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Louis DEBILLON, Clemence Bonnet, Dominique Monnet, Antoine Brézin; Peripheral ulcerative keratitis analysis in anterior segment-optical cocherence tomography : a case series.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2142.
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To assess the use of Anterior Segment- Optical Coherence Tomography (AS-OCT) in the diagnosis and follow up of peripheral ulcerative keratitis (PUK).
We performed a retrospective, monocentric, non-comparative, interventional case series.Participants: Five eyes of five consecutive patients with clinical diagnosis of PUK associated with proven systemic vasculitis.Intervention: AS-OCT imaging of the PUK in acute and scar phase. Main outcome Measures: Clinical course and photographs, AS-OCT findings. Two observers reviewed all OCT pictures and measured thinnest corneal point and slope of the ulceration edge in acute and scar phase.
4 females and 1 male were included : 3 rheumatoid arthritis, 1 granulomatosis with polyangiitis and one relapsing polychondritis. AS-OCT images of all PUK showed close correlation to the clinical findings. AS-OCT provided optical signs that guided towards a more specific diagnosis and management at onset, during the follow-up and in case of recurrence. Thinnest point measurement during follow up showed a thickening of cornea after healing (646,6+/-15,2 µm vs 750 +/- 21.4 p=0.034). Slope of ulceration edge showed a flattening during follow up (40,2 +/-3.4 degrés vs 27,7 +/-2.7 p=0.045). AS-OCT of PUK scars showed epithelial full-fill in of ulceration and anterior stromal hyperreflectivity in all the eyes. In case of recurrence, AS-OCT was instrumental in guiding the diagnosis, suggesting an earlier diagnosis that the clinical one diagnosis, favored an earlier management.
Correlation between AS-OCT and clinical findings confirms that AS-OCT is an adjunctive diagnostic modality that can provide a non-invasive means to help and guide diagnosis and management of PUK.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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