Pediatric Corneal Structural Development During Childhood Characterized by Ultrasound Biomicroscopy

Abstract

Purpose: To quantitatively describe the structural corneal changes from infancy to early adulthood using ultrasound biomicroscopy. Methods: In this prospective study, 168 ultrasound biomicroscopy images were obtained from 24 healthy eyes of 24 patients who consented and enrolled in the Pediatric Anterior Segment Imaging Innovation Study. Their ages ranged from birth to 26 years. An established ultrasound biomicroscopy imaging protocol including seven views of one eye per patient were obtained and measured using ImageJ software (National Institutes of Health). Twelve corneal structural parameters were measured. Means were compared between younger and older groups. Results: Among the 12 measured structures, 5 demonstrated statistically significant differences ( P < .05) between patients younger than 1 year and patients older than 1 year. The mean values for corneal cross-sectional width and length, central corneal thickness, and radii of curvature (anterior and posterior) were significantly different in patients younger than 1 year. Curvature and limbus-to-limbus dimensions changed more dramatically than thickness and tissue density. When comparing the youngest to oldest subgroups, anterior curvature flattened (6.14 to 7.55 radius), posterior curvature flattened (5.53 to 6.72 radius), angle-to-angle distance increased (8.93 to 11.40 mm), and endothelial cross-sectional distance increased (10.63 to 13.61 mm). Conclusions: Pediatric corneal structures change with age. The most significant changes occur in the first months of life, with additional changes later in childhood. This study further demonstrates the importance of age in pediatric corneal imaging analysis. [ J Pediatr Ophthalmol Strabismus. 2020;57(4):238–245.]

Corneal Structural Changes in Congenital Glaucoma

“…The average measurement from the six images was used for analysis. A total of 21 parameters (Table 2) were measured based on a previously defined protocol, 13 including measurements from the central and posterior cornea, anterior chamber, trabecular iris angles, and sclera, using the angle-to-angle distance (AA-D) and scleral spur (SS) as landmarks. In this study, additional parameters including distance from the scleral spur to the mid-iris insertion and anterior ciliary body insertion (Fig.…”

“…All images included in this study were obtained by the same examiner, a trained ophthalmologist who obtained two axial and four longitudinal images per eye in predefined locations and probe positions according to previously published protocols. 12,13 Ultrasound biomicroscopy image analysis was performed using ImageJ software. Masked measurements for each image were performed by two different expert observers, and their measurements were averaged to determine each parameter measurement value.…”

A systematic review of ultrasound biomicroscopy use in pediatric ophthalmology

“…Other pediatric corneal diseases evaluated using UBM includes keratoconus (acute hydrops [60,61], and intrastromal ring implantation [62]), and deep anterior lamellar keratoplasty (DALK) outcomes and indications [63]. Normal corneal growth evaluation using UBM identified and quantified structures with statistically significant differences in younger eyes, and provided baseline reference values for comparison in future studies [64].…”

“…Three of these studies focused on premature infants [79][80][81], and four focused on anterior segment changes concurrent with accommodation and dilation [65,[82][83][84]. These studies provide useful normative data [64,[85][86][87], and emphasize the importance of controlling for age and environmental factors during UBM imaging.…”

Deep Learning Model for Accurate Automatic Determination of Phakic Status in Pediatric and Adult Ultrasound Biomicroscopy Images

“…4 Previous case-control studies have shown UBM findings in various anatomic locations, including the ciliary body, iridocorneal angle, and iris, are associated with primary congenital glaucoma. [5][6][7][8][9][10] Although the prognostic and diagnostic impact of these features are still under investigation, there is a current need to produce methods for successful automatic characterization of multiple anatomic locations in UBM to aid these efforts.…”