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Wen Y, Chen Z, McAlinden C, Zhou X, Huang J. Recent advances in corneal neovascularization imaging. Exp Eye Res 2024; 244:109930. [PMID: 38750782 DOI: 10.1016/j.exer.2024.109930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/25/2024] [Accepted: 05/12/2024] [Indexed: 05/19/2024]
Abstract
Corneal neovascularization (CoNV) is a vision-threatening ocular disease commonly secondary to infectious, inflammatory, and traumatic etiologies. Slit lamp photography, in vivo confocal microscopy, angiography, and optical coherence tomography angiography (OCTA) are the primary diagnostic tools utilized in clinical practice to evaluate the vasculature of the ocular surface. However, there is currently a dearth of comprehensive literature that reviews the advancements in imaging technology for CoNV administration. Initially designed for retinal vascular imaging, OCTA has now been expanded to the anterior segment and has shown promising potential for imaging the conjunctiva, cornea, and iris. This expansion allows for the quantitative monitoring of the structural and functional changes associated with CoNV. In this review, we emphasize the impact of algorithm optimization in anterior segment-optical coherence tomography angiography (AS-OCTA) on the diagnostic efficacy of CoNV. Through the analysis of existing literature, animal model assessments are further reported to investigate its pathological mechanism and exhibit remarkable therapeutic interventions. In conclusion, AS-OCTA holds broad prospects and extensive potential for clinical diagnostics and research applications in CoNV.
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Affiliation(s)
- Yinuo Wen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key laboratory of Myopia and Related Eye Diseases, NHC; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Zhongxing Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key laboratory of Myopia and Related Eye Diseases, NHC; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Colm McAlinden
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key laboratory of Myopia and Related Eye Diseases, NHC; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Corneo Plastic Unit & Eye Bank, Queen Victoria Hospital, East Grinstead, UK
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key laboratory of Myopia and Related Eye Diseases, NHC; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jinhai Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key laboratory of Myopia and Related Eye Diseases, NHC; Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
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Wen Y, Jiang D, Tang K, Chen W. Current clinical applications of anterior segment optical coherence tomography angiography: a review. Graefes Arch Clin Exp Ophthalmol 2023; 261:2729-2741. [PMID: 36862203 DOI: 10.1007/s00417-023-05997-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 03/03/2023] Open
Abstract
Optical coherence tomography (OCT) is a revolutionary in vivo imaging technology that presents real-time information on ocular structures. Angiography based on OCT, known as optical coherence tomography angiography (OCTA), is a noninvasive and time-saving technique originally utilized for visualizing retinal vasculature. As devices and built-in systems have evolved, high-resolution images with depth-resolved analysis have assisted ophthalmologists in accurately localizing pathology and monitoring disease progression. With the aforementioned advantages, application of OCTA has extended from the posterior to anterior segment. This nascent adaptation showed good delineation of the vasculature in the cornea, conjunctiva, sclera, and iris. Thus, neovascularization of the avascular cornea and hyperemia or ischemic changes involving the conjunctiva, sclera, and iris has become prospective applications for AS-OCTA. Although traditional dye-based angiography is regarded as the gold standard in demonstrating vasculature in the anterior segment, AS-OCTA is expected to be a comparable but more patient-friendly alternative. In its initial stage, AS-OCTA has exhibited great potential in pathology diagnosis, therapeutic evaluation, presurgical planning, and prognosis assessments in anterior segment disorders. In this review of AS-OCTA, we aim to summarize scanning protocols, relevant parameters, and clinical applications as well as limitations and future directions. We are sanguine about its wide application in the future with the development of technology and refinement in built-in systems.
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Affiliation(s)
- Yajing Wen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Dan Jiang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kexin Tang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Wei Chen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Malyugin BE, Isabekov RS, Kalinnikova SY, Antonova OP. [Methods of diagnosis and treatment of corneal neovascularization]. Vestn Oftalmol 2023; 139:86-92. [PMID: 37638577 DOI: 10.17116/oftalma202313904186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Corneal neovascularization is one of the most common causes of decreased visual acuity and disability for vision loss, increase in the risk of corneal graft rejection, and appearance of opacifications on the cornea. This article reviews literature on etiological factors of the development of corneal neovascularization, as well as modern methods of diagnosis, conservative and surgical treatment of this pathology.
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Affiliation(s)
- B E Malyugin
- S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Moscow, Russia
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - R S Isabekov
- S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Moscow, Russia
| | - S Yu Kalinnikova
- S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Moscow, Russia
| | - O P Antonova
- S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", Moscow, Russia
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Xu H, Sapienza JS, Jin Y, Lin J, Zheng X, Dong H, Diao H, Zhao Y, Gao J, Tang J, Feng X, Micceri D, Zeng H, Lin D. Lamellar Keratoplasty Using Acellular Bioengineering Cornea (BioCorneaVetTM) for the Treatment of Feline Corneal Sequestrum: A Retrospective Study of 62 Eyes (2018–2021). Animals (Basel) 2022; 12:ani12081016. [PMID: 35454262 PMCID: PMC9026742 DOI: 10.3390/ani12081016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/03/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Corneal sequestrum is a specific and common corneal disease in cats. Surgery treatment is the recommended option. Acellular bioengineering cornea (ABC) is a popular and effective corneal transplantation material. However, no study has been published to evaluate the effectiveness and outcome of ABC lamellar transplantation for the treatment of feline corneal sequestrum (FCS). The purpose of this retrospective study was to evaluate the surgical effect of ABC lamellar transplantation in the treatment of FCS. All cats were diagnosed with FCS. All eyes received ABC lamellar transplantation for the first time, including 61 cats (62 eyes), aged 6–120 months. The average sequestrum size was 7.98 mm, with a medium of 7.75 mm (range, 4.75–11.75 mm), and the sequestrum thickness included 200 microns for 1 eye (1.61%), 300 microns for 28 eyes (45.16%), 400 microns for 29 eyes (46.77%), and 450 microns for 4 eyes (6.45%). All eyes retained vision after surgical treatment, and there was no recurrence during the follow-up period. This study has several limitations, including incomplete unification and standardization of data collection, some vacancies of follow-up time, inconsistency between then optical coherence tomography(OCT) examination and postoperative photo collection. Despite several limitations, our results show that ABC is easy to obtain and store, and has the choice of different sizes and thicknesses to achieve rapid corneal healing, and satisfactory visual and cosmetic effects in FCS treatment. Acellular bioengineering cornea can be a good alternative for the treatment of FCS. Abstract To retrospectively evaluate the effectiveness and outcome of lamellar keratoplasty using acellular bioengineering cornea (BioCorneaVetTM) for the treatment of feline corneal sequestrum (FCS). The medical records of cats diagnosed with FCS that underwent lamellar keratoplasty with BioCorneaVetTM between 2018 and 2021 with a minimum of 3 months of follow-up were reviewed. Follow-up examinations were performed weekly for 3 months, and then optical coherence tomography (OCT) examination was performed on select patients at 0, 3, 6, and 12 months post-operatively. A total of 61 cats (30 left eyes and 32 right eyes) were included. The Persian breed was overrepresented, 48/61 (78.69%). Four different thicknesses of acellular bioengineering cornea were used (200, 300, 400, or 450 microns), and the mean graft size was 8.23 mm (range, 5.00–12.00 mm). Minor complications were composed of partial dehiscence, and protrusion of the graft occurred in 7/62 eyes (11.29%). The median postoperative follow-up was 12.00 months (range, 3–41 months). A good visual outcome was achieved in 60/62 eyes (96.77%), and a mild to moderate corneal opacification occurred in 2/62 (3.23%). No recurrence of corneal sequestrum was observed. From the results, lamellar keratoplasty using acellular bioengineering cornea (BioCorneaVetTM) is an effective treatment for FCS, providing a good tectonic support and natural collagen framework, and resulting in satisfactory visual and cosmetic effects.
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Affiliation(s)
- Huihao Xu
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - John S. Sapienza
- Long Island Veterinary Specialists, Plainview, NY 11803, USA; (J.S.S.); (D.M.)
| | - Yipeng Jin
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Jiahao Lin
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Xiaobo Zheng
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - Haodi Dong
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Hongxiu Diao
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Ying Zhao
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Jiafeng Gao
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Jing Tang
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - Xueqian Feng
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - Danielle Micceri
- Long Island Veterinary Specialists, Plainview, NY 11803, USA; (J.S.S.); (D.M.)
| | - Haoran Zeng
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - Degui Lin
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
- Correspondence:
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Almeida I, Dias L, Jesus J, Fonseca I, Matias MJ, Pedro JC. Optical coherence tomography angiography in herpetic leucoma. BMC Med Imaging 2022; 22:17. [PMID: 35114961 PMCID: PMC8812036 DOI: 10.1186/s12880-022-00747-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Herpes simplex virus (HSV) keratitis remains a leading infectious cause of blindness worldwide. Although all forms of HSV keratitis are commonly recurrent, the risk is greatest in stromal keratitis, which is the most likely to result in corneal scarring, thinning, and neovascularization. Recent studies showed the ability of Optical Coherence Tomography Angiography (OCTA) to detect and study vascular abnormalities in the anterior segment, including abnormal corneal vessels. This study intends to investigate the potential of OCTA device to image and describe quantitatively the vascularization in eyes diagnosed with herpetic leucoma and to discuss and review the usefulness of this technique in this pathology. METHODS A Cross-sectional study was made, including 17 eyes of 15 patients with leucoma secondary to herpetic keratitis. All eyes underwent anterior segment Slit-Lamp photography (SLP), and OCTA with en-face, b-scans and c-scans imaging. The vessel density (VD) was analyzed in the inferior, nasal and temporal corneal margin in all patients, and in the central area, in eyes with central corneal neovascularization (CoNV). The measurements were calculated after binarization with ImageJ software, using OCTA scans with 6 × 6 mm in a depth of 800 μm. RESULTS Patients included had a mean age 53.267 ± 21.542 (years ± SD). The mean total vessel area was 50.907% ± 3.435%. VD was higher in the nasal quadrant (51.156% ± 4.276%) but there were no significant differences between the three analyzed areas (p = 0.940). OCTA was able to identify abnormal vessels when SLP apparently showed no abnormal vessels; OCTA was able to distinguish between larger and smaller vessels even in central cornea; OCTA scans allowed the investigation of several corneal planes and the relation of them with clinical findings. CONCLUSIONS OCTA can be useful in both qualitative and quantitative follow-up of patients and may become a non-invasive alternative to objectively monitor treatment response in eyes with corneal vascularization due to herpetic infection.
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Affiliation(s)
- Inês Almeida
- Department of Ophthalmology, Centro Hospitalar Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal.
| | - Libânia Dias
- Department of Ophthalmology, Centro Hospitalar Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal.,Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Jeniffer Jesus
- Department of Ophthalmology, Centro Hospitalar Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal
| | - Inês Fonseca
- Department of Orthoptics, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Maria João Matias
- Department of Ophthalmology, Centro Hospitalar Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal
| | - João Carlos Pedro
- Department of Ophthalmology, Centro Hospitalar Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal
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Romano V, Steger B, Ahmad M, Coco G, Pagano L, Ahmad S, Zhao Y, Zheng Y, Kaye SB. Imaging of vascular abnormalities in ocular surface disease. Surv Ophthalmol 2021; 67:31-51. [PMID: 33992663 DOI: 10.1016/j.survophthal.2021.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/25/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022]
Abstract
The vascular system of the ocular surface plays a central role in infectious, autoimmune, inflammatory, traumatic and neoplastic diseases. The development, application, and monitoring of treatments for vascular abnormalities depends on the in vivo analysis of the ocular surface vasculature. Until recently, ocular surface vascular imaging was confined to biomicroscopic and color photographic assessment, both limited by poor reproducibility and the inability to image lymphatic vasculature in vivo. The evolvement and clinical implementation of innovative imaging modalities including confocal microscopy, intravenous, and optical coherence tomography-based angiography now allows standardized quantitative and functional vascular assessment with potential applicability to automated analysis algorithms and diagnostics.
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Affiliation(s)
- Vito Romano
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK; Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
| | - Bernhard Steger
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Mohammad Ahmad
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK
| | - Giulia Coco
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK; Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Luca Pagano
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK; Humanitas Clinical and Research, Rozzano (Mi) Italy
| | | | - Yitian Zhao
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Yalin Zheng
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Stephen B Kaye
- Corneal and External Eye Disease Service, The Royal Liverpool University Hospital, Liverpool, UK; Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Application of Corneal Optical Coherence Tomography Angiography for Assessment of Vessel Depth in Corneal Neovascularization. Cornea 2021; 39:598-604. [PMID: 31868851 DOI: 10.1097/ico.0000000000002232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To map and measure the depths of corneal neovascularization (NV) using 3-dimensional optical coherence tomography angiography (OCTA) at 2 different wavelengths. METHODS Corneal NV of varying severity, distribution, and underlying etiology was examined. Average NV depth and vessel density were measured using 840-nm spectral-domain OCTA and 1050-nm swept-source OCTA. The OCTA results were compared with clinical slit-lamp estimation of NV depth. RESULTS Twelve eyes with corneal NV from 12 patients were imaged with OCTA. Clinically "superficial," "midstromal," and "deep" cases had an average vessel depth of 23%, 39%, and 66% on 1050-nm OCTA, respectively. Average vessel depth on OCTA followed a statistically significant ordinal trend according to the clinical classification of vessel depth (Jonckheere-Terpstra test, P < 0.001). In 8 cases where both 840-nm OCTA and 1050-nm OCTA were acquired, there was excellent agreement in the mean vessel depth between the 2 systems (concordance correlation coefficient = 0.94, P < 0.001). The average vessel density measured by 840-nm OCTA was higher (average 1.6-fold) than that measured by 1050-nm OCTA. CONCLUSIONS Corneal OCTA was able to map corneal NV in 3 dimensions and measure vessel depth and density. The depth of corneal NV varied between different pathologies in a manner consistent with previous pathologic studies. The measured vessel density appeared to be affected by the interscan time, which affects blood flow velocity sensitivity, and the wavelength, which affects the ability to penetrate through opacity. These findings suggest possible clinical applications of OCTA for the diagnosis of corneal pathology and quantitative monitoring of therapeutic response in patients with corneal NV.
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Hall MN, Moshirfar M, Amin-Javaheri A, Ouano DP, Ronquillo Y, Hoopes PC. Lipid Keratopathy: A Review of Pathophysiology, Differential Diagnosis, and Management. Ophthalmol Ther 2020; 9:833-852. [PMID: 33058067 PMCID: PMC7708541 DOI: 10.1007/s40123-020-00309-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022] Open
Abstract
Lipid keratopathy is a disease in which fat deposits accumulate in the cornea, leading to opacification and decrease of visual acuity. This condition can be idiopathic without signs of previous corneal disease or secondary to ocular or systemic diseases. Lipid keratopathy is usually associated with abnormal vascularization of the cornea, and the lipid classically deposits adjacent to these vessels. Treatment of this condition usually aims to eliminate or prevent abnormal vessel formation, and several modalities have been described. In this review we summarize the etiology, pathophysiology, and clinical presentation of lipid keratopathy and describe current and emerging treatment regimens.
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Affiliation(s)
- MacGregor N Hall
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Utah Lions Eye Bank, Murray, UT, USA.
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Nicholas MP, Mysore N. Corneal neovascularization. Exp Eye Res 2020; 202:108363. [PMID: 33221371 DOI: 10.1016/j.exer.2020.108363] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022]
Abstract
The optical clarity of the cornea is essential for maintaining good visual acuity. Corneal neovascularization, which is a major cause of vision loss worldwide, leads to corneal opacification and often contributes to a cycle of chronic inflammation. While numerous factors prevent angiogenesis within the cornea, infection, inflammation, hypoxia, trauma, corneal degeneration, and corneal transplantation can all disrupt these homeostatic safeguards to promote neovascularization. Here, we summarize its etiopathogenesis and discuss the molecular biology of angiogenesis within the cornea. We then review the clinical assessment and diagnostic evaluation of corneal neovascularization. Finally, we describe current and emerging therapies.
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Affiliation(s)
- Matthew P Nicholas
- Flaum Eye Institute, University of Rochester Medical Center, 210 Crittenden Blvd., Rochester, NY, USA
| | - Naveen Mysore
- Flaum Eye Institute, University of Rochester Medical Center, 210 Crittenden Blvd., Rochester, NY, USA.
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Role of optical coherence tomography angiography in the characterization of vascular network patterns of ocular surface squamous neoplasia. Ocul Surf 2020; 18:926-935. [DOI: 10.1016/j.jtos.2020.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/24/2020] [Accepted: 03/29/2020] [Indexed: 02/06/2023]
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Anterior Segment Optical Coherence Tomography Angiography in Patients Following Cultivated Oral Mucosal Epithelial Transplantation. Am J Ophthalmol 2019; 208:242-250. [PMID: 31449791 DOI: 10.1016/j.ajo.2019.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/28/2019] [Accepted: 08/16/2019] [Indexed: 11/22/2022]
Abstract
PURPOSE To analyze corneal neovascularization using anterior segment optical coherence tomography angiography (AS-OCTA) in patients following cultivated oral mucosal epithelial sheet transplantation (COMET). DESIGN Observational case series. METHODS Nine 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 1 of the following 5 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. MAIN OUTCOME MEASURES Depth and image quality of corneal neovascularization following COMET. RESULTS Six 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 = .021). Segmentation images clearly demonstrated both epithelial and stromal vasculatures individually. CONCLUSIONS AS-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.
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