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

Varma, Shobhit; Shanbhag, Swapna S; Donthineni, Pragnya Rao; Mishra, Dilip Kumar; Singh, Vivek; Basu, Sayan

doi:10.3390/diagnostics11061130

Cited by 14 publications

(9 citation statements)

References 26 publications

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“…Disposable sterile plastic caps were used to lubricate and improve optical connections (Tomo-Cap, Heidelberg Engineering, Heidelberg, Heidelberg, Texas, USA). 10 …”

Section: Methodsmentioning

confidence: 99%

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Epidemiological features and management of eye burn patients in Wuxi, China

Chu

Yang

et al. 2023

BMJ Open Ophth

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BackgroundThe current study aimed to analyse epidemiological data on eye burns in Wuxi, China, for the years 2015–2021, and to provide insight into the development of appropriate prevention strategies.MethodsA retrospective study was conducted on 151 hospitalised patients with eye burns. Data collected included gender, age, the monthly distribution of incidence, cause of eye burn, the site of eye burn, the type of surgery, visual outcome, the length of hospital stay and the cost of hospital admission. Statistical analysis was performed using SPSS V.19.0 and Graph Pad Prism V.9.0.ResultsIn a total of 151 eye burn patients, 130 were males (86.09%) and 21 were females (13.91%). The proportion of patients classified as grade III was the greatest (46.36%). The average age of our hospitalised patients with eye burns was 43.72 years and the average length of hospital stay was 17 days. The number of injuries was highest in September (14.6%). Among eye burn patients, workers and farmers became the most common occupations (62.91%, 12.58%). The most frequent cause of burns was alkali burns (19.21%), followed by acid burns (16.56%). When admitted to the hospital, patients’ average vision was 0.06, and 49% of them had a poor vision (<0.3, ≥0.05).ConclusionWith an investigation of 7-year hospitalisation data, the current study provided a fundamental reference for epidemiological features and management of eye burns in Wuxi, China, which could contribute to the development of treatment and prevention strategies.

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“…Disposable sterile plastic caps were used to lubricate and improve optical connections (Tomo-Cap, Heidelberg Engineering, Heidelberg, Heidelberg, Texas, USA). 10 …”

Section: Methodsmentioning

confidence: 99%

“…Each subject was given 0.5% procaine eye drops as a topical anaesthetic prior to the examination. Disposable sterile plastic caps were used to lubricate and improve optical connections (Tomo-Cap, Heidelberg Engineering, Heidelberg, Heidelberg, Texas, USA) 10…”

Section: Methodsmentioning

confidence: 99%

Epidemiological features and management of eye burn patients in Wuxi, China

Chu

Yang

et al. 2023

BMJ Open Ophth

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“…The use of the angiography feature of the OCT has been explored in quantifying the changes seen in the limbal vasculature as well as in corneal neovascularization ( Figure 4 ) ( 46 , 47 ). A progressive increase in the density of vascularization and its extent into the cornea has been reported with increasing severity of LSCD ( 48 ).…”

Section: Diagnostic Investigationsmentioning

confidence: 99%

A Review of the Diagnosis and Treatment of Limbal Stem Cell Deficiency

Kate

Basu

2022

Front. Med.

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Limbal stem cell deficiency (LSCD) can cause significant corneal vascularization and scarring and often results in serious visual morbidity. An early and accurate diagnosis can help prevent the same with a timely and appropriate intervention. This review aims to provide an understanding of the different diagnostic tools and presents an algorithmic approach to the management based on a comprehensive clinical examination. Although the diagnosis of LSCD usually relies on the clinical findings, they can be subjective and non-specific. In such cases, using an investigative modality offers an objective method of confirming the diagnosis. Several diagnostic tools have been described in literature, each having its own advantages and limitations. Impression cytology and in vivo confocal microscopy (IVCM) aid in the diagnosis of LSCD by detecting the presence of goblet cells. With immunohistochemistry, impression cytology can help in confirming the corneal or conjunctival source of epithelium. Both IVCM and anterior segment optical coherence tomography can help supplement the diagnosis of LSCD by characterizing the corneal and limbal epithelial changes. Once the diagnosis is established, one of various surgical techniques can be adopted for the treatment of LSCD. These surgeries aim to provide a new source of corneal epithelial stem cells and help in restoring the stability of the ocular surface. The choice of procedure depends on several factors including the involvement of the ocular adnexa, presence of systemic co-morbidities, status of the fellow eye and the comfort level of the surgeon. In LSCD with wet ocular surfaces, autologous and allogeneic limbal stem cell transplantation is preferred in unilateral and bilateral cases, respectively. Another approach in bilateral LSCD with wet ocular surfaces is the use of an autologous stem cell source of a different epithelial lineage, like oral or nasal mucosa. In eyes with bilateral LSCD with significant adnexal issues, a keratoprosthesis is the only viable option. This review provides an overview on the diagnosis and treatment of LSCD, which will help the clinician choose the best option amongst all the therapeutic modalities currently available and gives a clinical perspective on customizing the treatment for each individual case.

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“…A manual inspection is usually required to detect and remove artifacts. Automated reduction of noise is also feasible through the software mentioned above by the thresholding of a signal greater than a pre-defined value [6,20,39]. This image is subsequently binarized by the software wherein the vessel is assigned one color and the background another.…”

Section: Quantitative Assessment Of Limbal Vasculaturementioning

confidence: 99%

Role of Anterior Segment-Optical Coherence Tomography Angiography in Acute Ocular Burns

Kate

Basu

2022

Diagnostics

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Acute ocular burns have varied manifestations which require prompt diagnosis and management to prevent chronic sequelae. Of these, the detection of limbal ischemia poses a challenge because of the subjective nature of its clinical signs. Anterior segment optical coherence tomography angiography (AS-OCTA) offers an objective method of assessing ischemia in these eyes. This review provides an overview of the technology of AS-OCTA and its applications in acute burns. AS-OCTA generates images by isolating the movement of erythrocytes within blood vessels from sequentially obtained b-scans. Limbal ischemia manifests in these scans as absent vasculature and the extent of ischemia can be quantified using different vessel-related parameters. Of these, the density of vessels is most commonly used and correlates with the severity of the injury. Incorporation of the degree of ischemia in the classification of acute burns has been attempted in animal studies and its extension to human trials may provide an added dimension in determining the final prognosis of these eyes. Thus, AS-OCTA is a promising device that can objectively evaluate limbal ischemia. This will facilitate the identification of patients who will benefit from revascularization therapies and stem cell transplants in acute and chronic ocular burns, respectively.

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

Cited by 14 publications

References 26 publications

Epidemiological features and management of eye burn patients in Wuxi, China

Epidemiological features and management of eye burn patients in Wuxi, China

A Review of the Diagnosis and Treatment of Limbal Stem Cell Deficiency

Role of Anterior Segment-Optical Coherence Tomography Angiography in Acute Ocular Burns

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