Abstract
Precis:Three-dimensional (3D) spectral domain optical coherence tomography (OCT) volume scans of the optic nerve head (ONH) and the peripapillary area are useful in the management of glaucoma in patients with a type I or II Boston Keratoprosthesis (KPro).Purpose:The purpose of this study was to report the use of spectral domain OCT in the management of glaucoma in patients with a type I or II Boston KPro.Materials and Methods:This study is an observational case series. Four consecutive patients with KPro implants were referred for glaucoma evaluation. A comprehensive eye examination was performed which included disc photography, visual field testing, and high-density spectral domain OCT volume scans of the ONH and the peripapillary area. 2D and 3D parameters were calculated using custom-designed segmentation algorithms developed for glaucoma management.Results:Spectral domain OCT parameters provided useful information in the diagnosis and management of 4 KPro patients. OCT parameters which can be used in KPro patients included 2D retinal nerve fiber layer (RNFL) thickness, 3D peripapillary RNFL volume, 3D peripapillary retinal thickness and volume, 3D cup volume, and 3D neuroretinal rim thickness and volume. In 3 of 4 cases where the traditional 2D RNFL thickness scan was limited by artifacts, 3D spectral domain OCT volume scans provided useful quantitative objective measurements of the ONH and peripapillary region. Therefore, 3D parameters derived from high-density volume scans as well as radial scans of the ONH can be used to overcome the limitations and artifacts associated with 2D RNFL thickness scans.Conclusions:Spectral domain OCT volume scans offer the possibility to enhance the evaluation of KPro patients with glaucoma by using both 2D and 3D diagnostic parameters that are easily obtained in a clinic setting.
| Original language | English |
|---|---|
| Pages (from-to) | 718-726 |
| Number of pages | 9 |
| Journal | Journal of Glaucoma |
| Volume | 28 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 2019 |
Funding
T.C.C. has received funding from Fidelity Charitable Fund (Harvard University), the American Glaucoma Society Mid-Career Award, the Massachusetts Lions Research Eye Fund, the Harvard Catalyst National Institutes of Health UL 1 RR025758, and the Department of Defense Small Business Innovation Research DHP15-016. B.B., B.J. V., and B.E.B. received funding from the Center for Biomedical OCT Research and Translation through Grant Number P41EB015903, awarded by the National Institute of Biomedical Imaging and Bio-engineering of the National Institutes of Health. Disclosure: J.C., C.H.D., and T.C.C. work at the Massachusetts Eye and Ear, a nonprofit hospital and distributor of the Boston Keratopros-thesis. J.F.d.B. has the following financial disclosures: Center for Biomedical Optical Coherence Tomography Research and Trans-lation Scientific Advisory Board Chair (Harvard Medical School), licenses to NIDEK Inc, Terumo Corporation, Ninepoint Medical, and Heidelberg Engineering. B.J.V. licenses to Terumo Corporation (Tokyo, Japan) and Ninepoint Medical (Bedford, Massachusetts). B.E.B. licenses to NIDEK Inc. (Fremont, CA), Terumo Corporation, Ninepoint Medical, Heidelberg Engineering. The remaining authors declare no conflict of interest.
| Funders | Funder number |
|---|---|
| Fidelity Charitable Fund | |
| Harvard Catalyst National Institutes of Health | UL 1 RR025758 |
| National Institutes of Health | |
| National Institute of Biomedical Imaging and Bioengineering | |
| Small Business Innovation Research | DHP15-016, P41EB015903 |
| Massachusetts Lions Eye Research Fund | |
| American Glaucoma Society |
Keywords
- diagnosis
- glaucoma
- keratoprosthesis
- retinal nerve fiber layer
- spectral domain optical coherence tomography