Anterior segment optical coherence tomography imaging in peripheral ulcerative keratitis, a corneal structural description

BMC Ophthalmol. 2020 May 25;20(1):205. doi: 10.1186/s12886-020-01466-1.

Abstract

Background: Anterior segment optical coherence tomography (AS OCT) is a helpful tool used to diagnose and manage many corneal conditions, but its use has not been reported in case of peripheral ulcerative keratitis (PUK). The aim of this study is to describe AS OCT findings in cases of PUK.

Methods: Retrospective observational case series of six eyes presenting with a PUK and proven systemic vasculitis. Clinical course, slit lamp photographs, and AS OCT findings were the main outcomes.

Results: The AS OCT findings were found to correlate with the ocular disease's level of activity. In the acute stage, an absence of corneal epithelium, a scrambled appearance of the anterior stroma and a heterogeneous stromal reflectivity were observed. During the reduction of disease level activity, an irregular hyporeflective epithelium, a smoother anterior stroma, and a homogenous hyperreflective stroma were seen. At the healed stage, a filling of the corneal defect by a hyporeflective thick epithelium, the persistence of the hyperreflective underlying stroma, and a demarcation line were observed. The mean total corneal thickness at last follow-up was significantly thicker (509 ± 147 μm) compared with the mean corneal thickness at onset (408 ± 131 μm; P = 0.03).

Conclusions: AS OCT provides an assessment of structural changes occurring in PUK, useful for its diagnosis and monitoring.

Keywords: Anterior segment optical coherence tomography; Cornea; Peripheral ulcerative keratitis; Systemic vasculitis.

MeSH terms

  • Adult
  • Aged
  • Anterior Eye Segment / diagnostic imaging*
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Corneal Stroma / diagnostic imaging*
  • Corneal Stroma / pathology
  • Corneal Ulcer / diagnostic imaging*
  • Corneal Ulcer / drug therapy
  • Drug Therapy, Combination
  • Epithelium, Corneal / diagnostic imaging*
  • Epithelium, Corneal / pathology
  • Female
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Retrospective Studies
  • Slit Lamp Microscopy
  • Tomography, Optical Coherence*

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • Immunosuppressive Agents
  • Azithromycin
  • Methylprednisolone