Lossing Laura Ashley, Sinnott Loraine T, Kao Chiu-Yen, Richdale Kathryn, Bailey Melissa D
College of Optometry, The Ohio State University, Columbus, Ohio 43210, USA.
Optom Vis Sci. 2012 May;89(5):719-26. doi: 10.1097/OPX.0b013e318252cadc.
To develop a measurement protocol for changes in the shape and size of the ciliary muscle with accommodation using the Zeiss Visante™ anterior segment optical coherence tomography (AS-OCT) and to determine the test-retest repeatability of these measurements.
Subjects were 25 adults aged 23 to 28 years. The ciliary muscle was imaged at two visits with the Visante™ while accommodative response was monitored during imaging using the PowerRefractor. Ciliary muscle thickness (CMT) was measured at 1 mm (CMT1), 2 mm (CMT2), and 3 mm (CMT3) posterior to the scleral spur and at the point of maximal thickness (CMTMAX). Thickness was measured at these locations while subjects viewed a target at distance and at a 4.00 D accommodative stimulus. Outcome measures were the change in thickness between distance and the 4.00 D stimulus and the change in thickness per diopter of accommodative response (PowerRefractor). Finally, the repeatability measurements between visit 1 and visit 2 were determined with a Bland-Altman analysis.
The statistically significant modeled changes in CMT were as follows: CMTMAX = 69.2 μm (4.00 D stimulus) and 18.1 μm (per diopter of accommodation); CMT1 = 45.2 μm (4.00 D stimulus) and 12.3 μm (per diopter of accommodation); and CMT3 = -45.9 μm (4.00 D stimulus) and -12.0 μm (per diopter of accommodation); p < 0.0001 for all.
The combination of the Visante™ and the PowerRefractor is a feasible tool for measuring thickening of ciliary muscle at more anterior locations and thinning at more posterior locations during accommodation. We noted a wide range of accommodative responses during the time of image capture in this study indicating that the most accurate estimates of the change in ciliary muscle dimensions with accommodation may be obtained by using accommodative response rather than stimulus values and by using measurements taken simultaneously with image capture.
利用蔡司Visante™眼前节光学相干断层扫描（AS - OCT）制定一种测量睫状肌在调节时形状和大小变化的方案，并确定这些测量的重测重复性。
研究对象为25名年龄在23至28岁之间的成年人。使用Visante™在两次检查时对睫状肌进行成像，同时在成像过程中使用PowerRefractor监测调节反应。在巩膜突后方1毫米（CMT1）、2毫米（CMT2）和3毫米（CMT3）以及最大厚度点（CMTMAX）测量睫状肌厚度。在受试者观察远处目标和4.00 D调节刺激时，在这些位置测量厚度。观察指标为从远距离到4.00 D刺激时的厚度变化以及每屈光度调节反应（PowerRefractor）的厚度变化。最后，通过Bland - Altman分析确定第1次和第2次检查之间的重复性测量结果。
CMT的统计学显著模型化变化如下：CMTMAX = 69.2μm（4.00 D刺激）和18.1μm（每屈光度调节）；CMT1 = 45.2μm（4.00 D刺激）和12.3μm（每屈光度调节）；CMT3 = - 45.9μm（4.00 D刺激）和 - 12.0μm（每屈光度调节）；所有p值均<0.0001。
Visante™和PowerRefractor的组合是测量调节过程中睫状肌在前部位置增厚和后部位置变薄的可行工具。我们在本研究的图像采集期间注意到广泛的调节反应范围，这表明通过使用调节反应而非刺激值以及通过与图像采集同时进行的测量，可以获得睫状肌尺寸随调节变化的最准确估计。
