Cornea - ARVO

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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaCommercial Relationships: Eric H. Chan, None; Martin N.Nakatsu, None; Sophie X. Deng, NoneProgram Number: 2602 Poster Board Number: D0402Presentation Time: 2:45 PM - 4:30 PMIncidence and type of higher order corneal aberrations in thecataract populationNeil M. Vyas 1 , Bonnie A. Henderson 2 . 1 Ophthalmology, BostonUniversity, Boston, MA; 2 Ophthalmic Consultants of Boston, Boston,MA.Purpose: Corneal higher order aberrations (HOA) are commonculprits in symptoms such as glare, halos, night vision disturbances,and decreased contrast sensitivity. These can become even moreapparent after cataract surgery with presbyopia correcting multifocalintraocular lenses. Evaluation of HOAs has been proposed asscreening tool to predict which patients may be dissatisfied afterimplantation of these lenses. This project compares the incidence andtypes of higher order aberrations in patients presenting for cataractextraction.Methods: Retrospective case series of consecutive patients whopresented for cataract extraction. Patients underwent topographicaland higher order corneal wavefront mapping with the Nidek OPD 2.Age, gender, amounts and types of corneal higher order aberrationswere recorded in both eyes.Results: 200 eyes (100 patients) were evaluated. Trefoil was noted tohave the highest incidence and highest Z-coefficient values across allage groups. It accounted for more of the total higher order aberrationsthan coma or quatrefoil. This was also noted to be consistent betweeneyes. A correlation between increasing age and increasing totalamounts of quatrefoil was also observed. The average values forcoma were similar between eyes across all age groups.Conclusions: The total amount of corneal HOA, especiallyquatrefoil, increased with age. The most common HOA and highestZernike coefficient in patients undergoing cataract surgery wastrefoil. Knowing the average amount of different HOAs may beuseful when evaluating the HOA maps of preoperative patients whoare choosing multifocal intraocular lenses in order to better predictpost operative satisfaction. Given the large variation of errorsbetween eyes, each eye should be evaluated separately and successfuloutcome in one eye does not necessarily mean similar success can beanticipated in the fellow eye.Commercial Relationships: Neil M. Vyas, None; Bonnie A.Henderson, Alcon (C), Bausch and Lomb (C)Program Number: 2603 Poster Board Number: D0403Presentation Time: 2:45 PM - 4:30 PMComparison of Dual Scheimpflug imaging parameters in eyeswith forme fruste keratoconus, keratoconus and low and highametropiaMaria A. Henriquez, Luis Izquierdo, Harumi M. Moreyra.Ophthalmology, Oftalmo-Salud, Lima, Peru.Purpose: To evaluate the efficacy of several parameters obtainedfrom Dual Scheimpflug Analyzer to discriminate between formefruste keratoconus, keratoconus and low and high ametropia.Methods: This prospective study included 382 eyes (100 eyes withlow ametropia, 50 with high cylinder, 29 with high myopia, 41 formefruste keratoconus and 162 keratoconus). Scheimpflug imaging usingthe Galilei Dual Scheimpflug Analyzer (Ziemer) was performed and30 parameters derived from pachymetry, curvature, anterior andposterior elevation maps, corneal wavefront high order aberrations,asphericity and others was recorded. Receiver operating characteristiccurves (ROC) was used and logistic regression analysis was used toevaluate the sensitivity and specificity of the parameters in aconstructed model.Results: There were statistically significant difference between lowametropic eyes and high cylinder group in the anterior and posteriorelevation at the thinnest point of the cornea (p < 0.001 both). Therewere not statistically significant differences between the lowametropic eye and high myopic group in pachymetric and elevationvariables (p > .05). Logistic regression analysis showed that acombination of corneal power, thickness, elevation, and cornealaberrations had a 100% sensitivity and specificity discriminatingbetween low ametropic eyes and keratoconus.Conclusions: Combined analysis of anterior and posterior cornealpower, thickness, elevation and corneal aberrations effectivelydiscriminated between ectatic corneas and normal corneas. Highastigmatism group showed greater posterior elevation values thanhigh myopic group and eyes with low refraction.Commercial Relationships: Maria A. Henriquez, None; LuisIzquierdo, None; Harumi M. Moreyra, NoneSupport: None in the Support field belowProgram Number: 2604 Poster Board Number: D0404Presentation Time: 2:45 PM - 4:30 PMStructural changes in the retina and cornea during diabeticneuropathyMaxwell Stem 1 , Munira Hussain 1 , Melody Chan 2 , Stephanie J. Chiu 2 ,Pratul Srinivasan 2 , Jeffrey M. Sundstrom 1 , Thomas W. Gardner 1 ,Sina Farsiu 2 , Rodica Pop-Busui 1 , Roni M. Shtein 1 . 1 Ophthalmologyand Visual Sciences, University of Michigan, Ann Arbor, MI;2 Biomedical Engineering, Duke University, Durham, NC.Purpose: To examine the relationship between neuroretinal thicknessand corneal nerve fiber length (CNFL) relative to diabetic neuropathy(DN) status in patients with diabetes mellitus (DM)Methods: In this cross-sectional study, we examined 25 diabeticpatients without DN, 10 patients with mild DN, 8 patients with severeDN, and 9 controls without diabetes. DN status was assigned basedon a combination of clinical symptoms, signs, and neurophysiologictesting. Patients underwent optical coherence tomography (OCT)imaging of the retina, in vivo confocal microscopy (IVCM) of thecorneal sub-basal nerve plexus, and nerve conduction velocity (NCV)testing. DOCTRAP software was used to segment inner retinal layerboundaries. Post-hoc analysis of the OCT and IVCM images wasperformed to quantify the average thickness of each retinal layer andthe average CNFL. ANOVA was used to assess for differences inretinal thickness, CNFL, and NCV among the subjects. Pearsoncorrelations were used to evaluate the relationship between NCV andthe retinal and corneal parameters.Results: All 25 diabetic patients without DN had type 1 DM, and theremaining patients with DN had type 2 DM. There were nosignificant differences in average retinal nerve fiber layer, ganglioncell/inner plexiform layer, inner nuclear layer, outer plexiform layer,outer nuclear layer/inner segment, outer segment, retinal pigmentepithelial, or total retinal thicknesses among the 4 groups. Patientswith type 2 DM and severe DN had reduced corneal nerves (CNFL ±SD = 12.5 ± 6.1 mm/mm 2 ) compared to controls (20.7 ± 2.2mm/mm 2 ) (p=0.009). Persons with type 1 DM without DN also hadreduced CNFL (15.1 ± 4.7 mm/mm 2 ) relative to controls (p=0.033).Peroneal NCV was reduced only in severe DN (mean velocity ± SD =32.4 ± 4.1 m/s) relative to controls (45.8 ± 6.9 m/s) (p
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneacontrols. This suggests that IVCM of the corneal sub-basal nerveplexus may be a more sensitive indicator of peripheral nervedegeneration in type 1 vs. type 2 DM.Commercial Relationships: Maxwell Stem, None; MuniraHussain, None; Melody Chan, None; Stephanie J. Chiu, DukeUniversity (P); Pratul Srinivasan, None; Jeffrey M. Sundstrom,None; Thomas W. Gardner, Kalvista (C), Aerpio (C), Akebia (C),Penn State University (P); Sina Farsiu, Duke University (P); RodicaPop-Busui, None; Roni M. Shtein, NoneSupport: This research was supported by the Michigan DiabetesResearch & Training Center funded by NIH P60DK020572 from theNational Institute of Diabetes and Digestive and Kidney Diseases(RMS); American Diabetes Association-Merck (MS); JuvenileDiabetes Research Foundation (TWG); Taubman Institute (TWG);Research to Prevent Blindness (TWG); NIH Grant 1R01EY022691-01 (SF); NIH Grant R01 HL102334 (RP)Program Number: 2605 Poster Board Number: D0405Presentation Time: 2:45 PM - 4:30 PMRepeatability of peripheral (near-limbal) corneal thicknessmeasurements of Pentacam Scheimpflug corneal topographyRaul Martin 1 , Sven Jonuscheit 2, 3 , Michael J. Doughty 2 , Ana del RioSan Cristóbal 1 , Lisa J. Mackintosh 2 , David MacTaggart 2 , MichaelHiscock 2 . 1 Optometry Research Group, IOBA Eye Institute,Valladolid, Spain; 2 Vision Sciences, Department of Life Sciences,Glasgow Caledonian University, Glasgow, United Kingdom;3 Diabetes Research Group, Institute for Applied Health Research,Glasgow Caledonian University, Glasgow, United Kingdom.Purpose: To assess the repeatability of peripheral corneal thickness(CT) measurements along the horizontal meridian as close to thelimbus as possible in healthy eyes with Scheimpflug topographyPentacam.Methods: CT was measured in 63 corneas of 63 healthy subjects ateleven corneal locations nominally 1 mm apart along the horizontalmeridian with Scheimpflug topography Pentacam. Two consecutiveScheimpflug scans were performed in quick succession to determinethe repeatability of the pachymetry values measured in each corneallocation up to 5 mm away from the corneal apex. Ocular assessmentsalso included habitual visual acuity, slit-lamp biomicroscopy, andoptical coherence tomography. To rule out corneal endotheliopathynon-contact specular microscopy was performed. Descriptivestatistics were generated. The repeatability was determined byassessing absolute differences between measurement 1 and 2. Therelative difference was then calculated and expressed as the ratio ofthe absolute difference to the central CT. A variant of Bland-Altmananalysis was carried out to determine the effect of the overallmagnitude of CT on the differences between pachymetrymeasurements.Results: The mean [SD] age was 27 [7] years. CT increasedprogressively and asymmetrically from the corneal center to theperiphery. Mean CT (µm) at the temporal 5 mm location was 771[49] and 823 [53] at the corresponding nasal location; central CT was558 [33]. Peripheral CT repeatability, based on absolute differences(microns) between 2 measurements was 2.41 [13.41] temporally and-1.03 [15.39] nasally, both at 5 mm away from the corneal apex.These values decreased to just 0.27 [5.33] for central CT. Thisdifference in repeatability between peripheral and central locationswas not statistically significant (p=0.918 Kruskal-Wallis ANOVA,nasal and temporal). Regression analyses indicate that differencesbetween measurements (repeatability) were not dependent on theabsolute thickness values (p=0.978; r= 0.10).Conclusions: Pentacam shows excellent repeatability not only forcentral pachymetry measurements near the corneal apex, but also forperipheral measurements close to the corneal limbus 5 mm awayfrom the corneal centre in normal eyes. The results provide evidenceof the utility of Pentacam assessment of the peripheral cornea inextended contact lens wear and surgical procedures.Commercial Relationships: Raul Martin, None; Sven Jonuscheit,Santander UK plc (F); Michael J. Doughty, None; Ana del Rio SanCristóbal, None; Lisa J. Mackintosh, Santander UK plc (F); DavidMacTaggart, Santander UK PLC (F); Michael Hiscock, NoneSupport: Jose Castillejo Program, Spanish Ministry of EducationProgram Number: 2606 Poster Board Number: D0406Presentation Time: 2:45 PM - 4:30 PMComparison of corneal shape and ocular aberrations in eyes withforme fruste keratoconus to that of normal corneaRyotaro Ueki 1, 2 , Naoyuki Maeda 1 , Mutsumi Fuchihata 1 , ShizukaKoh 1 , Takashi Kitaoka 2 , Kohji Nishida 1 . 1 Ophthalmology, OsakaUniv School of Medicine, Osaka-Shi, Japan; 2 Ophthalmology,Nagasaki Univ School of Medicine, Nagasaki-Shi, Japan.Purpose: Forme fruste keratoconus (FFK) is defined as a corneawhich has no abnormal findings by slit-lamp examinations andPlacido-based corneal topography, and is the fellow eye of a patientwith clinical keratoconus. FFK has recently gained a lot of attentionbecause it is the borderline condition between keratoconus suspectand normal cornea. The purpose of this study was to compare thecorneal shape and ocular aberrations of eyes with FFK to that ofnormal corneas.Methods: We studied 38 eyes with FFK and 50 eyes with normalcorneas. The corneal thickness and location of thinnest point, Belin-Ambrósio enhanced ectasia Display (BAD) parameters, Df, Db, Dp,Dt, Da, and D, and corneal coma aberrations (anterior, posterior andtotal cornea) for a 4 mm diameter were obtained with a rotatingScheimpflug camera (Pentacam HR, OCULUS Optikgeräte GmbH,Germany). The ocular spherical aberration (C4,0) and comaaberration (C3,1 and C3,-1) for a 4 mm diameter were obtained by anaberrometer (KR-1W, Topcon Corp., Japan). Multiple logisticregression analyses and the receiver operating characteristic (ROC)analyses were performed on these data to determine whether the twogroups can be differentiated.Results: Multiple logistic regression analyses showed the BADparameter D, the anterior corneal coma, and the total corneal comawere significant variables for differentiating FFK group from thenormal group (P
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