Assessment of the Use of Anterior Segment Optical Coherence Tomography in Microbial Keratitis

• Published in: American journal of ophthalmology 2008-10, Vol.146 (4), p.534-542.e2
• Main Authors: Konstantopoulos, Aris, Kuo, Jennifer, Anderson, David, Hossain, Parwez
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anterior Eye Segment - drug effects; Anterior Eye Segment - microbiology; Anterior Eye Segment - pathology; Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Cataracts; Cefuroxime - therapeutic use; Contact Lenses; Corneal Ulcer - diagnosis; Corneal Ulcer - drug therapy; Corneal Ulcer - microbiology; Corynebacterium - isolation & purification; Defects; Diseases of cornea, anterior segment and sclera; Drug Therapy, Combination; Endothelium; Eye Infections, Bacterial - diagnosis; Eye Infections, Bacterial - drug therapy; Eye Infections, Bacterial - microbiology; Eye surgery; Female; Humans; Longitudinal Studies; Male; Medical sciences; Middle Aged; Miscellaneous; Ofloxacin - therapeutic use; Ophthalmology; Patients; Prospective Studies; Pseudomonas aeruginosa - isolation & purification; Risk Factors; Staphylococcus aureus - isolation & purification; Tomography, Optical Coherence
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2008.05.030

Purpose To investigate the imaging capabilities of anterior segment optical coherence tomography (AS OCT) in microbial keratitis and to assess whether measurements of the quantitative parameters, infiltrate thickness and corneal thickness, were possible. Design Prospective, noncomparative, observational case series. Methods The study was conducted at a university hospital clinical setting. Seven patients (eyes) with suspected microbial keratitis underwent standard clinical examination and treatment based on slit-lamp clinical findings. AS OCT scanning was performed on presentation and at two follow-up appointments. All scans were carried out with the scanning beam passing through the center of the infiltration and at a specific meridian. Examination was carried out by the same operator. Results Corneal infiltration was imaged as a hyperreflective area in the corneal stroma on high-resolution AS OCT scans. Retrocorneal pathologic features and anterior chamber inflammatory cells could be imaged. Corneal and infiltrate thickness could be measured with calipers in six cases. In one case, corneal and infiltrate thickness could not be measured because of a thick inflammatory plaque attached to the endothelium. In this case, the width of the plaque was measured on serial scans. Conclusions AS OCT imaging provides a range of parameters that can be used to assess microbial keratitis and the treatment response objectively.