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

Abstract

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.

Optical coherence tomography angiography: a review of the current literature

“…Opportunity lies in the ability to identify patients who will benefit from revascularisation therapies such as stem cell transplants. 41 …”

Optical coherence tomography angiography (OCTA): A review of the current literature

“…Although this is a new use of this technology and will need further evidence for utility, it holds potential to be incorporated into the clinical setting for the management chemical injuries. Potential opportunity lies in the ability to identify patients who would benefit from revascularisation therapies such as stem cell transplants (21).…”

Role of AS-OCT in Managing Corneal Disorders

“…The degree of ischemia present may also predict the rate of epithelial healing and these eyes can be closely monitored for the need for procedures such an amniotic membrane grafting to augment the healing process. OCTA was used for serial monitoring of the suspect areas can help confirm the presence of ischemia, as vasospasm is reversible, and the normal vasculature becomes evident on the subsequent scans [25].…”