Corneal Epithelial Thickness Measured Using Anterior Segment Optical Coherence Tomography as a Diagnostic Parameter for Limbal Stem Cell Deficiency

Liang, Qingfeng; Le, Qihua; Cordova, Daniel; Tseng, Chi‐Hong; Deng, Sophie X.

doi:10.1016/j.ajo.2020.04.006

Cited by 33 publications

(29 citation statements)

References 21 publications

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“…Previously, Karp et al utilised epithelial hyperreflectivity on OCT to diagnose cases of ocular surface squamous neoplasia [ 24 ]. Additionally, Liang et al described lower values of central corneal epithelial thickness and maximum limbal epithelial thickness on OCT as reliable parameters for confirmation of the diagnosis of LSCD [ 13 ]. However, epithelial thickness parameters depend on stage and chronicity of LSCD, hence could be useful for quantitatively staging LSCD but may not be a reliable criterion for diagnosis of LSCD.…”

Section: Discussionmentioning

confidence: 99%

“…The HR-OCT imaging of the cornea is a rapid, non-contact technique, with low operator dependence and provides instantaneous output and analysis with good histopathological correlation [ 11 , 12 ]. Previous studies have reported the usefulness of HR-OCT in cases of LSCD by assessing the limbal epithelial thickness [ 13 ], for visualising palisades [ 14 ], and quantifying the limbal stem cell niche [ 15 ]. Recently, the HR-OCT angiography (OCTA) has been used for the anterior segment for imaging corneal neovascularisation [ 16 ], limbal and peri-limbal vasculature [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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High-Resolution Optical Coherence Tomography Angiography Characteristics of Limbal Stem Cell Deficiency

et al. 2021

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This study aimed to identify the anterior segment high-resolution optical coherence tomography (HR-OCT) and HR-OCT angiography (HR-OCTA) features suggestive of limbal stem cell deficiency (LSCD) as confirmed by both impression cytology (IC) and in vivo confocal microscopy (IVCM). This was a single-centre prospective cross-sectional study including 24 eyes of 22 patients with clinical suspicion of LSCD based on peripheral superficial corneal vascularisation and scarring. On IC and IVCM, performed and interpreted by blinded observers, 12 eyes each were diagnosed with and without LSCD. Additionally, 10 eyes of 5 healthy volunteers with no ocular pathology were also imaged. The 136 HR-OCT/A images of these 34 eyes were analysed with respect to 12 imaging parameters; the parameters most suggestive of LSCD were identified and the sensitivity and specificity were calculated. In the LSCD group, the most common aetiology was ocular chemical burns (83%), whereas in the non-LSCD group, the most common aetiology was viral keratitis (67%). Multiple logistic regression analysis revealed that mean epithelial reflectivity, mean stromal reflectivity, and mean superficial vascular density were the parameters that were diagnostic of LSCD on HR-OCT/A (p < 0.0001). A ratio of the mean epithelial reflectivity to stromal reflectivity of >1.29 corresponded with a high sensitivity (91.7%) and specificity (98.75%); while a mean superficial vascular density score of >0.38 corresponded with a sensitivity of 97.9% and specificity of 73.8%. In conclusion, HR-OCT/A as a non-invasive imaging modality could prove to be a useful tool for confirming the diagnosis of LSCD, with potential clinical and research applications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High-Resolution Optical Coherence Tomography Angiography Characteristics of Limbal Stem Cell Deficiency

et al. 2021

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“…Anterior Segment Optical Coherence Tomography (AS-OCT) is another imaging technique that allows scanning in variable orientations (e.g., en face sections, cross sections, and sections parallel to the limbus), with the trade-off being lower resolution than IVCM (Banayan et al, 2018). AS-OCT is quicker, more convenient, provides for a larger field of view, and permits the diagnosis of LSCD induced epithelial thinning by measuring the corneal epithelial thickness, corneal epithelial irregularity, and structural changes in the limbus (Le et al, 2018;Liang, Le, Cordova, Tseng, & Deng, 2020;Mehtani, Agarwal, Sharma, & Chaudhary, 2017). Also, AS-OCT angiography can be used to measure neovascularization (Binotti et al, 2021).…”

Section: Diagnosis Of Lscdmentioning

confidence: 99%

Understanding cornea epithelial stem cells and stem cell deficiency: Lessons learned using vertebrate model systems

Adil

Henry

2021

Genesis

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Summary Animal models have contributed greatly to our understanding of human diseases. Here, we focus on cornea epithelial stem cell (CESC) deficiency (commonly called limbal stem cell deficiency, LSCD). Corneal development, homeostasis and wound healing are supported by specific stem cells, that include the CESCs. Damage to or loss of these cells results in blindness and other debilitating ocular conditions. Here we describe the contributions from several vertebrate models toward understanding CESCs and LSCD treatments. These include both mammalian models, as well as two aquatic models, Zebrafish and the amphibian, Xenopus. Pioneering developments have been made using stem cell transplants to restore normal vision in patients with LSCD, but questions still remain about the basic biology of CESCs, including their precise cell lineages and behavior in the cornea. We describe various cell lineage tracing studies to follow their patterns of division, and the fates of their progeny during development, homeostasis, and wound healing. In addition, we present some preliminary results using the Xenopus model system. Ultimately, a more thorough understanding of these cornea cells will advance our knowledge of stem cell biology and lead to better cornea disease therapeutics.

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“…100 A research group also used anterior segment optical coherence tomography (AS-OCT) and investigated the epithelial thickness (ET) of the central cornea and limbal regions in patients with limbal stem cell deficiency (LSCD) as a diagnostic and staging parameter. 101…”

Section: Cornea Thicknessmentioning

confidence: 99%

The progress in corneal translational medicine

et al. 2020

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Corneal Epithelial Thickness Measured Using Anterior Segment Optical Coherence Tomography as a Diagnostic Parameter for Limbal Stem Cell Deficiency

Cited by 33 publications

References 21 publications

High-Resolution Optical Coherence Tomography Angiography Characteristics of Limbal Stem Cell Deficiency

High-Resolution Optical Coherence Tomography Angiography Characteristics of Limbal Stem Cell Deficiency

Understanding cornea epithelial stem cells and stem cell deficiency: Lessons learned using vertebrate model systems

The progress in corneal translational medicine

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