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Mark Welch, DO and Steven Waller, MD No financial interest

Pterygia Measurements with Standard Slitlamps and with Anterior Segment Optical Coherence Tomography: Pilot Study. Mark Welch, DO and Steven Waller, MD No financial interest. Background. Previous Studies Demonstrating Anterior OCT Anterior Chamber Dimensions Intraocular Lens Position

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Mark Welch, DO and Steven Waller, MD No financial interest

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  1. Pterygia Measurements with Standard Slitlamps and with Anterior Segment Optical Coherence Tomography: Pilot Study Mark Welch, DO and Steven Waller, MD No financial interest

  2. Background • Previous Studies Demonstrating Anterior OCT • Anterior Chamber Dimensions • Intraocular Lens Position • Corneal Thickness • Corneal thinning after Mytomycin C • Clinical challenges of pterygium measurements • Subjectivity of Slit Lamp measurements • Cannot measure thickness with Slit Lamp

  3. Compare horizontal measurements of pterygia by slit lamp beam to caliper measurements overlayed on Anterior Segment OCT images Purpose

  4. Methods • 10 Patients and 13 nasal pterygia were evaluated. Patients with significant ocular surface disease were excluded • Horizontal measurements were taken by two physicians with the slit lamp beam and caliper at 16 mag • Measurements were taken from the apex of the lesion to the limbus • Two images of lesions with Anterior Segment OCT • Caliper measurements of lesions

  5. Methods Example of INCORRECT meridian to see lesion – 45 degrees Example of CORRECT Meridian at 180 degrees images the lesion

  6. Visante OCT measurements Caliper Measurements

  7. Results Difference in Slit Lamp Measurements MD = 0.30 SD = 0.32

  8. Results Difference in OCT Measurements MD = 0.1 SD = 0.12

  9. Conclusions • OCT gives statistically more reproducible results than slit lamp for horizontal measurements of pterygia (P=0.0256) • OCT can reproduce measurements in the same axis meridian and appears to be less subjective with regard to the starting and stopping point for making measurements

  10. Study Limitations • Small number of patients • Inherant variability of slit lamp measurements

  11. References Buchwald HJ, Muller A, Spraul CW, Lang GK. Ultrasound Biomicroscopy of Conjunctival Lesions. KlinMonatsblAugenheilkd. 2003 Jan-Feb; 220(1-2):29-34. Buchwald HJ, Muller A, Kampmeier J, Lang GK. Optical Coherence Tomography versus Ultrasound Biomicroscopy of Conjunctival and Eyelid Lesions. KlinMonatsblAugenheilkd. 2003 Dec; 220(12):822-9. Baikoff G, Lutun E, Ferraz C, and Wei J. Static and Dynamic Analysis of the Anterior Segment With Optical Coherence Tomography. J Cataract Refract Surg. 2004 Sep; 30(9):1843-50. Adamis AP, Starck T, Kenyon KR. The Management of Pterygium. OphthalmolClin North Am. 1990; 2(4):611. Kent C. Breaking New Ground in Ultrasound. Review of Ophthalmology. 2006 Nov; 13(11):22-26. Lin, H, Shen S, Huang S, Tsai R. Ultrasound Biomicroscopy in Pigmented Conjunctival Cystic Nevi. Cornea. 2004 Jan; 23(1):97-99. Solomon A, Kaiserman I, Raiskup F, Landau D, Frucht-Pery J. Long-term Effects of Mitomycin C in Pterygium Surgery on Scleral Thickness and the Conjunctival Epithelium. Ophthalmology. 2004 Aug; 111(8):1522-1527. Dada T, Sihota R, Gadia R, Aggarwal A, Mandal S, Gupta V. Comparison of Anterior Segment Optical Coherence Tomography and Ultrasound Biomicroscopy for Assessment of the Anterior Segment. J Cataract Refract Surg. 2007 May; 33:837-840. Emmy YM, Mohamed S, Leung C, Rao S, Cheng A, Cheung C, Lam D. Agreement Among 3 Methods to Measure Corneal Thickness: Ultrasound Pachymetry, Orbscan II, and Visante Anterior Segment Optical Coherence Tomography. Opthalmology. 2007 October; 114(10):1842-1847. Fujimoto JG. Optical Coherence Tomography: Introduction. In: Bouma BE, Tearney GJ, eds, Handbook of Optical Coherence Tomography. New York, NY, Marcel Dekker, 2002; 1-40. Goldsmith J, Li Y, Regina M, Chalita MR, Westphal V, Patil C, Rollins AM, Izatt JA, Huang D. Anterior Chamber Width Measurement by High-Speed Optical Coherence Tomography. Ophthalmology. 2005 Feb; 112(2):238-244. 12. Lin A, Stern G. Correlation between pterygium size and induced corneal astigmatism. Cornea. 17:1998; 28-30. Payman A, Mohammed-Salih, Ahmad F, Sharif . Analysis of Pterygium Size and Induced . Corneal Astigmatism. Cornea. 27: 2008; 434-438.

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