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In Vivo Three-Dimensional Corneal Epithelium Imaging in Normal Eyes by Anterior-Segment Optical Coherence Tomography: A Clinical Reference Study

Kanellopoulos, Anastasios John MD*,†; Asimellis, George PhD*

doi: 10.1097/ICO.0b013e3182a15cee
Basic Investigation

Purpose: To evaluate the safety and efficacy of real-time measurement of corneal epithelial thickness and investigate the distribution characteristics in a large normal-eye population using a clinically available spectral-domain anterior-segment optical coherence tomography (AS OCT) system.

Methods: Corneal epithelial thickness distribution and topographic thickness variability were clinically investigated using AS OCT imaging in 373 patients with normal, healthy eyes. Descriptive statistics investigated 3 sets of subgroups, male (n = 171) and female (n = 202), younger (n = 194) and older (n = 179), right eyes (n = 195) and left eyes (n = 197).

Results: Pupil center epithelial thickness repeatability was an average 0.88 ± 0.71 μm; a similar repeatability was noted for the superior, inferior, maximum, and minimum epithelial thickness. On average, the pupil center epithelial thickness was 53.28 ± 3.34 μm, superior 51.86 ± 3.78 μm, inferior 53.81 ± 3.44 μm, minimum 48.65 ± 4.54 μm, maximum 56.35 ± 3.80 μm, and topographic variability was 1.78 ± 0.78 μm. Small differences were noted between male (average center 54.10 ± 3.34 μm) and female (52.58 ± 3.19 μm) subjects. The topographic thickness variability seems to increase with age: younger group, 1.65 ± 0.83 μm; older group, 1.93 ± 0.90 μm (P = 0.173).

Conclusions: We present a comprehensive investigation of corneal epithelial thickness distribution characteristics in a healthy, untreated human eye population by using in vivo, clinically available Fourier-domain AS OCT. The 3-dimensional epithelial maps reveal epithelial nonuniformity and provide a novel benchmark for future and comparative studies.

* Eye Institute, Athens, Greece; and

NYU Medical School, New York, NY.

Reprints: Anastasios John Kanellopoulos, Clinical Professor of Ophthalmology, NYU Medical School, New York, NY, Eye Institute, 17 Tsocha St, Athens 11521, Greece (e-mail:

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The authors have no funding or conflicts of interest to disclose.

Received April 17, 2013

Accepted June 19, 2013

© 2013 by Lippincott Williams & Wilkins.