Comparison of anterior chamber depth measurements by 3-dimensional optical coherence tomography, partial coherence interferometry biometry, Scheimpflug rotating camera imaging, and ultrasound biomicroscopy

PURPOSE: To evaluate the congruity of anterior chamber depth (ACD) measurements using 4 devices. SETTING: Saneikai Tsukazaki Hospital, Himeji City, Japan. DESIGN: Comparative case series. METHODS: In 1 eye of 42 healthy participants, the ACD was measured by 3-dimensional corneal and anterior segment optical coherence tomography (CAS-OCT), partial coherence interferometry (PCI), Scheimpflug imaging, and ultrasound biomicroscopy (UBM). The differences between the measurements were evaluated by 2-way analysis of variance and post hoc analysis. Agreement between the measurements was evaluated using Bland-Altman analysis. To evaluate the true ACD using PCI, the automatically calculated ACD minus the central corneal thickness measured by CAS-OCT was defined as PCI true. Two ACD measurements were also taken with CAS-OCT. RESULTS: The mean ACD was 3.72 mm G 0.23 (SD) (PCI), 3.18 G 0.23 mm (PCI true), 3.24 G 0.25 mm (Scheimpflug), 3.03G 0.25 mm (UBM), 3.14 G 0.24 mm (CAS-OCT auto), and 3.12 G 0.24 mm (CAS-OCT manual). A significant difference was observed between PCI biometry, Scheimpflug imaging, and UBM measurements and the other methods. Post hoc analysis showed no significant differences between PCI true and CAS-OCT auto or between the CAS-OCT auto and CAS-OCT manual. Strong correlations were observed between all measurements; however, Bland-Altman analysis showed good agreement only between PCI true and Scheimpflug imaging and between CAS-OCT auto and CAS OCT manual. CONCLUSION: The ACD measurements obtained from PCI biometry, Scheimpflug imaging, CAS-OCT, and UBM were significantly different and not interchangeable except for PCI true and CAS-OCT auto and CAS-OCT auto and CAS-OCT manual. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned

Cross-sectional study of the association between a deepening of the upper eyelid sulcus-like appearance and wide-open eyes.

BACKGROUND: Deepening of the upper eyelid sulcus (DUES) is a common complication of prostaglandin F2α analog treatment, which causes cosmetic problems. However, identifying this condition using photographs is difficult due to such problems as the camera flash effects, blepharoptosis or wide-open eyes. PURPOSE: We investigated the association between a DUES-like appearance and wide-open eyes regarding the presence of wide-open eyes as a cause for overestimating the incidence of DUES. SUBJECTS AND METHODS: One eye and the forehead in 100 subjects (31 younger subjects, 30 older subjects and 39 patients with blepharoptosis) were evaluated in the present study. Digital photographs of the subjects with natural open and wide-open eyes were taken with a flash. Five signs (a puffy eyelid, the presence/absence of the upper eyelid sulcus (UES), wrinkles on the forehead with natural open eyes and an increase in the number of wrinkles on the forehead and a DUES-like appearance with wide-open eyes) were judged to be negative or positive by three independent observers. Univariate and multivariate logistic regression analyses were performed to determine the independent predictor(s) of a DUES-like appearance with wide-open eyes. RESULTS: Fourteen subjects (four young, three old and seven subjects with blepharoptosis) were judged to have a DUES-like appearance with wide-open eyes (14%). The only predictive factor was the presence of UES in the patients with natural open eyes (odds ratio = 17.244, 95% confidence interval: 3.447-86.270, P<0.001). Among the 12 UES-positive subjects, six (50%) exhibited a DUES-like appearance with wide-open eyes. CONCLUSIONS: The presence of wide-open eyes can thus cause a DUES-like appearance. Blepharoptosis itself is not a predictive factor; however, care should be taken not to overestimate the incidence of DUES, especially in patients with UES with natural open eyes, as a DUES-like appearance can be caused by wide-open eyes, even in treatment-naïve patients. TRIAL REGISTRATION: UMIN000010500

Prevalence of the five signs among the three groups.

<p>All p values were obtained using the chi-square test.</p><p>* = statistically significant difference observed compared to the other two groups using Fisher's exact probability test and the Bonferroni correction.</p

Patient demographics and measured MRD.

<p>MRD1  =  upper eyelid margin-to-corneal light reflex distance.</p><p>MRD difference  =  difference between the MRD1 with natural open and wide-open eyes.</p><p>*ANOVA, ^†chi-square test, ^‡Kruskal-Wallis test.</p>§<p> = statistically significant difference observed compared to the other two groups using Student's <i>t</i>-test or the Mann-Whitney U test following the Bonferroni correction.</p

Results of the univariate and multivariate logistic regression analyses of the independent predictors of a DUES-like appearance.

<p>OR = odds ratio, CI = confidence interval.</p

An older subject judged to have a DUES-like appearance.

<p>A healthy 72-year-old female with a DUES-like appearance of the left eye. An UES was judged to be present when she had natural open eyes, while other signs were judged to be negative.</p

Incidence of a DUES like-appearance according to predictive factors.

<p>Incidence of a DUES like-appearance according to predictive factors.</p

Interobserver agreement regarding the five signs.

<p>Interobserver agreement regarding the five signs.</p

A younger subject judged to have a DUES-like appearance.

<p>A healthy 28-year-old male with a DUES-like appearance of the left eye. An UES was judged to be present when he had natural open eyes. All other signs were judged to be negative.</p