Abstract
To examine the use of anterior segment-optical coherence tomography angiography (AS-OCTA) in the assessment of limbal ischemia in an animal model chemical ocular injury. We conducted a prospective study using an established chemical ocular injury model in 6 rabbits (12 eyes), dividing the cornea limbus into 4 quadrants. Chemical injury grade was induced based on extent of limbal injury (0 to 360 degrees) and all eyes underwent serial slit-lamp with AS-OCTA imaging up to one month. Main outcome measure was changes in AS-OCTA vessel density (VD) comparing injured and control cornea limbal quadrants within 24 h and at one month. AS-OCTA was able to detect differences in limbal VD reduction comparing injured (3.3 ± 2.4%) and control quadrants (7.6 ± 2.3%; p < 0.001) within 24 h of ocular chemical injury. We also observed that AS-OCTA VD reduction was highly correlated with the number of quadrants injured (r = − 0.89; p < 0.001; 95% CI − 5.65 to − 1.87). Corneal vascularization was detected by AS-OCTA in injured compared to control quadrants (10.1 ± 4.3% vs 7.0 ± 1.2%; p = 0.025) at 1 month. Our animal pilot study suggests that AS-OCTA was able to detect limbal vessel disruption from various severities of acute chemical insult, and in the future, could potentially serve as an adjunct in providing objective grading of acute ocular chemical injury once validated in a clinical trial.
Highlights
To examine the use of anterior segment-optical coherence tomography angiography (AS-Optical coherence tomography angiography (OCTA)) in the assessment of limbal ischemia in an animal model chemical ocular injury
We did not find any significant difference within control quadrants (6.8 ± 2.1% vs 7.0 ± 1.2%; p = 0.99). In this pilot animal study, we observed that anterior segment-optical coherence tomography angiography (AS-OCTA) was able to detect a reduction in limbal vessel density (VD) within 24 h after acute chemical injury, and that the VD reduction significantly correlated with the extent of limbal alkali exposure
Our findings suggest that AS-OCTA may be a useful non-invasive imaging tool in acute chemical injury as it objectively detects limbal vessel disruption in such a setting and subsequent corneal vascularization at 1 month post-injury
Summary
To examine the use of anterior segment-optical coherence tomography angiography (AS-OCTA) in the assessment of limbal ischemia in an animal model chemical ocular injury. Our animal pilot study suggests that AS-OCTA was able to detect limbal vessel disruption from various severities of acute chemical insult, and in the future, could potentially serve as an adjunct in providing objective grading of acute ocular chemical injury once validated in a clinical trial. AS-OCTA may be a useful objective imaging method to identify limbal involvement from acute chemical injuries, and has been used in a pilot clinical study to suggest that it may improve prognostication and guide clinical management[22] As this was a clinical study it could not examine the correlation between the exact extent of limbal chemical injury with AS-OCTA findings, and instead used slit-lamp examination with fluorescein staining as a surrogate. We conducted an animal study using an established model of acute chemical injury to study the effect of chemical injury burns directly on the limbus using AS-OCTA imaging and examine changes in limbal vessel density over one month
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