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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Measuring corneal astigmatism using OCT in keratoconus.

Clara Llorens-Quintana1, Daniel J Lee, Elias Pavlatos

  • 1From the Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.

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|May 26, 2022
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Summary

Optical coherence tomography (OCT) offers superior accuracy and precision for measuring net corneal astigmatism in keratoconus patients compared to Scheimpflug imaging (Pentacam HR). Pupil centration with a smaller zone enhances accuracy in these individuals.

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Area of Science:

  • Ophthalmology
  • Corneal Imaging
  • Refractive Surgery

Background:

  • Accurate measurement of net corneal astigmatism is crucial for diagnosing and managing keratoconus.
  • Existing imaging techniques have limitations in precision and repeatability for this condition.

Purpose of the Study:

  • To compare the accuracy and repeatability of net corneal astigmatism measurements between optical coherence tomography (OCT) and Scheimpflug imaging in keratoconus patients.
  • To evaluate different measurement settings for OCT and Scheimpflug imaging.

Main Methods:

  • Prospective cross-sectional observational study involving 46 keratoconic eyes and 52 control eyes.
  • Net corneal astigmatism was calculated using OCT (Avanti) and Scheimpflug imaging (Pentacam HR) with varying centration and analytical zone settings.
  • Zernike polynomial fitting of corneal elevation maps (OCT) and comparison with manifest refraction astigmatism were used to assess accuracy. Repeatability was determined by the coefficient of repeatability.

Main Results:

  • OCT demonstrated significantly better agreement with manifest refraction astigmatism compared to Pentacam HR in keratoconic eyes.
  • For OCT measurements in keratoconus, pupil centration with a 3 mm zone yielded better accuracy, while vertex centration with a 4 mm zone provided better repeatability (coefficient of repeatability = 0.53 D).
  • No significant differences were observed between instruments or settings in normal control eyes.

Conclusions:

  • Optical coherence tomography (OCT) provides more accurate and precise measurements of net corneal astigmatism in keratoconic eyes than Scheimpflug imaging (Pentacam HR).
  • Pupil centration and a smaller analytical zone (3 mm) may optimize accuracy for OCT measurements in keratoconus.
  • OCT shows promise as a valuable tool for assessing corneal astigmatism in keratoconus management.