Abstract
Purpose: :
To assess and describe the use of anterior segment optical coherence tomography (OCT) in the evaluation of corneal graft rejection through pachometric map and high resolution images, and its association with clinical evolution.
Methods: :
A prospective, descriptive, case series study was done. We included patients after penetrating keratoplasty with clinical data of rejection, during the the period of April to October 2008. Graft rejection criteria was used according to CCTS group. We performed images with OCT Visante model 1000 Karl Zeiss. We analized the following:Pachometric map and high resolution images (rainbow, grey scales and oct color). Brightness and contrast standard properties 90% and 75% vs predetermined properties 95% and 90% respectively were compared, and caliper measurement of the corneal thickness.
Results: :
We included 10 cases, 60% female, average age 51.8 years old (30-68), with the average of 24 months between surgery and presence of rejection (4-96). All cases were classified into severe according to CCTS group. The pachometric maps in all cases were irregular, however thickness values at 0-2mm of the map, 50% were similar compared with the caliper assessed in high resolution images which were in average 720µ(610-860). At the high resolution image all cases showed high reflectivity, that stand out all through the anterior corneal surface and 1/3 of corneal thickness in 80% of cases. The details of high resolution images predominated with oct color, also brightness 95% and contrast 90% than standard properties. Nowithstanding no correlation between thickness and reflectivity was seen.
Conclusions: :
OCT is a non-invasive method, to assess clinical data of graft rejection through evaluating the high reflectivity of the corneal surface and thickness. The thickness values were more reliable using caliper in high resolution image than pachometric maps.
Keywords: transplantation • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical