelberg Engineering, Heidelberg, Germany).A 38 year old woman with keratoconus was imaged. The extent of keratoconus was documented (Figure 1) by Placido disc analysis (Orbscan, Bausch & Lomb, NY). OCT images were captured with and without the use of the novel contact lens.
Without the lens the OCT image quality was severely compromised. With the application of the lens, high-quality OCT images of the maculae and retinal nerve fibre layers of both eyes were captured (Figure 2).
Our fundal contact lens significantly increased the quality of the OCT images. It is anticipated that the lens will improve imaging in severe keratoconus and other tectonic corneal disorders.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Keratometric mapping of the right (A) and left (C) corneas demonstrating bilateral paracentral cones (maximum powers at apices 64.8D and 66.1D in the right and left eyes respectively; Pachymetric mapping of the right (B) and left (D) corneas showing bilateral central thinning (thicknesses of 386 microns and 368 microns in the right and left corneal apices).
OCT images of the left macula (A) and the peripapillary retinal nerve fibre layer (PRNFL) of the right (B) and left (C) eyes captured without the use of the contact lens. It was impossible to image the right macula. OCT image using the contact lens described here for the macula of the left eye (D) and the PRNFL of the right (E) and left (F) eyes. The resolution and clarity of all the images were significantly improved compared with the images obtained without use of the lens. Right macular images were obtained.
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