Monitoring therapy in anterior necrotizing scleritis with inflammation with anterior segment optical coherence tomography

2021 ◽  
pp. 112067212110655
Author(s):  
Lourdes Vidal Oliver ◽  
Ana López Montero ◽  
Irene Gil Hernández ◽  
Francisca García Ibor ◽  
Sara Vela Bernal ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Early Diagnosis ◽  
Surgical Intervention ◽  
Anterior Segment ◽  
Clinical Signs ◽  
Objective Evaluation ◽  
Optical Coherence ◽  
Necrotizing Scleritis ◽  
Monitoring Therapy ◽  
Oral Corticosteroids

Introduction Early diagnosis and initiation of immunosuppression can prevent the necessity of surgical intervention in necrotizing scleritis with inflammation and lowers the risk of perforation and loss of vision. However, clinical signs for early diagnosis and methods for monitoring response to immunosuppressive therapy are missing. Methods Here, we present a case of necrotizing scleritis with inflammation where avascular plaques precede scleral defects. We use slit lamp imaging and anterior segment optical coherence tomography to evaluate evolution lesions depth and impact on scleral structure. Results The patient presented 5 months after detection of avascular plaques with a new scleral ulcer of the left eye. After 3-day-administration of i.v. corticosteroids anterior segment optical coherence tomography showed progressive scleral thickening. The patient was therefore spared surgical intervention and discharged resulting in complete remission under decreasing doses of oral corticosteroids. Conclusions Avascular plaques can precede necrotizing scleritis with inflammation by several months and may therefore qualify as early clinical signs. Anterior segment optical coherence tomography enables objective evaluation of scleral structure for making rational decisions about surgical intervention.

scholarly journals Role of anterior segment optical coherence tomography in the evaluation of microbial keratitis

2021 ◽  
Vol 7 (3) ◽  
pp. 548-553
Author(s):  
Isha Chaturvedi ◽  
Kamaljeet Singh ◽  
Jagriti Rana ◽  
Kshama Dwivedi ◽  
Reena Sachan
Keyword(s):  
Optical Coherence Tomography ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Morphological Characteristics ◽  
Objective Evaluation ◽  
Response To Treatment ◽  
Optical Coherence ◽  
Microbial Keratitis ◽  
The Mean

Anterior segment optical coherence tomography (AS-OCT) is a newer technology that provides two-dimensional images of corneal infiltration. This study was undertaken to assess whether AS-OCT can aid objective evaluation and response to treatment in resolving microbial keratitis. This prospective study was performed on 17 patients of who underwent slit lamp and AS-OCT examination at presentation and follow up on days 3, 7, 14, 28 and 6 weeks. A standardized scanning protocol was used to measure the corneal thickness (CT) and infiltrate thickness (IT) using the caliper tool of a commercially available AS-OCT device. The mean CT in the infiltrated area and mean IT, both were thickest at presentation (710.88 um and 288.76 um respectively). The mean CT decreased to 665.12 µm, 650.24 µm, 584.35 µm, 549 µm, 507.47 µm on days 3, 7, 14, 28 and 6 weeks respectively. Similarly, the mean IT decreased to 287.24 µm, 244.41 µm, 197 µm, 174.59 µm and 154.82 µm. Paired t- test was used to calculate the statistical change in CT and IT, which was significant (p<0.0001) at 6 weeks, at the rate of 0.67% and 1.01% per day. AS-OCT can show morphological characteristics of microbial keratitis and give quantitative assessment at every follow up.

scholarly journals Longitudinal changes in complete avascular area assessed using anterior segmental optical coherence tomography angiography in filtering trabeculectomy bleb

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ai Kido ◽  
Tadamichi Akagi ◽  
Hanako Ohashi Ikeda ◽  
Takanori Kameda ◽  
Kenji Suda ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Anterior Segment ◽  
Objective Evaluation ◽  
Optical Coherence ◽  
Avascular Area ◽  
Longitudinal Changes ◽  
Surgical Success ◽  
A New Technique ◽  
Over Time

AbstractOptical coherence tomography angiography (OCTA) is a new technique for non-invasive imaging of blood vessels, allowing combined evaluation of both deep and surface vessels. The purpose of this study was to evaluate the post-trabeculectomy longitudinal changes in complete avascular area (CAA) of filtering blebs using anterior segment (AS-) OCTA and their association with surgical outcomes. This study included 57 eyes of 53 patients who had undergone trabeculectomy with mitomycin C. AS-OCTA images of filtering bleb were acquired at 3 and 6 months after trabeculectomy, and at 1 month in possible cases. CAAs, regions where complete blood flow was not depicted in AS-OCTA images, were evaluated for their presence, extent, and change over time. CAAs were detected in 37 eyes (65%) and 33 eyes (58%) at 3 and 6 months postoperatively, respectively. The extent of CAAs reduced over time after surgery in most cases. No parameters related to CAAs were significantly associated with surgical success (i.e., intraocular pressure (IOP) ≤ 12 mmHg and IOP reduction > 20% without medication). In conclusion, although it is difficult to predict surgical success by CAA itself, AS-OCTA may be useful for the objective evaluation of the vascularity of filtering blebs.

Pediatric Free-floating Anterior Chamber Cyst of the Iris Pigment Epithelium

2018 ◽  
Vol 1 ◽  
pp. 3
Author(s):  
Joshua S Agranat ◽  
Yoshihiro Yonekawa
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Incidental Finding ◽  
Pigment Epithelium ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Optical Coherence ◽  
Visual Axis ◽  
Associated Malignancy ◽  
Anatomic Locations

Iris pigment epithelial (IPE) cysts are a subset of iris cysts that arise from the IPE. They are spontaneously erupting epithelial-lined cavities that are found in various anatomic locations of the iris, including the iris pupillary margin, midzone, periphery, and free floating in the vitreous or anterior chamber. We report the case of an asymptomatic 13-year-old boy with an incidental finding of a dislodged anterior chamber cyst diagnosed on routine examination. Modern multimodal image analysis of the cyst including anterior segment optical coherence tomography and ultrasound biomicroscopy (UBM) was utilized to characterize the microstructural anatomy of the lesion. The patient was managed conservatively without complications. Cysts of the IPE typically do not affect vision or ocular health and can be monitored and observed after ascertaining no associated malignancy. Initial diagnostic investigation can include UBM and anterior segment optical coherence tomography. Intervention should be reserved only for cases where the cyst growth leads to obstruction of the visual axis and/or other secondary complications.

Evaluation of Intraocular Lens Tilt With Anterior Segment Optical Coherence Tomography

2011 ◽  
Vol 151 (3) ◽  
pp. 406-412.e2 ◽  
Author(s):  
Dhivya Ashok Kumar ◽  
Amar Agarwal ◽  
Gaurav Prakash ◽  
Soosan Jacob ◽  
Yoga Saravanan ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Lens ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Intraocular Lens Tilt

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

scholarly journals Non-malignant conjunctival epithelial masses with ocular surface squamous neoplasia-like optical coherence tomography features

2021 ◽  
Author(s):  
Ágnes Füst ◽  
Jeannette Tóth ◽  
László Imre ◽  
Zoltán Zsolt Nagy
Keyword(s):  
Optical Coherence Tomography ◽  
Ocular Surface ◽  
Anterior Segment ◽  
Histological Diagnosis ◽  
Optical Coherence ◽  
Ocular Surface Squamous Neoplasia ◽  
Ocular Coherence Tomography ◽  
Maximal Thickness ◽  
Epithelial Lesions ◽  
Mass Lesions

Abstract Purpose To observe and describe the anterior segment optical coherence tomography features of limbally localised non-malignant epithelial mass lesions Methods Thirteen patients (age: 66.9 ± 16.3 years) with conjunctival mass suggesting ocular surface squamous neoplasia with biomicroscopic examination were imaged using anterior segment ocular coherence tomography (anterior segment optical coherence tomography)/Cirrus HD-OCT, Model 4000, Carl Zeiss Meditec, Inc., Dublin, CA, and Spectralis HRA + OCT system, Heidelberg Engineering, Vista, CA/. Cases with ocular surface squamous neoplasia-like anterior segment optical coherence tomography (hyperreflective, thickened epithelium and an abrupt transition from normal to abnormal) were included in the study. Maximal thickness of the epithelium was measured. Histological diagnosis was gained from an excisional or incisional biopsy or impression cytology specimens. Results In six patients (age: 68.5 ± 15.4 years) with ocular surface squamous neoplasia-like anterior segment optical coherence tomography features, the histological diagnosis was other than ocular surface squamous neoplasia (papilloma, parakeratosis and a keratotic plaque with mild dysplasia), and ocular surface squamous neoplasia in seven cases (age: 65.6 ± 18.0 years). The maximal epithelial thickness was between 250 and 859 µm in non-ocular surface squamous neoplasia cases and between 252 and 596 µm in ocular surface squamous neoplasia cases. Conclusion Non-malignant epithelial lesions can mimic ocular surface squamous neoplasia on anterior segment optical coherence tomography.

scholarly journals Diagnosing Paraproteinemic Keratopathy: A Case Report

2021 ◽  
pp. 337-343
Author(s):  
Eugenie Mok ◽  
Ka Wai Kam ◽  
Anthony J. Aldave ◽  
Alvin L. Young
Keyword(s):  
Optical Coherence Tomography ◽  
Genetic Testing ◽  
Serum Protein ◽  
Molecular Genetic ◽  
Anterior Segment ◽  
Protein Electrophoresis ◽  
Serum Protein Electrophoresis ◽  
Optical Coherence ◽  
Molecular Genetic Testing ◽  
Corneal Opacities

A 65-year-old man presented with bilateral, painless, progressive blurring of vision over 9 years. Slit-lamp examination revealed bilateral subepithelial corneal opacities in clusters located at the mid-periphery. Anterior segment optical coherence tomography, in vivo confocal microscopy (IVCM), serum protein electrophoresis, and molecular genetic testing were performed to evaluate the cause of corneal opacities. Anterior segment optical coherence tomography revealed a band-like, hyperreflective lesion in the Bowman layer and anterior stroma of both corneas. IVCM revealed hyperreflective deposits in the epithelium, anterior stroma, and endothelium. Serum protein electrophoresis identified the presence of paraproteins (immunoglobulin kappa), and molecular genetic testing revealed absence of mutations in the transforming growth factor beta-induced gene (<i>TGFBI</i>) and collagen type XVII alpha 1 gene (<i>COL17A1</i>). The ocular diagnosis of paraproteinemic keratopathy eventually led to a systemic diagnosis of monoclonal gammopathy of undetermined significance by our hematologist/oncologist. Paraproteinemic keratopathy is a rare differential diagnosis in patients with bilateral corneal opacities and therefore may be misdiagnosed as corneal dystrophy or neglected as scars. In patients with bilateral corneal opacities of unknown cause, serological examination, adjunct anterior segment imaging, and molecular genetic testing play a role in establishing the diagnosis.

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