Anterior Segment Optical Coherence Tomography Angiography in Patients Following Cultivated Oral Mucosal Epithelial Transplantation.

Abstract

PURPOSE\nTo analyze corneal neovascularization using anterior segment optical coherence tomography angiography (AS-OCTA) in patients following cultivated oral mucosal epithelial sheet transplantation (COMET).\n\n\nDESIGN\nObservational case series.\n\n\nMETHODS\nNine eyes in 7 patients were analyzed. Four images of corneal quadrant were obtained by AS-OCTA from each patient during follow-up post-COMET in the Department of Ophthalmology at Osaka University Hospital. The depth of corneal neovascularization was evaluated using en face and B-scan images. Each quadrant image was classified as one of the following five types: stromal, predominantly stromal, epithelial, predominantly epithelial, or avascular. The image quality of slit-lamp photography and AS-OCTA was graded from 0 to 4. Manually segmented images of the epithelial and stromal vessels were obtained.\n\n\nMAIN OUTCOME MEASURES\nDepth and image quality of corneal neovascularization following COMET.\n\n\nRESULTS\nSix patients were male and 1 was female. The mean patient age was 61.3 ± 19.1 years. Thirty-six quadrant images were obtained, of which 4 (11.1%) were stromal, 16 (44.4%) were predominantly stromal, 3 (8.3%) were epithelial, 11 (30.6%) were predominantly epithelial, and 2 (5.6%) were avascular. The image quality obtained by AS-OCTA was significantly better than that obtained by slit-lamp photography (2.38±0.94 vs 2.03±0.90; P = 0.021). Segmentation images clearly demonstrated both epithelial and stromal vasculatures individually.\n\n\nCONCLUSIONS\nAS-OCTA is useful for evaluation of depth of corneal neovascularization and has the potential to distinguish between conjunctivalization and stromal neovascularization following COMET. Findings on AS-OCTA could contribute to clinical decision-making, given that retreatment is required for conjunctivalization after COMET.