Anterior Segment OCT-Based Diagnosis and Management of Descemet’s Membrane Detachment

Abstract

Aims: To evaluate anterior segment optical coherence tomography (AS-OCT) in the diagnosis and treatment of Descemet’s membrane detachment (DMD) with severe corneal edema. Methods: Nine eyes of 7 consecutive patients with suspected DMD with severe corneal edema due to different causes were imaged with the AS-OCT system. Configuration of Descemet’s membrane (DM) was delineated before and after treatment, and quantitative analysis was performed. An appropriate treatment was chosen based on the imaging findings. Results: DMD was demonstrated as being present in all eyes via AS-OCT. Different statuses of the DM including planar/nonplanar detachment, local/extensive detachment, and rupture was documented using AS-OCT images. Two eyes were treated with conservative therapy, 6 eyes with intracameral air/gas tamponade and 1 eye with penetrating keratoplasty. One of the air tamponade treatments failed and all the other treatments were successful. Conclusion: AS-OCT is a valuable tool in the diagnosis of DMD both in terms of selecting the appropriate treatment, and monitoring treatment outcomes when corneal edema is present.