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A. Konstantopoulos, D. F. Anderson, P. N. Hossain; In-vivo Study of Human Microbial Keratitis With Anterior Segment OCT. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3690.
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Anterior Segment Optical Coherence Tomography (AS-OCT) is a novel imaging modality that provides high-resolution corneal scans by non-contact examination. We investigate microbial keratitis (MK) in a prospective longitudinal study with AS-OCT. We assess the ability of Visante AS-OCT to measure corneal thickness (CT) and infiltrate thickness (IT) in the affected area and investigate the temporal change of these parameters during the course of the disease.
Twenty seven patients with suspected microbial keratitis underwent slit-lamp examination and AS-OCT scans on day of presentation and days 3, 7 and 14 post-presentation. The scanning beam passed through the infiltrate centre at a specific meridian for all scans. Measurements of CT and IT were obtained in the centre of the infiltrated area on high-resolution images with calliper tools provided by the Visante OCT software (version 1.1.2). Scans and measurements were carried out by the same investigator.
Clinical resolution occurred in 26 cases; mean CT decreased from 898m (SD±204) on presentation to 753m (SD±161) [p<0.01], 677m (SD±178) [p<0.001] and 584m (SD±146) [p<0.001] on days 3, 7 and 14 respectively. Mean IT decreased from 394m (SD±182) to 319m (SD±162) [p=0.16], 295m (SD±135) [p=0.06] and 207m (SD±87) [p<0.001] respectively. CT and IT decreased significantly more rapidly (48m/day and 25m/day respectively) in the first 3 days of treatment compared to later time intervals, 3-7 and 7-14 days (p<0.05). In one case with clinical deterioration, CT decreased and IT increased before penetrating keratoplasty was required for perforation.
This is the first study to measure in-vivo CT and IT during the clinical course of MK. Clinical resolution is associated with a rapid reduction of CT and IT the first 3 days of treatment; CT decreases significantly by day 3, whereas IT only decreases significantly by day 14. AS-OCT provides serial objective assessment of the extent and depth of corneal inflammation.
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