June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Anterior Segment OCT Evaluation of Ocular Graft-versus-Host Disease
Author Affiliations & Notes
  • Peng Li
    Bioengineering, University of Washington, Seattle, WA
  • Yichen Sun
    Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan
    Ophthalmology, Buddhist Tzu-Chi General Hospital, Taipei Branch, New Taipei, Taiwan
  • Yoshihiro Inamoto
    Fred Hutchinson Cancer Research Center, Seattle, WA
  • Stephanie Lee
    Fred Hutchinson Cancer Research Center, Seattle, WA
  • Tueng Shen
    Bioengineering, University of Washington, Seattle, WA
    Ophthalmology, University of Washington, Seattle, WA
  • Ruikang Wang
    Bioengineering, University of Washington, Seattle, WA
    Ophthalmology, University of Washington, Seattle, WA
  • Footnotes
    Commercial Relationships Peng Li, None; Yichen Sun, None; Yoshihiro Inamoto, None; Stephanie Lee, None; Tueng Shen, None; Ruikang Wang, National Institutes of Health (F), W.H. Coulter Foundation Translational Research Partnership Program (F), Research to prevent blindness (F), Oregon Health & Science University (P), University of Washington (P)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2588. doi:
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    • Get Citation

      Peng Li, Yichen Sun, Yoshihiro Inamoto, Stephanie Lee, Tueng Shen, Ruikang Wang; Anterior Segment OCT Evaluation of Ocular Graft-versus-Host Disease. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2588.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

The aim of this pilot study is to explore the feasibility of using OCT for examining and monitoring ocular graft-versus-host disease (GVHD) and its treatment efficacy through bandage contact lens procedures.

 
Methods
 

An anterior segment OCT system was developed for imaging microstructure, blood and lymphatic vessels and their responses to the treatment of GVHD patients. OCT imaging of the anterior segment, including cornea, conjunctiva, eyelids and tear meniscus, was conducted in four patients who had ocular GVHD after allogeneic related donor stem cell transplant, together with 3 normal subjects for comparison.

 
Results
 

OCT imaged several manifestations in ocular GVHD, including abnormal meibomian gland orifice, conjunctival keratinization, conjunctival hyperemia and chemosis, corneal epithelium opacification, thinning and sloughing. OCT also visualized the changes of vasculature and lymphatic vessels in patients during the treatment of ocular GVHD.

 
Conclusions
 

This pilot study demonstrates the feasibility of using OCT for monitoring the distinct features of microstructure, vasculature and lymphatic vessels in ocular GVHD. The detailed information extracted from OCT can be potentially used to enrich the current ocular GVHD staging system and the clinical guidelines for GVHD treatment.

 
 
Fig. 1. (A) Lower eyelid from fold toward eyelashes: (A1) normal subject, MGO is visible. MG appears as a high-scattering region beneath PCE and MCJ; (A2) GVHD patient, MGO less visible. MG is inflamed and appears as low-scattering holes (thin red arrows). (B) Lower tear meniscus: (B1) normal subject, tear meniscus is clear and transparent; (B2) GVHD patient. Visible tear meniscus but turbid. (C) Cornea: (C1) normal subject, epithelium is transparent; (C2) GVHD patient, epithelium is opaque and high scattering. The corneal surface is less smooth. The less-transparent epithelium is thinning and sloughing (comparing the region indicated by bold red arrows and by thin red arrows). (D) Conjunctiva of GVHD patient: (D1) OCT along the dashed lines in row (D2). Thin arrows indicate the chemosis. (D2) Depth-encoded view of lymphatic vessels (LyV, superficial layer) and chemosis (Chem, deep layer), segmented from the 3D OCT images. (D3) Depth-encoded view of conjunctiva vasculature.
 
Fig. 1. (A) Lower eyelid from fold toward eyelashes: (A1) normal subject, MGO is visible. MG appears as a high-scattering region beneath PCE and MCJ; (A2) GVHD patient, MGO less visible. MG is inflamed and appears as low-scattering holes (thin red arrows). (B) Lower tear meniscus: (B1) normal subject, tear meniscus is clear and transparent; (B2) GVHD patient. Visible tear meniscus but turbid. (C) Cornea: (C1) normal subject, epithelium is transparent; (C2) GVHD patient, epithelium is opaque and high scattering. The corneal surface is less smooth. The less-transparent epithelium is thinning and sloughing (comparing the region indicated by bold red arrows and by thin red arrows). (D) Conjunctiva of GVHD patient: (D1) OCT along the dashed lines in row (D2). Thin arrows indicate the chemosis. (D2) Depth-encoded view of lymphatic vessels (LyV, superficial layer) and chemosis (Chem, deep layer), segmented from the 3D OCT images. (D3) Depth-encoded view of conjunctiva vasculature.
 
Keywords: 421 anterior segment • 557 inflammation • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)  
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