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Rene Marcel Werkmeister, Sabina Sapeta, Doreen Schmidl, Gerhard Garhofer, Leopold Schmetterer; Ultrahigh-resolution OCT imaging of the anterior eye segment. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2438.
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To test whether ultrahigh-resolution optical coherence tomography (UHR-OCT) can be employed for imaging of the anatomy of the anterior eye segement in healthy subjects and for visualization of morphological changes in various corneal pathologies.
An UHR-OCT system was applied for imaging of the anterior eye segement. The imaging device allowed to acquire OCT data at the central, paracentral and peripheral cornea as well as the limbal region with 1.2 µm x 20 µm (axial x lateral) resolution at a rate of 140 000 A-scans/s. Measurements were performed in healthy subjects to visualize and evaluate various tissue structures in the cornea and limbus with high resolution. Furthermore, several corneal pathologies such as Fuchs' endothelial dystrophy, keratoconus as well as changes caused by Acanthamoeba keratitis and scarring after herpes keratitis were imaged.
In 5 healthy individuals, based on the 3D data sets, average thicknesses of all corneal layers were measured as follows: central cornea 585 ± 65 µm, epithelium 55 ± 8 µm, Bowman’s layer 18 ± 3 µm, Descemet’s membrane 10 ± 2 µm and endothelium 4.5 ± 1.1 µm. Futhermore, the basal layer of the epithelium could be visualized and its thickness (16 ± 2.2 μm) was measured. Measurements in patients allowed visualization of smallest morphological changes due to the pathology. In Fig. 1, guttatae in an early stage of Fuchs endothelial dystrophy can be seen. In a patient with Acanthamoeba keratitis, UHR-OCT revealed highly reflective dots corresponding to cysts in the anterior stroma (Fig. 2). Furthermore, radial keratoneuritis and changes in the Descemet's membrane-endothelium-complex could be visualized. In addition, imaging in patients with keratoconus and herpes keratitis presented several characteristic morphological changes.
UHR-OCT allowed for visualization of the anterior eye segment ultrastructure and revealed morphological changes in the presented clinical cases that have, to the best of our knowledge, not been shown by any other OCT system before. It shows the potential of the non-invasive, non-contact OCT technology for gaining a better insight into the pathophysiology of the cornea and helping with clinical decision-making and follow-up of patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
UHR-OCT of an early stage Fuchs’ endothelial dystrophy in a 60 year old female patient.
UHR-OCT of a 45 year patient with Acanthamoeba keratitis revealing cysts in the anterior stroma.
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