Three-Dimensional Optical Coherence Tomography Imaging for Glaucoma Associated with Boston Keratoprosthesis Type I and II. J Glaucoma 2019;Abstract.
PRECIS: 3D spectral domain OCT volume scans of the optic nerve head and the peripapillary area are useful in the management of glaucoma in patients with a type I or II Boston Keratoprosthesis (KPro). PURPOSE: To report the use of spectral domain optical coherence tomography (OCT) in the management of glaucoma in patients with a type I or II Boston Keratoprosthesis (KPro). METHODS: Observational case series. Four consecutive patients with KPro's were referred for glaucoma evaluation. A comprehensive eye exam was performed which included disc photography, visual field testing, and high-density spectral domain OCT volume scans of the optic nerve head and the peripapillary area. Two-dimensional (2D) and three-dimensional (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 out 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 optic nerve head and peripapillary region. Therefore, 3D parameters derived from high-density volume scans as well as radial scans of the optic nerve head can be used to overcome the limitations and artifacts associated with 2D RNFL thickness scans. CONCLUSION: 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.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.