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J. A. Scholl, A. Gomes, R. Angeles, J. Cecka, C. Anderson, S. Turner; Method to Characterize Pharmacologically Induced Accommodation by Anterior Chamber OCT. Invest. Ophthalmol. Vis. Sci. 2007;48(13):991.
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© ARVO (1962-2015); The Authors (2016-present)
To assess an objective test method for imaging pharmacologically induced accommodative response of the lens inside a normal eye using anterior chamber optical coherence tomography (AC-OCT), and to assess the method’s potential utility measuring the response of accommodating IOLs in vivo.
Under an IRB approved protocol 4 healthy subjects (age range from 29 to 52) with no previous history of ocular surgery or eye disease were enrolled. The non-dominant eye of each subject was dilated using Phenylephrine 2.5% (Neosynepherine). After the subject’s pupil was dilated to 7mm or more accommodation was stimulated using one drop of Pilocarpine 2% and followed 30 minutes later with a second drop of Pilocarpine 2%. After the first drop of pilocarpine, pupil diameter and central lens thickness were imaged and recorded every 5 minutes using the VisanteTM AC-OCT until three successive readings showed no change in central lens thickness. It was anticipated that the Phenylephrine would dilate the pupil sufficiently to enable enhanced full thickness imaging of the lens as the Pilocarpine induced accommodative response. The primary outcome was the AC-OCT’s ability to image the full thickness of the lens as accommodation is induced.
All subjects tolerated the test method well. The AC-OCT was able to image the full thickness of the lens for all subjects at all test points. The Pilocarpine induced pupil constriction never went below 2.6mm for any subject. Measured lens thickness increase ranged from .46mm for the youngest subject to .08 mm for the oldest subject. For three of the patients, accommodative response, as measured by lens thickness change, stopped about 45 minutes after first drop of Pilocarpine was administered. For the remaining subject lens thickness change stopped about 60 minutes after the first drop of Pilocarpine.
This test protocol demonstrated the ability to objectively measure accommodative response in normal eyes, and demonstrated the potential to evaluate the response of accommodative IOLs in vivo where lens thickness changes are indicative of power changes.
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