Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark

A John Kanellopoulos1,2 George Asimellis11Laservision.gr Institute, Athens, Greece; 2New York University Medical School, New York, NY, USAPurpose: To introduce a novel, noninvasive technique to determine the depth and extent of anterior corneal stroma changes induced by collagen cross-linking (CXL)...

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Autores principales:	Kanellopoulos AJ, Asimellis G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/d6cc4279fdef4226823b0d01a8099669
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spelling	oai:doaj.org-article:d6cc4279fdef4226823b0d01a80996692021-12-02T01:27:29ZIntroduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark1177-54671177-5483https://doaj.org/article/d6cc4279fdef4226823b0d01a80996692013-02-01T00:00:00Zhttp://www.dovepress.com/introduction-of-quantitative-and-qualitative-cornea-optical-coherence--a12212https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483A John Kanellopoulos1,2 George Asimellis11Laservision.gr Institute, Athens, Greece; 2New York University Medical School, New York, NY, USAPurpose: To introduce a novel, noninvasive technique to determine the depth and extent of anterior corneal stroma changes induced by collagen cross-linking (CXL) using quantitative analysis of high-resolution anterior-segment optical coherence tomography (OCT) post-operative images.Setting: Private clinical ophthalmology practice.Patients and methods: Two groups of corneal cross-sectional images obtained with the OptoVue RTVue anterior-segment OCT system were studied: group A (control) consisted of unoperated, healthy corneas, with the exception of possible refractive errors. The second group consisted of keratoconic corneas with CXL that were previously operated on. The two groups were investigated for possible quantitative evidence of changes induced by the CXL, and specifically, the depth, horizontal extent, as well as the cross-sectional area of intrastromal hyper-reflective areas (defined in our study as the area consisting of pixels with luminosity greater than the mean +2 &times; standard deviation of the entire stromal cross section) within the corneal stroma.Results: In all images of the second group (keratoconus patients treated with CXL) there was evidence of intrastromal hyper-reflective areas. The hyper-reflective areas ranged from 0.2% to 8.8% of the cross-sectional area (mean &plusmn; standard deviation; 3.46% &plusmn; 1.92%). The extent of the horizontal hyper-reflective area ranged from 4.42% to 99.2% (56.2% &plusmn; 23.35%) of the cornea image, while the axial extent (the vertical extent in the image) ranged from 40.00% to 86.67% (70.98% &plusmn; 7.85%). There was significant statistical difference (P &lt; 0.02) in these values compared to the control group, in which, by application of the same criteria, the same hyper-reflective area (owing to signal noise) ranged from 0.00% to 2.51% (0.74% &plusmn; 0.63%).Conclusion: Herein, we introduce a novel, noninvasive, quantitative technique utilizing anterior segment OCT images to quantitatively assess the depth and cross-sectional area of CXL in the corneal stroma based on digital image analysis. Mean cross-sectional area showing evidence of CXL was 3.46% &plusmn; 1.92% of a 6 mm long segment.Keywords: Collagen cross-linking, keratoconus, optical coherence tomography, higher fluence cross-linking, cornea ectasia, Athens ProtocolKanellopoulos AJAsimellis GDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 329-335 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Kanellopoulos AJ Asimellis G Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark
description	A John Kanellopoulos1,2 George Asimellis11Laservision.gr Institute, Athens, Greece; 2New York University Medical School, New York, NY, USAPurpose: To introduce a novel, noninvasive technique to determine the depth and extent of anterior corneal stroma changes induced by collagen cross-linking (CXL) using quantitative analysis of high-resolution anterior-segment optical coherence tomography (OCT) post-operative images.Setting: Private clinical ophthalmology practice.Patients and methods: Two groups of corneal cross-sectional images obtained with the OptoVue RTVue anterior-segment OCT system were studied: group A (control) consisted of unoperated, healthy corneas, with the exception of possible refractive errors. The second group consisted of keratoconic corneas with CXL that were previously operated on. The two groups were investigated for possible quantitative evidence of changes induced by the CXL, and specifically, the depth, horizontal extent, as well as the cross-sectional area of intrastromal hyper-reflective areas (defined in our study as the area consisting of pixels with luminosity greater than the mean +2 &times; standard deviation of the entire stromal cross section) within the corneal stroma.Results: In all images of the second group (keratoconus patients treated with CXL) there was evidence of intrastromal hyper-reflective areas. The hyper-reflective areas ranged from 0.2% to 8.8% of the cross-sectional area (mean &plusmn; standard deviation; 3.46% &plusmn; 1.92%). The extent of the horizontal hyper-reflective area ranged from 4.42% to 99.2% (56.2% &plusmn; 23.35%) of the cornea image, while the axial extent (the vertical extent in the image) ranged from 40.00% to 86.67% (70.98% &plusmn; 7.85%). There was significant statistical difference (P &lt; 0.02) in these values compared to the control group, in which, by application of the same criteria, the same hyper-reflective area (owing to signal noise) ranged from 0.00% to 2.51% (0.74% &plusmn; 0.63%).Conclusion: Herein, we introduce a novel, noninvasive, quantitative technique utilizing anterior segment OCT images to quantitatively assess the depth and cross-sectional area of CXL in the corneal stroma based on digital image analysis. Mean cross-sectional area showing evidence of CXL was 3.46% &plusmn; 1.92% of a 6 mm long segment.Keywords: Collagen cross-linking, keratoconus, optical coherence tomography, higher fluence cross-linking, cornea ectasia, Athens Protocol
format	article
author	Kanellopoulos AJ Asimellis G
author_facet	Kanellopoulos AJ Asimellis G
author_sort	Kanellopoulos AJ
title	Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark
title_short	Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark
title_full	Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark
title_fullStr	Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark
title_full_unstemmed	Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark
title_sort	introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/d6cc4279fdef4226823b0d01a8099669
work_keys_str_mv	AT kanellopoulosaj introductionofquantitativeandqualitativecorneaopticalcoherencetomographyfindingsinducedbycollagencrosslinkingforkeratoconusanoveleffectmeasurementbenchmark AT asimellisg introductionofquantitativeandqualitativecorneaopticalcoherencetomographyfindingsinducedbycollagencrosslinkingforkeratoconusanoveleffectmeasurementbenchmark
_version_	1718403104958840832

Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark

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