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

Clemence Bonnet,Saba Al-Hashimi,Antoine Brézin,Florence Hoogewoud,Louis Debillon,Jean-Louis Bourges,Dominique Monnet

doi:10.1186/s12886-020-01466-1

Clemence Bonnet, Saba Al-Hashimi + Show 5 more

Open Access

https://doi.org/10.1186/s12886-020-01466-1

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Abstract

BackgroundAnterior 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.MethodsRetrospective 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.ResultsThe 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).ConclusionsAS OCT provides an assessment of structural changes occurring in PUK, useful for its diagnosis and monitoring.

Highlights

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)
Peripheral ulcerative keratitis (PUK) is a rare form of corneal inflammation leading to corneal ulceration and stromal destruction
The purpose of this study is to describe the AS OCT cornea features during active stage of PUK and to evaluate its contribution for its diagnosis and follow-up

Summary

Introduction

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. Peripheral ulcerative keratitis (PUK) is a rare form of corneal inflammation leading to corneal ulceration and stromal destruction. The most critical ophthalmic complication is corneal perforation which can occur quickly once the inflammation begins [2, 3]. Systemic glucocorticoids have been the basis of therapy for noninfectious PUK and additional immunosuppressive agents are usually used to prevent perforation and allow for a transition to a steroid sparing agent.

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