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M. Parikh, T. Vajaranant, J. DeLaCruz; Retinal Nerve Fiber Layer OCT as an Adjunct in Glaucoma Monitoring After Boston Keratoprosthesis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5709. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if optic nerve head and nerve fiber layer OCT can serve as an adjunct to glaucoma management in patients with a Boston Keratoprosthesis.
Optic nerve head and 3.4 mm circumpapillary retinal nerve fiber layer imaging by StratusOCT (Carl Zeiss Meditec Inc, Dublin, CA) from patients undergoing Boston KPro between December 2006 and December 2007 at the University of Illinois were reviewed. All images were aquired through the keratoprosthesis with an overlying Kontour lens. Signal strength and image centration were assessed.
Seven eyes of seven patients underwent Boston KPro secondary to repeated graft failure after chemical injury, Stevens Johnson syndrome, pseudophakic bullous keratopathy and opacification secondary to infectious keratitis.Three of seven (43%) eyes had preexisting glaucoma. One eye developed medically uncontrolled glaucoma requiring Ahmed tube placement 10 weeks after keratoprosthesis.Three eyes underwent 3.4 mm circumpapillary nerve fiber layer thickness OCT. The signal strength of the images ranged from 5 to 7 (average of 6.8). All video fundus images showed good centration of the circular scan.One patient that developed glaucoma postoperatively underwent 3 separate RNFL studies over 6 months after Ahmed tube placement. The studies demonstrated reproducible RNFL map morphology.Two eyes underwent fast optic nerve head OCT. Six radial scans of each optic nerve were reviewed with signal strengths ranging from 4 to 10 (average of 6.4).
Our small cohort demonstrates it is possible to obtain good quality OCT images though a keratoprosthesis. Since only tactile estimation of IOP is possible postoperatively, OCT may serve as an adjunct to visual field testing and optic nerve biomicroscopy in monitoring the development and progression of glaucoma.
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