Early structural changes in keratoconic eyes after corneal crosslinking detected by polarization sensitive optical coherence tomography
Abstract
OBJECTIVE/PURPOSE
To assess early structural changes in keratoconic corneas secondary to epi-off corneal crosslinking (CXL) using polarization sensitive optical coherence tomography (PS-OCT).
DESIGN
Interventional case series.
SUBJECTS
Eight eyes of 8 subjects with bilateral keratoconus were included.
METHODS
Epi-off CXL using 10 min of hydroxypropyl methylcellulose based riboflavin soaking before 10 min UV-irradiation (9 mW/cm²) was performed. Eyes were imaged using conventional Scheimpflug, anterior segment (AS-) OCT and PS-OCT imaging. PS-OCT raster scanning was performed prior to (BSL) as well as immediately after (D0), 1 week (D7), 1 month (M1) and 3 months (M3) after CXL.
MAIN OUTCOME MEASURES
Degree of polarization uniformity (DOPU) images of each visit were evaluated as indicator for structural changes. Findings were compared with corresponding AS-OCT imaging.
RESULTS
Scheimpflug and AS-OCT imaging revealed expected CXL-induced changes in corneal curvature (compared to BSL: Kmax increase at M1, p=0.01; Kmax decrease at M3, p=0.02) and the appearance of a demarcation line 1 month after CXL followed by normalization of the corneal structure. PS-OCT revealed a distinct, time-dependent pattern of polarization-maintaining backscattering in the corneal stroma secondary to CXL. At 1 week, ring-shaped polarization preservation appeared: anterior stroma DOPU 0.720±0.015, mid-stroma 0.767±0.016 (p0.05 vs D7), and 0.802±0.016 (p=0.001 vs D7), respectively, with decreasing ring…
How strong is the evidence?
Evidence Hub reads this as a case series. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 8 participants or records.
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