Faculty Bibliography

We present a new technique for coherent optical imaging of ocular structure based on optical coherence tomography (OCT). OCT is a noncontact, noninvasive, tomographic imaging technique with superior spatial resolution to ultrasound (< 20 micrometers ) and high sensitivity (100 dB dynamic range). We have used OCT to perform direct imaging of ocular structure in the anterior and posterior segments of human eyes in vitro and in vivo. In the anterior segment, we have measured corneal thickness and profile, anterior chamber depth and angle, and iris thickness and profile. These and other possible measurements have potential applications in diagnosis of pathologies of the cornea, angle, and iris, as well as in noncontact biometry for applications in cataract and corneal refractive surgeries. In the posterior segment, we have obtained high-resolution images of retinal structure in human subjects in vivo. These images demonstrate higher resolution than available with any other existing technique, and include characterization of optic disk morphology and topology. These measurements have potential applications in early diagnosis and assessment of glaucoma and other retinal diseases

BACKGROUND: Early reports of both contact and noncontact transscleral Nd:YAG laser cyclophotocoagulation have been encouraging; however, recent evidence indicates a significant incidence of hypotony, visual loss, and phthisis with the noncontact technique with more than 6 months of follow-up. The authors sought to determine the intermediate term effects of contact transscleral Nd:YAG laser cyclophotocoagulation (CYC). METHODS: The authors followed 116 eyes of 114 patients for a minimum of 1 year after treatment of advanced glaucoma with CYC. RESULTS: The mean preoperative intraocular pressure (IOP) of 35.0 +/- 1.0 mmHg decreased to 18.6 +/- 1.1 mmHg (P less than 0.0001) during the average follow-up of 19.0 +/- 0.6 months (range, 12 to 36 months). Intraocular pressure control of 3 to 25 mmHg was achieved in 72%, 3 to 22 mmHg in 65%, and 3 to 19 mmHg in 56% of eyes. Retreatment was required in 31 of the 116 eyes (27%). Intraocular pressure decreased to less than 3 mmHg in 9 eyes and to 0 mmHg in 6 of these 9 eyes. Nineteen eyes, all with initial visual acuity of counting fingers or worse, progressed to no light perception; 17 of 36 eyes (47%) with visual acuity of 20/200 or better lost 2 or more Snellen lines. CONCLUSION: Midterm results of CYC continue to be encouraging but are tempered by a nearly 10% incidence of hypotony or phthisis and the progression of visual loss.