Abstract
Purpose :
Cell injection therapy is an emerging treatment for bullous keratopathy (BK). Anterior segment optical coherence tomography (AS-OCT) imaging allows high resolution assessment of the anterior chamber. Our study aimed to investigate the predictive value of the visibility of cellular aggregates on corneal deturgescence in an animal model of bullous keratopathy
Methods :
Cell injection of corneal endothelial cells were performed on 45 eyes of a rabbit model of BK. AS-OCT imaging and central corneal thickness (CCT) measurement was performed at baseline, day 1, day 4, day 7 and day 14 following cell injection. A logistic regression was modelled to predict successful corneal deturgescence and failure with cell aggregate visibility and CCT. Receiver-operating characteristic (ROC) curves were plotted, and areas under the curve (AUC) calculated for each time point from these models
Results :
Cellular aggregates were identified on days 1, 4, 7 and 14 in 86.7%, 39.5%, 20.0% and 4.4% of eyes respectively. The positive predictive value of cellular aggregate visibility for successful corneal deturgescence was 71.8%, 64.7%, 66.7% and 100.0% at each time point respectively. Using logistic regression modelling, the visibility of cellular aggregates on day 1 appeared to increase the likelihood of successful corneal deturgescence, but this did not reach statistical significance. An increase in pachymetry, however, resulted in a small, but statistically significant decreased likelihood of success by an odds ratio of 0.996 for days 1 (95% CI 0.993 – 1.000), 2 (95% CI 0.993 – 0.999) and 14 (95% CI 0.994 – 0.998), and an odds ratio of 0.994 (95% CI 0.991 – 0.998) for day 7. ROC curves were plotted and AUC values were 0.72 (95% CI 0.55 – 0.89), 0.80 (95% CI 0. 62 – 0.98), 0.86 (95% CI 0.71 – 1.00) and 0.90 (95% CI 0.80 – 0.99) for days 1, 4, 7 and 14 respectively.
Conclusions :
Logistic regression modelling of cell aggregate visibility and CCT was predictive of successful corneal endothelial cell injection therapy from even day 1 postop
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.