Optical Coherence Tomography Angiography in Penetrating Keratoplasty
DOI:
https://doi.org/10.48560/rspo.28278Keywords:
Corneal Neovascularization, Fluorescein Angiography, Keratoplasty, Penetrating, Tomography, Optical CoherenceAbstract
INTRODUCTION: Penetrating keratoplasty (PK) is one of the most common surgical procedure in corneal transplantation worldwide. Graft failure and rejection risk progressively increases with the increasing number of quadrants with corneal neovascularization (CNV). Optical coherence tomography angiography (OCTA) is a noninvasive imaging technique that has been widely used to visualize vascular abnormalities in the retina and some studies have shown its potential use in the anterior segment (AS) of the eye. The purpose of this study was to investigate the potential of OCTA technology to image and describe quantitatively CNV in eyes submitted to PK.
MATERIAL AND METHODS: A cross-sectional study was performed, including 20 eyes from 18 patients submitted to PK at least 5 years before and with no history of graft rejection. All eyes underwent anterior segment slit-lamp photography (SLP) and OCTA with en face, b-scans and c-scans imaging. The vessel density (VD) was analyzed in the inferior, nasal and temporal corneal margin in all patients. The measurements were calculated after binarization with ImageJsoftware, using OCTA scans with 6 × 6 mm in a depth of 800 μm.
RESULTS: The mean age was 59 years-old and most patients were submitted to PK due to corneal leucoma, followed by keratoconus, and a few had Fuchs endothelial corneal dystrophy and bullous keratopathy. The mean total VD was 50.16% and it was higher in the temporal quadrant and lower in the inferior one. However, there were no statistically significant differences between the 3 analyzed areas (p=0.801) or between each area and the other two and there was nocorrelation between the areas. OCTA was able to identify abnormal vessels when SLP apparently showed no abnormal vessels; OCTA was able to distinguish between larger and smaller vessels; OCTA scans allowed the investigation of several corneal planes.
CONCLUSION: OCTA can become a new method for monitoring corneal diseases. It may allow the qualitative and quantitative follow-up of patients submitted to PK over time and to detect the appearance of CNV earlier than through SLP. OCTA applied to the anterior segment has promising and valuable features.
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