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Ping Situ, Carolyn G Begley, Meredith E Jansen, Xiqiao Ding, Kathrine E Lorenz, Danielle Boree, Tawnya Wilson, Robin L Chalmers; Using Optical Coherent Tomography (OCT) imaging to track progression and resolution of corneal infiltrates- a pilot study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4637.
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To determine the feasibility of developing a new evaluation method for objective tracking of the progression and resolution of corneal infiltrates using anterior segment OCT imaging
Seven soft contact lens (SCL) wearers who presented for clinical care with active symptomatic corneal infiltrates in the Indiana University Contact Lens Clinic, 2 positive control SCL wearers with established corneal scars (but no active disease), and 2 age-matched normal control SCL wearers with no corneal opacities or active disease were enrolled in the study. The active infiltrative events were observed until resolution (approximately 6 weeks). Visits for the scar and normal control groups were scheduled 6 weeks apart. Corneal images that captured infiltrate characteristics (size and depth) were captured using drawings, slit-lamp video photos and Zeiss Visante OCT imaging at each visit. Raw image data from OCT measurements were re-processed using a custom Matlab program for analysis of infiltrate size and density. Image J was applied in a selective few subjects whose images for both measurements were quantifiable to compare the infiltrate size captured by the two imaging systems.
The amount of time from presentation to resolution of infiltrates based on clinical observation was 9.9 days (±SD 5.5, range 2-16). The infiltrate width measured using slit-lamp photos and OCT decreased with the event resolution while the scar and normal control groups showed no changes between initial and final visits. Measured infiltrate width was similar between slit lamp and OCT imaging methods (median 0.69 and 0.75 mm for slit-lamp photo and OCT respectively, Mann-Whitney U p>0.05), while the drawings based on clinician slit-lamp estimation tended to overestimate. Active infiltrates appeared in OCT images as high intensity loci with diffuse edges. As the infiltrate progressed to an inactive scar, the edges became distinct and intensity decreased by 57% of integrate density.
Results from this study suggest that both OCT and high resolution slit lamp photographs can be used to demonstrate quantifiable changes to characterize the development, progression and resolution of contact lens related corneal infiltrates. The OCT and slit-lamp photo imaging methods may provide a more precise measure than slit-lamp estimation for infiltrate documentation.
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