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Glaucoma: Overview01:25

Glaucoma: Overview

Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
Open Angle Glaucoma: Treatment01:27

Open Angle Glaucoma: Treatment

In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

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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Corneal tomography detection of elevated ectasia risk in atopic dermatitis patients with no prior ophthalmologic diagnosis.

Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia·2026
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Corneal sub-basal nerve fiber plexus tortuosity in eyes with ectasia susceptibility and keratoconus: A cross-sectional in vivo confocal microscopy study.

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Influence of Topical Medication on Corneal Biomechanics in Primary Open-Angle Glaucoma.

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Comparison of conventional corneal crosslinking with the accelerated procedure in progressive keratoconus.

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A Novel Optical Coherence Tomography-based Keratoconus Diagnostic Index Incorporating Stromal and Epithelial Features.

Journal of refractive surgery (Thorofare, N.J. : 1995)·2025
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Related Experiment Video

Updated: May 12, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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New keratoconus grading system based on OCT: threshold adjustment for SS-OCT.

Nan-Ji Lu1, Frederik Raiskup, Lutz E Pillunat

  • 1From the Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China (Lu); Department of Ophthalmology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany (Raiskup, Pillunat, Herber); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Wang, Cui); State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Wang, Cui).

Journal of Cataract and Refractive Surgery
|February 26, 2025
PubMed
Summary

The STEP keratoconus grading system shows good performance with swept-source OCT (SS-OCT) for epithelium thickness but requires adjusted thresholds for stroma thickness. Discrepancies between SS-OCT and SD-OCT highlight considerations for clinical practice.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Keratoconus (KC) is a progressive corneal disease affecting vision.
  • Accurate thickness measurements are crucial for KC diagnosis and management.
  • Optical coherence tomography (OCT) technologies, including swept-source OCT (SS-OCT) and spectral-domain OCT (SD-OCT), offer advanced imaging capabilities.

Purpose of the Study:

  • To evaluate the performance of the STEP keratoconus grading system utilizing SS-OCT.
  • To compare the accuracy of thickness measurements between SS-OCT and SD-OCT devices.
  • To assess the agreement of SS-OCT derived STEP parameters with established keratoconus grading systems.

Main Methods:

  • A retrospective case-control study involving university hospitals in Germany and China.
  • Analysis of data from 152 normal and 314 KC eyes using Rotating Scheimpflug tomography (RSC, Pentacam) and SS-OCT (ANTERION).
  • Comparison of STEP system parameters (stroma thinnest thickness [ST] and epithelium SD [EP]) derived from SS-OCT with RSC ABC system and assessment of interdevice agreement with SD-OCT (RTVue-XR) using Bland-Altman plots and linear regression.

Main Results:

  • The STEP epithelium (EP) parameter demonstrated good agreement with the RSC ABC system in normal and KC eyes.
  • The STEP stroma thinnest thickness (ST) parameter showed lower agreement with the RSC 'C' metric in KC eyes, necessitating threshold adjustments.
  • SS-OCT estimated stroma thickness values were higher than those from SD-OCT, with mean differences of 23.18 μm (normal) and 20.91 μm (KC eyes).

Conclusions:

  • SS-OCT's STEP EP parameter aligns well with the RSC ABC system for keratoconus assessment.
  • Adjusted thresholds for SS-OCT's STEP ST are required for accurate clinical application.
  • Observed thickness measurement discrepancies between SS-OCT and SD-OCT warrant careful consideration for future clinical practice and research in keratoconus management.