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Hndw Pshn CopotonJon o OphthmooyVom 2013, Atc ID 397680, 5 pshttp://dx.do.o/10.1155/2013/397680

Research ArticleUse of Fourier-Domain Optical Coherence Tomography toEvaluate Anterior Stromal Opacities in Donor Corneas

Matthew R. Bald,1 Christopher Stoeger,2 Joshua Galloway,2 Maolong Tang,1

Jeffrey Holiman,2 and David Huang1

1 Center or Ophthalmic Optics & Lasers, Casey Eye Institute and Department o Ophthalmology, Oregon Health & Science University,3375 SW Terwilliger Boulevard, Portland, OR 97239-4197, USA

2

Lions VisionGif, Portland, OR 971214-5303, USA

Cospondnc shod ddssd to Dvd Hn; dvdhn@m.mt.d

Rcvd 6 Novm 2012; Accptd 8 Mch 2013

Acdmc Edto: Andw G. L

Copyht 2013 Mtthw R. Bd t . Ts s n opn ccss tc dsttd nd th Ctv Commons AtttonLcns, whch pmts nstctd s, dstton, nd podcton n ny mdm, povdd th on wok s popyctd.

Purpose. o vt Fo-domn optc cohnc tomophy(FD-OC) s n djnct to tdton st mpxmnton odono cons wth sspctdAnto Stom Opcts.Methods. Svn cons sspctdo hvn nto stom opcts yst mp xmnton w vtd wth FD-OC. Ech con ws vtd to confm th psnc o opcty nd, psnt,th dpth o opcty ws msd. Results. T opcty dpth nd om 82 m to 624m. T nt st mp mpssonso fv o th svn cons w confmd y OC. In two cons, th OC fndns w dnt om th nt st mpmpssons. St mp xmnton o th fst con v th mpsson o nto stom scn, t OC showd tht thopcty ws mtd to th pthm. St mp xmnton o th scond con sstd opcty mtd to th pthm, tOC dntfd snfcnt s-Bowmns scn. In css, th Ey Bnk chncns potd tht th octon nd dpth ocon opcty w mo shpy dfnd y OC thn y st mp. Conclusion. T hh soton o OC mks t s todtmn th octon o con opcts compd to st mp xmntons. Ts nhncd vszton cn mpov dcsonsdn tnspnt stty o dono cons.

1. Introduction

Ey nks cnty mpoy nm o mthods ossssn dono con tss, ncdn pnht xm,

spc mcoscopy, st mp omcoscopy, mdc codvw, nd my ntvw [1]. Athoh ths vtontchnqs y sccss n dntyn th con-tndctons tht cons om sn pocds sch spnttn ktopsty (PK), nto m ktopsty(ALK), nd ndoth ktopsty (EK), som y nkshv cnty n doptn Fo-domn optc coh-nc tomophy (FD-OC) s wy o sppmntn thstndd pocds o tss pps.

Povdn hh-soton, coss-scton ms ontn ooc mcostcts, OC ws fst sd yophthmoosts to m th tn [24] nd thn mocnty th nto smnt [57]. It hs so n sd to

nvstt th sts o ctv ss n st [810]ndscn dono cons o pvos ctv ss sch ss n st ktomss (LASIK) nd photoctv k-tctomy (PRK) [1113]. In ddton, OC hs povn to

s too n vtn dnt y nk tss pocssntchnqs o m ktopsty [14] nd optmzn ththcknss o con s ppd y mcoktom [15].

OCs nq ty to ccty mp con thcknssov wd nd povd pcs msmnts ostom opcts wh vodn tss contmnton [16,17] mks t potnty v nstmnt o scnndono cons. Ts potnt s ostd y th Ey BnkAssocton o Amcs (EBAA) 2005 dcson to xpndth ct o ccpt tss: [1] cons tht hd ndmd nst o PK cs o nto scn,cnt pty, o con ctv ss sch s RdKtotomy (RK) now n ctvy sd n EK

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2 Jon o Ophthmooy

() ()

Figure 1: () Stp o FD-OC mn. T vwn chm contnn th conosc dsc s pcd n th hodn dvc wh thcon s scnnd. In od to mnmz th sk o contmnton, th con mns n mdm thohot th scn. () Vw chmcosp.

pocds [18, 19]. It s tho ncsny mpotnt thtch dono con s vtd oth ccty ndcntyn od to mk th st s o v tss. T s oFD-OC s n djnct to stndd tss vton mthodsmy povd y nks wth th nomton ncssy tompov th dcson mkn pocsss nd ns tht nodono con s wstd o mssd. Ts stdy xmnd thtty o FD-OC s sppmnt too n vtn donocons sspctd o hvn nto stom opcts.

2. Materials and Methods

2.1. Standard Tissue Evaluation. Lons VsonG (omyth Lons Ey Bnk o Oon) dntfd svn cons shvn potnt nto stom pthooy. T conosc- ms w mmsd n Optso-GS (Bsch & Lom,Ivn, CA, USA) nsd con vwn chm (Ko-mn, Boston, MA, USA) thohot th vton pocss.Ech tss vton n wth n ndoth c contsn th Konn EKA-04 Ey Bnk Spc Mcoscop(Konn Mdc, Inc, Hyoo, Jpn) nd ws oowd yst mp xmnton wth th H Stt BX 900 (HStt, Konz, Swtznd). T st mp xmntons wosvd y mnmm o two EBAA Ctfd Ey Bnkchncns.

2.2. OCT Scanning o Corneas with Anterior Stromal Pathol-ogy. A th cons w dntfd s hvn potntnto stom pthooy y st mp xmnton, chws scnnd wth th RV FD-OC nstmnt (OptovInc, Fmont, CA, USA) fttd wth con dpto mod(CAM) n od to m th con. T RV-CAMscn t ws 26,000 x scns p scond wth 5 m xsoton. Ech conosc dsk ws scnnd thoh thtnspnt wndow o th con vwn chm whchws hd n pc y cstom-t ttchmnt (Fs 1()nd 1()). A 10 mm n scn ws ottd nt th opctycod vszd. Tn th dpth o th stom opcty

ws mny msd sn th compt cps n thRV sow st.

3. Results

Svn cons sspctd o hvn nto stom ptho-oy st mp xmnton w vtd wth thOptov RV FD-OC. In svn css, th Ey Bnkchncns potd tht th octon nd dpth o conopcty w mo shpy dfnd y OC thn y st mp.T msd dpth o opcty nd om 82mto624 mwth n v opcty dpth o 291 m ( 1).

In two o th svn cons, th OC fndns wdnt om th nt st mp mpssons. In ConOn, th st mp xmnton v th mpsson o nnto stom pthooy (F 2()). Howv, ponOC vton t ws shown tht th con contnd nostom scn nd, wth dpth o 82 m, th opctyws mtd to th pthm (F 2()). T tss wsvnty sd o EK. In Con wo, th nt stmpxmnton sstd th psnc o n opcty mtd toth pthm o th con (F 3()). It ws ony OC vton tht snfcnt s-Bowmns scn wsdntfd nd msd to dpth o 278 m (F 3()).

Ts tss ws so dsntd ccpt o EK t wsdsposd o th ct d ( 1).

OC mn o th mnn fv cons confmdth nt tss stty jdmnts md oown st-mp xmnton. In ths css, th OC nd thtchncn to mk spcfc dpth msmnts o stomopcty. Con T ws ond to hv Rd Ktotomy(RK) scs chn 624 m nto th stom. In ths cs,th con ws dcnd o s n tnspnt cs oth donos mdc hstoy. Howv, wth cnt conthcknss o 704m ( 1), th dpth ots RK scs wodhv so pvntd t om n sd n sy. ConFo contnd stom scn msd to dpth o

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() ()

Figure 2: () Wht pps to nto stom pthooy s vszd y st mp mcoscopy. () FD-OC vton vs thtscn s mtd to th con pthm. T ow ndcts th octon o opcts.

() ()

Figure 3: () St mp xmnton ssts tht th opcty s mtd to th pthm. () OC xmnton vs th psnc osnfcnt s-Bowmns scn msd to dpth o 278 m. T ow ndcts th octon o opcts.

() ()

Figure 4: () Mdstom Opcty s sn y st mp. () Mdstom Opcty msd to dpth o 397m. T ow ndcts thocton o opcts.

397m nd ws sd o EK tnspnt (Fs 4() nd4()). Cons Fv, Sx, nd Svn w ch dntfd s

hvn nto stom opcts msn 224m, 212m,nd 221m y OC, spctvy nd thss OC dnsd wth stmp xmntons.

4. Discussion

Rcnt ys hv sn mkd ncs n th s om sy tchnqs tht sctvy pc dmdcon ys wh psvn hthy tss [2027]. Tsncs, nd th cospondn dcson y th MdcAdvsoy Bod o th EBAA to ow th s o conswth nto pthooy n EK sy [1], mphszs thmpotnc o ccty vtn ch dono con.

Athoh th tss ssssmnt mthods cnty mpoydy y nks y sccss t dtctn th psnc o

stom pthooy, thy povd mtd nomton d-n th octon nd dpth o spcfc con opcts. Tcpty o FD-OC to ccty th dpth o conopcty hs th potnt to d y nks n cntytzn v tss. Ts stdy dmonsttd thtnot ony dos FD-OC ow Ey Bnk chncns toms th dpth o con scn, t so, whn sdn conjncton wth stndd st mp mcoscopy, t myoccsony mpct tss stty dcsons.

It shod mphszd tht w not sstn thtth nomton povdd y FD-OC s n ts scnto mkn tss s jdmnts. St mp mcoscopy s stth stndd cs t ows o comphnsv svy

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able 1: Compson o st mp nd OC fndns n vtn dono tss o tnspnt stty nd dpth o opcty s msdwth FD-OC.

ssnm

CC(m)

St mp fndn FD-OC fndnOpcty

dpth (m)OC mpct tss

stty?ss s

1 669 Anto Stom Opcty Epth 82 Ys Endoth ktopsty

2 623 Epth Anto Stom Opcty 278 YsIntndd o tnspnt tmcoktom ct dtssdsposd o

3 705 Rd Ktotomy Rd Ktotomy 624 No Dcnd d to mdc hstoy

4 641 Mdstom Opcty Mdstom Opcty 397 No Endoth ktopsty

5 623 Anto Stom Opcty Anto Stom Opcty 224 No Endoth ktopsty

6 577 Anto Stom Opcty Anto Stom Opcty 212 NoPoo ndothmtssdsposd o

7 595 Anto Stom Opcty Anto Stom Opcty 221 No ctonc n

CC: cnt con thcknss; FD-OC: Fo-domn optc cohnc tomophy.

o th con wth mttd o mnton tchnqsnd mnfcton cpts, mkn t th d too oth nt dtcton nd oczton o con opcts.Rth, th sts o ths stdy sst tht FD-OC s s compmnt to st mp xmnton, too o thconfmn o dscontn mos st mp fndns.Athoh th smp sz contnd n o stdy s phpsvdnc tht mty n st mp xms s not tycommon pom, t s n ss tht y nks nd toconont n od to ns tht no dono con s ndssywstd o mssd.

On mtton o th stdy s th sm smp sz. F-thmo, th cov o th OC n scn s mtd. Tnmnt o th n scn dpnds on th optos osv-tono th ontst.A ttscnpttn wod 3Dwd-n scn tht cn mp th nt con. T s so sm ctv ndx msmtch twn th psvtonmdm nd con. T cnt OC sow dos notccont o ths n ts dwpn othm whch cn dto sm os n con thcknss msmnts.

Movn owd, th coton twn st mp fnd-ns nd FD-OC my my t ond o thnvstton. FD-OC s not cnty sd to chctzknown nctons o dnty ctv nmmtoy pocsss.By sn FD-OC to m known contndctons schs ctv nctons, t my poss to tn t EyBnk chncns to tz FD-OC tchnooy n nw ndnnovtv wys.

Athoh th s cnty no stndd pocd oth o o FD-OC n y nks, o sts dmonstttht ts s s n djnct to stndd st mp mcoscopypovds v nomton ot stom pthooy thtcod ct tss s dcsons oth now nd n th t.

Conflict of Interests

Proprietary Interests. D. Hn hs snfcnt fnncntst n Optov nd C Zss Mdtc, compns tht

my hv commc ntst n th sts o ths schnd tchnooy. M. n hs snfcnt fnnc ntst nOptov. Ts potntconct o ntst, hsn vwdnd mnd y OHSU. M. R. Bd, C. Sto, J. Gowy,ndJ. Homn hv no fnnc o popty ntstn nymt o mthod mntond.

Acknowledgments

Ts stdy ws sppotd y NIH Gnt R01 EY018184 nd Gnt om Optov Inc.

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