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Edmund Tsui, Judy L Chen, Omar Leyva; Hyper-parallel optical coherence tomography imaging of herpes zoster stromal keratitis. Invest. Ophthalmol. Vis. Sci. 2021;62(11):2.
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Hyper-parallel optical coherence tomography (HP-OCT™) is a newly developed 3D spectral-domain OCT system that utilizes ultra-high speed snap-shot image acquisition (302,400 A-scans/sec). The HP-OCT also includes a micro-lens array to split the 840nm light source into 1008 individual beamlets, which are projected simultaneously onto the eye as a grid over an area of 16.8mm x 9.6mm. These unique features allow for widefield images to be captured in less than one second with minimal artifact from patient movement, and permit the user to evaluate structural OCT images of the majority of the cornea in one scan.
Serial anterior segment HP-OCT imaging was obtained in a patient with herpes zoster stromal keratitis during an acute episode, and in follow-up after treatment.
HP-OCT en face view of the cornea demonstrated numerous scattered hyperreflective lesions of the cornea corresponding to areas of stromal haze on clinical examination (Figure 1A). A single anterior segment scan visualized all involved areas of stromal keratitis (Figure 1B, 1C) and normal cornea (Figure 1D) without patient movement artifact. After a course of topical steroids and valacyclovir, repeat HP-OCT scans after two months revealed improvement in the areas of stromal haze (Figure 2).
A single HP-OCT scan of the cornea in a patient with herpes zoster stromal keratitis was able to demonstrate multiple areas of anterior stromal involvement. This facilitated objective follow-up over consecutive visits to monitor corneal findings and capture high-quality images without movement artifact. Future development of this imaging modality may allow for quantitative volumetric evaluation in the monitoring of corneal inflammatory diseases.
This is a 2021 Imaging in the Eye Conference abstract.
En face scan of patient with active herpes zoster stromal keratitis demonstrating scattered circular hyperreflective lesions in the anterior stroma (A). Colored lines and outlines correspond to locations of the B-scans, which demonstrate hyperreflective lesions in the anterior stroma corresponding to areas of stromal haze (B-C), in contrast to clear stroma in an area of unaffected normal cornea (D).
After treatment, en face imaging demonstrated improvement of hyperreflective corneal lesions (A). B-scans through previous areas of haze demonstrated decrease in anterior stromal hyperreflectivity (B-C) and normal cornea inferiorly (D).
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