Role of AS-OCT in Managing Corneal Disorders

Gupta, Nidhi; Varshney, Akhil; Ramappa, Muralidhar; Basu, Sayan; Romano, Vito; Acharya, Manisha; Gaur, Abha; Kapur, Neha; Singh, Aastha; Shah, Gaurav K.; Chaudhary, Isha; Patel, Nikunj V; Tiwari, Anil; Kate, Anahita; Sangwan, Virender S; Mathur, Umang

doi:10.3390/diagnostics12040918

Cited by 18 publications

(5 citation statements)

References 97 publications

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“…Recently, epithelial thickness has been used as a diagnostic biomarker for different conditions [ 31 , 32 ]. For example, in DED and limbal stem deficiency patients, studies have shown thinning of the epithelial thickness compared to controls [ 33 ]. Epithelial thickness measured by the AS-OCT has the potential to be a biomarker in some ocular surface conditions even if it has a promising role in the diagnosis of keratoconus [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

Biomarkers of ocular allergy and dry eye disease

2023

rjo

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The most common disorders of the ocular surface are dry eye disease (DED) and ocular allergy (OA). These conditions are frequently coexisting with or without a clinical overlap and can cause a severe impact on the patient’s quality of life. Therefore, it can sometimes be hard to distinguish between DED and OA because similar changes and manifestations may be present. Atopic patients can also develop DED, which can aggravate their manifestations. Moreover, patients with DED can develop ocular allergies, so these two pathological entities of the ocular surface can be considered as mutual conditions that share the same background. Nowadays, by using different techniques to collect tissue from ocular surfaces, the changes in molecular homeostasis can be detected and this can lead to a precise diagnosis. The article provides an up-to-date review of the various ocular surface biomarkers that have been identified in DED, OA, or both conditions. Abbreviations: DED = dry eye disease, OA = ocular allergy, SS = Sjogren syndrome, TBUT = tear break up time, TFO = tear film osmolarity, AKC = Atopic keratoconjunctivitis, ANXA1 = Annexin 1, ANXA11 = Annexin 11, CALT = Conjunctival associated lymphoid tissue, CCL2/MIP-1 = Chemokine (C-C motif) ligand2/Monocyte chemoattractant protein 1, CCL3/MIP-1α = Chemokine (C-C motif) ligand 3/Macrophage inflammatory protein 1 alpha, CCL4/MIP-1β = Chemokine (C-C motif) ligand 4/Macrophage inflammatory protein 1 beta, CCL5/RANTES = Chemokine (C-C motif) ligand 5 /Regulated on Activation, Normal T cell Expressed and Secreted, CCR2 = Chemokine (C-C motif) receptor 2, CCR5 = Chemokine (C-C motif) receptor 5, CD3+ = Cluster of differentiation 3 positive, CD4+ = Cluster of differentiation 4 positive, CD8+ = Cluster of differentiation 8 positive, CGRP = Calcitonin-gene-related peptide, CX3CL1 C-X3 = C motif -chemokine ligand 1 /Fractalkine, CXCL8 = Chemokine (C-X-C motif) ligand 8, CXCL9 = Chemokine (C-X-C motif) ligand 9, CXCL10 = Chemokine (C-X-C motif) ligand 10, CXCL11 = Chemokine (C-X-C motif) ligand 11, CXCL12 = Chemokine (C-X-C motif) ligand 12, CXCR4 = Chemokine (C-X-C motif) receptor 4, EGF = Epidermal growth factor, HLA-DR = Human leukocyte antigen-D-related, ICAM-1 = Intercellular adhesion molecule 1, IFN-γ = Interferon-gamma, IgG = Immunoglobulin G, IgE = Immunoglobulin E, IL-1 = Interleukin-1, IL-1α = Interleukin-1 alpha, IL-1β = Interleukin-1 beta, CGRP = Calcitonin-Gene-Related Peptide, IL-3 = Interleukin-3, IL-4 = Interleukin-4, IL-6 = Interleukin-6, IL-8 = Interleukin-8, IL-10 = Interleukin-10, IL-17 = Interleukin-17, IL-17A = Interleukin-17A, LPRR3 = Lacrimal proline-rich protein 3, LPRR4 = Lacrimal proline-rich protein 4, MUC5AC = Mucin 5 subtype AC, oligomeric mucus/gel-forming, MUC16 = Mucin 16, OCT = Optical coherence tomography, OGVHD = Ocular graft versus host disease, PAX6 = Paired-box protein 6, VKC = Vernal keratoconjunctivitis, TGF-β = Transforming growth factor β, S100 = proteins Calcium activated signaling proteins, Th1 = T helper 1 cell, T...

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Section: Resultsmentioning

confidence: 99%

Biomarkers of ocular allergy and dry eye disease

2023

rjo

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“…In addition, AS-OCT can provide valuable information regarding the extent and location of subtle corneal changes, which can be difficult to ascertain at the slit-lamp. 10 For instance, in Thygeson's keratitis, AS-OCT is currently an important aid in differential diagnosis, demonstrating characteristic intra-epithelial lesions, guiding its proper management, which is distinct from initially identical diseases such as infectious keratitis. Our case suggests a similar value of the AS-OCT for ocular LP which is usually diagnosed once irreversible ocular surface disease have developed, presumably due to unrecognized progression of mild ocular surface signs.…”

Section: Discussionmentioning

confidence: 99%

Isolated corneal involvement by Lichen Planus - multi-modal evaluation

Leitão¹,

Cabral

2023

European Journal of Ophthalmology

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Purpose To describe a case of ocular Lichen Planus, successfully managed using a multimodal evaulation, including Anterior Segment OCT (AS-OCT). Observations A female patient in her forties with a history of cutaneous Lichen Planus presents with blurred vision and burning eye sensation. Anterior segment evaluation revealed bilateral punctate keratitis, stromal haze and subepithelial pigmented dots. AS-OCT was pivotal for diagnosis, showing anterior stromal hyperreflective dots. A diagnosis of ocular Lichen Planus was estabilished and the patient was treated with topical hydrocortisone, with complete subsidence of the complaints. Conclusions and Importance Ocular Lichen Planus can present as isolated corneal involvement independent from severe cicatrizing conjunctivitis. Appropriate and timely treatment can prevent irreversible ocular surface disease. Ophthalmologists should be aware of Lichenoid Tissue Reaction (LTR) disorders, especially in patients with relentless blepharitis and/or ocular surface disease.

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“…It was repeated up to four times. Primary-graft failure (PGF) was defined as the failure of the pre-existing edema to resolve within 3 months of surgery, as measured with anterior segment-optical coherence tomography [ 27 ] at follow-up visits. Secondary-graft failure (SGF) was defined as the new emergence of corneal edema after 3 months.…”

Section: Methodsmentioning

confidence: 99%

Five-year clinical outcomes of 107 consecutive DMEK surgeries

Bichet,

Moskwa,

Goetz

et al. 2023

PLoS ONE

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Purpose The long-term clinical outcomes, postoperative complications, and graft survival of Descemet-membrane endothelial keratoplasty (DMEK) remain poorly understood. We retrospectively assessed these variables in all consecutive eyes that underwent DMEK for any indication in 2014–2018. The findings were compared to the long-term DMEK studies of five other groups (3–10-year follow-up). Methods Patients underwent ophthalmological tests preoperatively, at 1, 3, 6, and 12 postoperative months, and then annually. Five-year graft survival was determined by Kaplan-Meier estimator. Change in best-corrected visual acuity (BCVA), endothelial-cell density (ECD), and central-corneal thickness (CCT) at each timepoint was determined. Results 107 eyes (80 patients; 72 years old; 67% female) underwent first-time DMEK for uncomplicated Fuchs endothelial corneal dystrophy (94% of eyes), pseudophakic bullous keratopathy (3%), and regraft after previous keratoplasty (3%). The most common complication was graft detachment requiring rebubbling (18%). Thirteen grafts (12%) failed at ≤15 months. Cumulative 5-year graft-survival probability was 88% (95% confidence intervals = 79–94%). BCVA improved from 0.6 logMAR preoperatively to 0.05 logMAR at 1 year (p<0.0001) and then remained stable. Donor ECD dropped by 47% at 6 postoperative months and then continued to decrease by 4.0%/year. Five-year endothelial-cell loss was 65% (from 2550 to 900 cells/mm2). CCT dropped from 618 to 551 μm at 5 years (p<0.0001). These findings are generally consistent with previous long-term DMEK studies. Conclusions DMEK has low complication and high graft-survival rates and excellent clinical outcomes that persist up to 5 years post-surgery. DMEK seems to be a safe and effective treatment in the long term.

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Role of AS-OCT in Managing Corneal Disorders

Cited by 18 publications

References 97 publications

Biomarkers of ocular allergy and dry eye disease

Biomarkers of ocular allergy and dry eye disease

Isolated corneal involvement by Lichen Planus - multi-modal evaluation

Five-year clinical outcomes of 107 consecutive DMEK surgeries

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