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Alex Huang, Xiaobin Xie, Giulia Corradetti, Anmol Pardeshi, Abe Song, Sindhu Saraswathy, Thania Bogarin, Srinivas Sadda, Benjamin Xu, Vikas Chopra; In-Depth Assessment of Multiple Anterior Segment Biometric Changes during Accommodation using Anterion Swept-Source Anterior Segment OCT. Invest. Ophthalmol. Vis. Sci. 2020;61(7):843.
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© ARVO (1962-2015); The Authors (2016-present)
To perform an in-depth analysis of the accommodative apparatus which includes the ciliary body muscle, crystalline lens and the other anterior segment structures with age and in response to different measured accommodative stimuli, in order to gain a better understanding about the mechanism of accommodation and presbyopia.
This prospective observational study included right eyes from 44 healthy and phakic volunteers (mean age: 47.1±14.0 years [range 26-74]). The images of the ciliary muscle, lens, and the anterior segment were obtained using a new anterior segment swept-source OCT (Anterion, Heidelberg Engineering) with built-in static step-controlled accommodative stimulus states: relaxed, -1 diopter (D), -3D, and -5D. Measurements (automatic, semi-automatic, and manual) for all parameters were possible from single acquisition scans. In order to determine the repeatability of Anterion imaging, both eyes were imaged twice at zero accommodative stimulus on separate occasions. Inter- and intraobserver reliability of biometric measurements were determined using images from multiple accommodative states.
The interclass correlation (ICC) (95% confidence interval, CI) values of inter-observer measurements on the temporal and nasal maximum ciliary body muscle thickness (MCBMT) were 0.92 (0.86-0.96) and 0.91 (0.83-0.95), respectively. The ICC (95% CI) values of test-retest reproducibility on temporal and nasal MCBMT measurements were 0.83 (0.63-0.98) and 0.89 (0.74-0.95), respectively. The values of nasal MCBMT was significantly larger than those on the temporal side through all accommodative steps (p=0.01-0.04). Temporal and nasal MCBMT values, lens thickness and lens vault increased significantly during -3.0 and -5.0D accommodation (p=0.01-0.02), whereas aqueous depth and pupil size decreased significantly (p=0.01-0.047). No changes were observed in the anterior chamber angle parameters (ACA, SSA, AOD, and TISA at 500 & 750). Slopes obtained from the relationship of the temporal and nasal MCBMT to different accommodative steps were significantly steeper in younger subjects (p<0.01).
Imaging from anterior segment swept-source OCT was able to simultaneously capture changes in multiple components (ciliary muscle, lens, chamber, and angle) of the accommodative apparatus, providing a detailed picture of accommodative biomechanics.
This is a 2020 ARVO Annual Meeting abstract.
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