Anterior-segment optical coherence tomography– guided measurement of a melting ulcer for follow-up of corneoscleral thinning progression

Shai Cohen, Yisroel Tucker, Sharon Guttman, Ettel Bubis, Yair Rubinstein, Alon Skaat, Ifat Sher, Ygal Rotenstreich*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate the feasibility of using anterior-segment optical coherence tomography (AS-OCT) for three-dimensional assessment of corneoscleral thinning progression in ulcers after pterygium removal. Methods: A patient with corneoscleral melting after pterygium removal surgery and mitomycin C treatment was evaluated using AS-OCT imaging of the corneoscleral ulcer at five consecutive time points, up to 2 years. AS-OCT scans of 8.3×5.6 mm (15°×10°) containing 41 B-scans spaced 139 µm apart were performed monthly for 4 months and then at 2 years following pterygium removal. A single B-scan was comprised of 768 A-scans. Ten B-scans of the same position were averaged in a single AS-OCT image. The area of ulcer’s section (AUS) was measured in seven fixed landmarks through a horizontally aligned plane in order to provide an estimation of the three-dimensional size of the lesion. Results: The AUS in the two superior locations increased during the follow-up period to an average of 114% at 2 years compared to the initial visit. In the other five locations (three midline and two inferior), the AUS decreased and was on average 64% in the midline and 29% in the inferior locations at 24 months. Conclusion: AS-OCT provided a readily available assessment of the lesion’s three-dimensional size during repeated follow-ups and identification of localized areas at higher risk for perforation. This method may potentially be useful for corneal surface pathologies requiring repeated follow-ups and may aid in decision-making regarding corneal thickness based on an accurate measurement.

Original languageEnglish
Pages (from-to)335-338
Number of pages4
JournalInternational Medical Case Reports Journal
Volume12
DOIs
StatePublished - 2019

Keywords

  • Anterior segment optical coherence tomography
  • Corneoscleral melt
  • Corneoscleral thinning
  • Pterygium
  • Ulcer follow up

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