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MUHAMMAD AMIRUL SHAFIQ BIN ABDULLAH (2022478186), HS246 2A

NURFARAH ATHIRAH BINTI ISAHAK (2022478586), HS246 2A

WAN NOR MAHIRAH BINTI WAN DAUD (2022876144), HS246 2B

EMYLIA ERINA BINTI ROSLAN (2022855442), HS246 2C

NUR AIDA ADRIANA BINTI AZIZAN (2022663398), HS246 2C

NUR ALIYA DANISHA BINTI MOHD JAMIL (2022868186), HS246 2C

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1. Kojima, T., Ishida, R., Dogru, M., & Tsubota, K. (2004). A new noninvasive tear stability analysis system for assessment of dry eyes. ResearchGate. https://www.researchgate.net/publication/8592812_A_new_noninvasive_tear_stability_analysis_system_for_assessment_of_dry_eyes

2. Capture of Corneal Topography Maps. (n.d.). EyeSpace. https://www.eye.space/v1/kb/en-capture-of-corneal-topography-maps/

3. Kojima, T., Ishida, R., Dogru, M., Goto, E., Takano, Y., Matsumoto, Y., Kaido, M., Ohashi, Y., & Tsubota, K. (2004). A new noninvasive Tear Stability Analysis System for the assessment of dry eyes. Investigative Ophthalmology and Visual Science, 45(5), 1369-1374. https://doi.org/10.1167/iovs.03-0712

4. Tearcheck. ESW Vision. (2022, November 28). https://www.esw-vision.com/tearcheck

5. Tim S., Michael M., Weaam A., Abdelhak M. Z.(2016). A procedure to locate the eyelid position in noisy videokeratoscopic images. https://www.researchgate.net/publication/311653237_A_procedure_to_locate_the_eyelid_position_in_noisy_videokeratoscopic_images#fullTextFileContent

6. Saudi J. Ophtalmol. (2012, January 26). Clinical applications of Scheimpflug imaging in cataract surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729842/

7. Tommy C. Y. Chan, Gaurav Prakash. (2017, December). Applications of corneal topography and tomography: a review: Applications of corneal topography and tomography. https://www.researchgate.net/publication/321952298_Applications_of_corneal_topography_and_tomography_a_review_Applications_of_corneal_topography_and_tomography

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A problem of non-planar shape of the cornea, poor and unreliable capture of the corneal data from the periphery was using centrally located scanning slit-based cameras. The Scheimpflug principle solved this problem.

The modern topographies are based on Scheimpflug Imaging with a slit illumination system.

If the refracting lens plane and the intended image plane are parallel, an object parallel to the lens will form a plane of focus parallel to the lens plane as well.

However, if certain parts of the object to be mapped are not parallel to the prospective image plane, the complete image cannot be focused on a plane parallel to the image plane and caused image distortion.

When the image plane is not parallel to the lens plane, the Scheimpflug principle was applied to capture the images.

As the lens plane and image plane are not parallel, light rays reflected back from the any structure of the anterior segments can be capture by the camera.

The slit illumination a thin layer within the eye and the cells scatters the light since they are not complete transparent.

Due to scattering of slit, a sectional image is created from the anterior surface of the cornea to the anterior surface of the lens and this sectional image is captured by a camera.

The Slit camera device rotates 360° concentrically around the eye to provide a sequence of radially oriented sectional images of the anterior segment of the eye.

Sectional images are saved and adjusted in relation to common reference points before being combined to form a 3D image.

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The Slit-Scanning Elevation is a projective technique that measures the triangulation between surface of the reference slit beam and the reflected beam capture by a camera.

It contains a 3D scanning slit beam technology with an added placido attachment.

During image capture, forty slits are projected progressively on the cornea (20 nasal, 20 temporal) to create an overlapping pattern of scanning slits.

The data is interprets using triangulation, and the final image is represented as 3D topographic map of the complete corneal surface, including curvature, elevation and pachymetry maps.

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Placido Disc is made up of a circular target with alternating concentric light and dark rings and a central aperture for examine the corneal reflections of light and-dark bands over the cornea. Placido Disc was attached to video camera that can provide a permanent record.

First Purkinje image reflection of bright rings.

At first use of Placido Disc more qualitative but with the development of sophisticated software, the reflection patterns can be used to generate quantitative data and colour-coded maps.

Viewing from the centre with a magnifying lens.

The outer rings subtend a wider angle.

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Since Tear Stability Analysis System is using corneal topography system which is Videokeratography, so the principles involve with TSAS are:

Placido Disc.

Slit-scanning Elevation Topography.

Scheimpflug Imaging.

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Navy and Cream Minimalist Brain Strom Mind Map (1)

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TSAS was developed in 2004 and the updated version was implemented in another type of optical instrument made by Tomey Corporation, Nagoya Japan. This kind of software, however, has never been publicy shared to the public.

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1. Volunteers were recruited to test the sensitivity and specificity of TSAS in comparison with routine method for tear film breakup time evaluation by slit-lamp microscope (SLE-BUT) and fluorescence staining.

2. Analyzed the regressive correlations of TMS-BUT or TMS-BUA with SLE-BUT. TMS-BUT and TMS-BUA were compared with SLE-BUT data for evaluation of dry eye symptoms.

SLE result: Subject separated into two groups with normal and short BUT, respectively.

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New software, Tear Stability Analysis (TSAS), developed for videokeratography system TMS-2N (topographic modeling system).

TSAS is a noninvasive and objective method with increased sensitivity for tear film stability analysis.

TSAS automatically captures serial images of corneal surface every second for 10 seconds.

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> Basically, this system is used for analyzing the tear film stability by using the light cone system.

> The main function of TSAS ;
1. Used to analyzed for tear breakup
time  ( TMS-BUT ) and tear breakup
area ( TMS-BUA ) .

> In addition, TSAS was effective in objectively assessing the tear stability in patients with dry eye.

> Thus, this system may be useful in noninvasive diagnosis of dry eye and evaluation of treatment effects.

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Limitation

Due to distortion caused by shadows, eyelid position, irregularities in the corneal surface, and tear film, the actual number of data for analysis may be decreased.

Solutions

To completely capture the superior area, the eyelids can be moved out of the way using a cotton bud or lid retractor. Other than that, the Analyzed Area (AA) percentage shown in the red block in the image above is monitored. The higher the percentage value, the more area of the cornea is captured. Any amount above 60% is considered acceptable.

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Walker, B. M., OD. (2017, August 15). Mapping Out Corneal Topography. REVIEW of OPTOMETRY. https://www.reviewofoptometry.com/article/ro0817-mapping-out-corneal-

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TSAS was installed in Topographic Modelling System (TMS-2N) which is the computed anatomy by Tomey Technology.

During testing, 30 mire rings are projected on corneal surface and the projected images are captured by videokeratoscopy. Examiners now have the ability to dynamically assess how the quality of the tear film varies when the patient blinks.

The center of innermost mire act as a reference point during testing.

For 10 seconds after the eyes were opened, corneal topograms were recorded every second during the TSAS tests. The ocular surface was anaesthetized with 30 L of 0.4% oxybuprocaine to allow for the TSAS measurement without blinking. After five minutes, both patients and healthy control participants were instructed to stop blinking and keep their eyes open while their tear stability was assessed.

The data collected was analyzed by computer.

Computer analyzed the surface regularity and asymmetry indices (SRI, SAI) as well as the newly developed tear stability regularity and asymmetry indices (TSRI, TSAI), which were generated from SRI and SAI.

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A new software called TSAS was developed in collaboration of Tomey Technology (Nagoya,Japan) with Department of Ophthalmology, Ehime University.

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Ocular Surface Inflammatory Risk Evaluation

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1. OSIE®
> Provide higher risk of inflammation
> Precise dimension and rating of dryness
> The latest ideals tool for eye surgeons and lens-opticians

2. TFSE® / NIBUT
> Produce the equal imaging sequence
> Display the micro-movements of the tear film
> Fast: Evaluation over 10 seconds
> Grant the examiner an precise score of dryness