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Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
Keratoconus diagnosis using anterior segment polarization-sensitive optical coherence tomography.
Shinichi Fukuda1, Masahiro Yamanari, Yiheng Lim
1Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Investigative Ophthalmology & Visual Science
|January 26, 2013
Summary
Polarization-sensitive optical coherence tomography (PS-OCT) reveals increased corneal birefringence in keratoconus patients. This technique shows promise for detecting early or subclinical keratoconus by analyzing tissue microstructure.
Area of Science:
- Ophthalmology
- Biomedical Optics
- Medical Imaging
Background:
- Keratoconus is a progressive corneal ectasia characterized by thinning and irregular protrusion.
- Early detection of keratoconus is crucial for timely intervention and preventing vision loss.
- Current diagnostic methods may not reliably identify early or subclinical cases.
Purpose of the Study:
- To investigate in vivo corneal tissue properties of keratoconic and normal eyes using polarization-sensitive optical coherence tomography (PS-OCT).
- To evaluate the diagnostic potential of PS-OCT parameters, including phase retardation, for early keratoconus detection.
- To assess the utility of Area Under the Receiver Operating Characteristic Curve (AUROC) and Mahalanobis distance analysis in differentiating keratoconus stages.
Main Methods:
- PS-OCT and corneal and anterior segment (CAS)-OCT were employed on 31 keratoconus eyes, 7 keratoconus suspect eyes, and 25 normal eyes.
- Measurements included en face phase retardation of the posterior cornea, curvature, videokeratographic parameters, astigmatism, pachymetry, and elevation.
- AUROC was calculated for each parameter to assess diagnostic power for keratoconus and keratoconus suspect detection.
Main Results:
- Keratoconic corneas exhibited increased birefringence compared to normal corneas, correlating with disease severity.
- Some keratoconus suspects showed high birefringence without apparent anterior surface morphological changes.
- Phase retardation values were significantly different across normal, suspect, and keratoconus groups, particularly in larger corneal diameters.
Conclusions:
- Increased en face phase retardation of the posterior cornea in keratoconus is attributed to altered collagen fiber lamellar structure.
- Phase retardation analysis using PS-OCT is sensitive for discriminating keratoconus suspects.
- PS-OCT holds potential for detecting very early or subclinical keratoconus.
