Vertical and Horizontal Corneal Epithelial Thickness Profile Using Ultra-High Resolution and Long Scan Depth Optical Coherence Tomography

Purpose To determine the vertical and horizontal thickness profiles of the corneal epithelium in vivo using ultra-long scan depth and ultra-high resolution spectral domain optical coherence tomography (SD-OCT). Methods A SD-OCT was developed with an axial resolution of ∼3.3 µm in tissue and an extended scan depth. Forty-two eyes of 21 subjects were imaged twice. The entire horizontal and vertical corneal epithelial thickness profiles were evaluated. The coefficient of repeatability (CoR) and intraclass correlation (ICC) of the tests and interobserver variability were analyzed. Results The full width of the horizontal epithelium was detected, whereas part of the superior epithelium was not shown for the covered super eyelid. The mean central epithelial corneal thickness was 52.0±3.2 µm for the first measurement and 52.3±3.4 µm for the second measurement (P>.05). In the central zone (0–3.0 mm), the paracentral zones (3.0–6.0 mm) and the peripheral zones (6.0–10.0 mm), the mean epithelial thickness ranged from 51 to 53 µm, 52 to 57 µm, and 58 to 72 µm, respectively. There was no difference between the two tests at both meridians and in the right and left eyes (P>.05). The ICCs of the two tests ranged from 0.70 to 0.97 and the CoRs ranged from 2.5 µm to 7.8 µm from the center to the periphery, corresponding to 5.6% to 10.6% (CoR%). The ICCs of the two observers ranged from 0.72 to 0.93 and the CoRs ranged from 4.5 µm to 10.4 µm from the center to the periphery, corresponding to 8.7% to 15.2% (CoR%). Conclusions This study demonstrated good repeatability of ultra-high resolution and long scan depth SD-OCT to evaluate the entire thickness profiles of the corneal epithelium. The epithelial thickness increases from the center toward the limbus.

[1]  A. Kanellopoulos,et al.  In vivo 3-dimensional corneal epithelial thickness mapping as an indicator of dry eye: preliminary clinical assessment. , 2014, American journal of ophthalmology.

[2]  U Reischl,et al.  Regression and epithelial hyperplasia after myopic photorefractive keratectomy in a human cornea. , 1999, Journal of cataract and refractive surgery.

[3]  Jianhua Wang,et al.  Topographical thickness of the epithelium and total cornea after hydrogel and PMMA contact lens wear with eye closure. , 2001, Investigative ophthalmology & visual science.

[4]  T. Simpson,et al.  Diurnal Variation of Corneal and Corneal Epithelial Thickness Measured Using Optical Coherence Tomography , 2001, Cornea.

[5]  Lyndon Jones,et al.  The measurement of corneal epithelial thickness in response to hypoxia using optical coherence tomography. , 2002, American journal of ophthalmology.

[6]  Ronald H Silverman,et al.  Stromal thickness in the normal cornea: three-dimensional display with artemis very high-frequency digital ultrasound. , 2009, Journal of refractive surgery.

[7]  Meixiao Shen,et al.  Vertical and Horizontal Corneal Epithelial Thickness Profiles Determined by Ultrahigh Resolution Optical Coherence Tomography , 2012, Cornea.

[8]  Jianhua Wang,et al.  Topographical thickness of the epithelium and total cornea after overnight wear of reverse-geometry rigid contact lenses for myopia reduction. , 2003, Investigative ophthalmology & visual science.

[9]  Yan Li,et al.  Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes. , 2012, Ophthalmology.

[10]  T. Simpson,et al.  The Repeatability of Corneal and Corneal Epithelial Thickness Measurements Using Optical Coherence Tomography , 2006, Optometry and vision science : official publication of the American Academy of Optometry.

[11]  J Moreno-Montañés,et al.  Optical coherence tomography evaluation of the corneal cap and stromal bed features after laser in situ keratomileusis for high myopia and astigmatism. , 2000, Ophthalmology.

[12]  C. Baudouin,et al.  Ocular surface epithelial thickness evaluation with spectral-domain optical coherence tomography. , 2011, Investigative ophthalmology & visual science.

[13]  F. Hu,et al.  Comparison of in vivo confocal microscopic findings between epi-LASIK procedures with different management of the epithelial flaps. , 2011, Investigative ophthalmology & visual science.

[14]  J. Izatt,et al.  Correction of geometric and refractive image distortions in optical coherence tomography applying Fermat's principle. , 2002, Optics express.

[15]  Angelika Unterhuber,et al.  Precise Thickness Measurements of Bowman's Layer, Epithelium, and Tear Film , 2012, Optometry and vision science : official publication of the American Academy of Optometry.

[16]  D. Henson,et al.  Micropachometry: a technique for measuring the thickness of the corneal epithelium. , 1980, Investigative ophthalmology & visual science.

[17]  Kostadinka Bizheva,et al.  Swelling of the human cornea revealed by high-speed, ultrahigh-resolution optical coherence tomography. , 2010, Investigative ophthalmology & visual science.

[18]  Sander R. Dubovy,et al.  Topographic thickness of Bowman's layer determined by ultra-high resolution spectral domain-optical coherence tomography. , 2011, Investigative ophthalmology & visual science.

[19]  D. Koch,et al.  Repeatability of Corneal Epithelial Thickness Measurements Using Fourier-Domain Optical Coherence Tomography in Normal and Post-LASIK Eyes , 2013, Cornea.

[20]  Ronald H. Silverman,et al.  Epithelial Thickness in the Normal Cornea: Three-dimensional Display With Very High Frequency Ultrasound , 2008 .

[21]  Jianhua Wang,et al.  Entire Thickness Profiles of the Epithelium and Contact Lens In Vivo Imaged With High-Speed and High-Resolution Optical Coherence Tomography , 2013, Eye & contact lens.

[22]  Ronald H Silverman,et al.  Repeatability of layered corneal pachymetry with the artemis very high-frequency digital ultrasound arc-scanner. , 2010, Journal of refractive surgery.

[23]  Fan Lu,et al.  The role of axial resolution of optical coherence tomography on the measurement of corneal and epithelial thicknesses. , 2013, Investigative ophthalmology & visual science.

[24]  E A Swanson,et al.  Micrometer-scale resolution imaging of the anterior eye in vivo with optical coherence tomography. , 1994, Archives of ophthalmology.

[25]  R. Silverman,et al.  Epithelial thickness in the normal cornea: three-dimensional display with Artemis very high-frequency digital ultrasound. , 2008, Journal of refractive surgery.

[26]  A. Agarwal,et al.  Reliability and reproducibility of assessment of corneal epithelial thickness by fourier domain optical coherence tomography. , 2012, Investigative ophthalmology & visual science.

[27]  Jianhua Wang,et al.  Vertical and horizontal thickness profiles of the corneal epithelium and Bowman's layer after orthokeratology. , 2013, Investigative ophthalmology & visual science.

[28]  Lyndon Jones,et al.  Thickness Mapping of the Cornea and Epithelium Using Optical Coherence Tomography , 2008, Optometry and vision science : official publication of the American Academy of Optometry.

[29]  Meixiao Shen,et al.  Entire Contact Lens Imaged In Vivo and In Vitro With Spectral Domain Optical Coherence Tomography , 2010, Eye & contact lens.

[30]  Jianhua Wang,et al.  Ultra-high resolution and long scan depth optical coherence tomography with full-phase detection for imaging the ocular surface , 2013, Clinical ophthalmology.

[31]  R. D. Stulting,et al.  SD-OCT analysis of regional epithelial thickness profiles in keratoconus, postoperative corneal ectasia, and normal eyes. , 2013, Journal of refractive surgery.