Advances and Clinical Applications of Anterior Segment Imaging Techniques

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biosignal Processing".

Deadline for manuscript submissions: 15 June 2024 | Viewed by 5566

Special Issue Editor


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Guest Editor
Department of Ophthalmology, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon 24289, Republic of Korea
Interests: cornea; cataract; dry eye disease
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Special Issue Information

Dear Colleagues,

The development of imaging technology continues to ensure the precise and accurate assessment of even the most subtle changes in anterior segment structures, such as the eyelid conjunctiva, sclera, cornea, anterior chamber, iris, and lens. In recent years, the clinical application of devices employing these cutting-edge technologies has become critical for the enhanced diagnostic accuracy of anterior segment disorders. The utilization of these imaging devices can also lead to improvements in the visual and anatomical outcomes of the cornea, cataracts and refractive surgery. Hence, the introduction of these novel technology and devices can provide not only improved diagnostic accuracy but also enhanced treatment outcomes in anterior segment diseases. The further development of imaging technology, e.g., the application of artificial intelligence, for anterior segment disorders is expected to allow a more accurate diagnosis and precise assessment of changes in anterior segment structures in response to the specific treatment.

In this Special Issue, research or review papers on the advances and clinical applications of anterior segment Imaging techniques are welcome, as well as any papers on new devices or methods for the diagnosis or treatment of anterior segment disorders.

Prof. Dr. Sang Beom Han
Guest Editor

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Keywords

  • Keywords: anterior segment
  • cornea
  • cataract
  • conjunctiva
  • anterior segment imaging
  • refractive surgery

Published Papers (5 papers)

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Research

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11 pages, 2955 KiB  
Article
Limitations of and Solutions to Using 6 mm Corneal Spherical Aberration and Q Value after Laser Refractive Surgery
by Sung Ho Choi, Yeo Kyoung Won, Sung Jin Na, DeokJo Nam and Dong Hui Lim
Bioengineering 2024, 11(2), 190; https://doi.org/10.3390/bioengineering11020190 - 16 Feb 2024
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Abstract
This study aimed to evaluate the spherical aberration (SA) in different corneal areas before and after femtosecond laser-assisted in situ keratomileusis (fLASIK) and transepithelial photorefractive keratectomy (tPRK), with the goal of identifying the limitations of and potential improvements in using SA within a [...] Read more.
This study aimed to evaluate the spherical aberration (SA) in different corneal areas before and after femtosecond laser-assisted in situ keratomileusis (fLASIK) and transepithelial photorefractive keratectomy (tPRK), with the goal of identifying the limitations of and potential improvements in using SA within a 6 mm area. The study included 62 patients who underwent fLASIK and tPRK. Complete eye examinations including keratometry, corneal epithelial thickness, central corneal thickness, and topography were performed preoperatively and postoperatively. Anterior, posterior, and total corneal aberrations were measured preoperatively and three months postoperatively, with pupil diameters ranging from 2 to 8 mm. In the fLASIK group, compared to the preoperative SA, the anterior and total SA increased postoperatively in the 6 and 7 mm areas. In the tPRK group, meanwhile, the anterior and total SA of the 5 mm or larger areas increased postoperatively. An area of 6 mm or larger showed an increase in correlation with the changes in Q value and refractive correction. As the corneal SA and asphericity in the 6 mm zone cannot specifically demonstrate the status of areas smaller than 6 mm or changes in the optical zone after laser refractive surgery, comparison with normal values in various areas of the cornea is necessary. Full article
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10 pages, 1674 KiB  
Article
Artificial Tear Instillation-Induced Changes in Corneal Topography
by Yunjin Lee, Tae Hun Kim, Hae Jung Paik and Dong Hyun Kim
Bioengineering 2024, 11(2), 121; https://doi.org/10.3390/bioengineering11020121 - 26 Jan 2024
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Abstract
This study aims to compare changes of corneal topography (Galilei G4) before and after the instillation of artificial tears in patients with dry eye disease (DED). Corneal topography was performed in patients 1 min before and after artificial tear instillation. Two types of [...] Read more.
This study aims to compare changes of corneal topography (Galilei G4) before and after the instillation of artificial tears in patients with dry eye disease (DED). Corneal topography was performed in patients 1 min before and after artificial tear instillation. Two types of artificial tears were used: 1% polysorbate 80 (PSB) and 0.5% carboxymethylcellulose (CMC). Of 135 patients, PSB and CMC were instilled in 101 and 34 eyes, respectively. The average value of Sim K increased significantly after instillation (44.07 ± 2.26 diopter (D)) compared to before (43.90 ± 2.02 D, p = 0.006) the instillation of artificial tears. Mean Sim K astigmatism was statistically increased after PSB instillation (1.48 ± 2.17 D) compared to before instillation (1.31 ± 2.10 D, p = 0.049). An axis change of astigmatism 10° or more after artificial tear instillation was found in 51.9% of patients, and 30° or more in 20.0% of patients. Increased Sim K value and significant changes in the astigmatic axis in the corneal topography were observed after instillation of artificial tears in DED patients. PSB instillation had a greater effect on corneal keratometry values than CMC instillation. Full article
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11 pages, 761 KiB  
Article
Diagnostic Validation of the Screening Corneal Objective Risk of Ectasia Analyzer Evaluated by Swept Source Optical Coherence Tomography for Keratoconus in an Asian Population
by Kookyoung Kim, Kyungmin Koh, Seongjun Lee and Yongwoo Lee
Bioengineering 2023, 10(11), 1335; https://doi.org/10.3390/bioengineering10111335 - 20 Nov 2023
Viewed by 1063
Abstract
We aimed to investigate the diagnostic accuracy of Screening Corneal Objective Risk of Ectasia (SCORE) Analyzer software using ANTERION, a swept-source optical coherence tomography device, for keratoconus diagnosis in an Asian population. A total of 151 eyes of 151 patients were included in [...] Read more.
We aimed to investigate the diagnostic accuracy of Screening Corneal Objective Risk of Ectasia (SCORE) Analyzer software using ANTERION, a swept-source optical coherence tomography device, for keratoconus diagnosis in an Asian population. A total of 151 eyes of 151 patients were included in this retrospective study as follows: 60, 45, and 46 keratoconus, keratoconus suspects, and normal control eyes, respectively. Parameters in the SCORE calculation, including six indices, were compared for the three groups. The receiver operating characteristic curve analysis and cut-off value were estimated to assess the diagnostic ability to differentiate keratoconus and keratoconus suspect eyes from the normal group. The SCORE value and six indices were significantly correlated—“AntK max” (R = 0.864), “AntK oppoK” (R = 0.866), “Ant inf supK” (R = 0.943), “Ant irre 3mm” (R = 0.741), “post elevation at the thinnest point” (R = 0.943), and “minimum corneal thickness” (R = −0.750). The SCORE value showed high explanatory power (98.1%), sensitivity of 81.9%, and specificity of 78.3% (cut-off value: 0.25) in diagnosing normal eyes from the keratoconus suspect and keratoconus eyes. The SCORE Analyzer was found to be valid and consistent, showing good sensitivity and specificity for keratoconus detection in an Asian population. Full article
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6 pages, 383 KiB  
Communication
Long-Term Efficacy of Inferior Oblique Myectomy Accompanied with Tenon’s Capsule Closure: Objective Analysis Using Nine-Gaze Photographs
by Chang Ki Yoon, Hee Kyung Yang, Sang Beom Han and Jeong-Min Hwang
Bioengineering 2023, 10(3), 352; https://doi.org/10.3390/bioengineering10030352 - 12 Mar 2023
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Abstract
Background: The aim is to evaluate the long-term efficacy of inferior oblique (IO) myectomy combined with Tenon’s capsule closure to prevent muscle reattachment to the sclera. Methods: We retrospectively reviewed the medical records of 18 patients with primary and secondary IO overaction who [...] Read more.
Background: The aim is to evaluate the long-term efficacy of inferior oblique (IO) myectomy combined with Tenon’s capsule closure to prevent muscle reattachment to the sclera. Methods: We retrospectively reviewed the medical records of 18 patients with primary and secondary IO overaction who underwent IO myectomy accompanied by Tenon’s capsule closure. Patients were followed up for at least 1 year after the surgery. The main outcome measures included oblique muscle dysfunction, which was objectively graded through computerized analysis of nine-gaze photographs, and the amount of vertical deviation in the primary position using alternate prism cover testing. Results: After a mean follow up of 2.5 years, the grade of IO overaction decreased from +2.2 ± 1.0 to −0.8 ± 1.0 (p < 0.001). In patients with secondary IO overaction with superior oblique (SO) palsy, SO underaction improved from −2.2 ± 1.5 to −0.2 ± 1.8 (p = 0.006). Successful vertical deviation in the primary position of seven prism diopters or less was achieved in 83.3% of the patients. Underaction of the IO was observed in 11.1% of patients, whereas none of the patients showed antielevation syndrome. Conclusion: IO myectomy combined with Tenon’s capsule closure might be safe and effective for the treatment of primary and secondary IO overaction in the long term. Full article
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Review

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16 pages, 6185 KiB  
Review
Applications of Imaging Technologies in Fuchs Endothelial Corneal Dystrophy: A Narrative Literature Review
by Sang Beom Han, Yu-Chi Liu, Chang Liu and Jodhbir S. Mehta
Bioengineering 2024, 11(3), 271; https://doi.org/10.3390/bioengineering11030271 - 11 Mar 2024
Viewed by 869
Abstract
Fuchs endothelial corneal dystrophy (FECD) is a complex genetic disorder characterized by the slow and progressive degeneration of corneal endothelial cells. Thus, it may result in corneal endothelial decompensation and irreversible corneal edema. Moreover, FECD is associated with alterations in all corneal layers, [...] Read more.
Fuchs endothelial corneal dystrophy (FECD) is a complex genetic disorder characterized by the slow and progressive degeneration of corneal endothelial cells. Thus, it may result in corneal endothelial decompensation and irreversible corneal edema. Moreover, FECD is associated with alterations in all corneal layers, such as thickening of the Descemet membrane, stromal scarring, subepithelial fibrosis, and the formation of epithelial bullae. Hence, anterior segment imaging devices that enable precise measurement of functional and anatomical changes in the cornea are essential for the management of FECD. In this review, the authors will introduce studies on the application of various imaging modalities, such as anterior segment optical coherence tomography, Scheimpflug corneal tomography, specular microscopy, in vitro confocal microscopy, and retroillumination photography, in the diagnosis and monitoring of FECD and discuss the results of these studies. The application of novel technologies, including image processing technology and artificial intelligence, that are expected to further enhance the accuracy, precision, and speed of the imaging technologies will also be discussed. Full article
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