Natsuko Yamazaki1, Akira Kobayashi2, Hideaki Yokogawa1, Yasuhisa Ishibashi3, Yosaburo Oikawa4, Masaharu Tokoro5, Kazuhisa Sugiyama1. 1. Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. 2. Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. Electronic address: kobaya@kenroku.kanazawa-u.ac.jp. 3. Department of Ophthalmology, Tsukuba Hospital, Tsukuba, Japan. 4. Department of Medical Zoology, Kanazawa Medical University, Kahoku, Japan. 5. Department of Parasitology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Abstract
PURPOSE: To investigate in vivo corneal changes of radial keratoneuritis in early-stage Acanthamoeba keratitis (AK) using anterior-segment optical coherence tomography (AS-OCT). DESIGN: Single-center, prospective clinical study. PARTICIPANTS: Four eyes (4 patients with a mean age of 28.5 years) with early-stage AK showing radial keratoneuritis were included in this study. Definitive diagnosis was made by confirmation of AK cysts using in vivo confocal microscopy and culture. METHODS: Anterior-segment OCT examination was performed on the initial visit and at follow-up visits paying special attention to radial keratoneuritis. MAIN OUTCOME MEASURES: Selected AS-OCT images of the cornea were evaluated qualitatively for the shape and degree of light reflection of abnormal neurons. RESULTS: With the use of AS-OCT, we successfully obtained high-resolution images of putative radial keratoneuritis in all patients as highly reflective bands or lines in the corneal stroma. The depth and width of the highly reflective bands/lines varied from case to case (anterior stroma to mid-stroma, from 20 to 200 μm). Some lines ran obliquely from the deep peripheral stroma toward the anterior stroma, and some were located at different depths (subepithelial and mid-stroma) and ran relatively parallel to the corneal layers. After appropriate treatment, radial keratoneuritis was resolved by both slit-lamp biomicroscopy and AS-OCT in all patients. CONCLUSIONS: High-resolution Fourier-domain AS-OCT provides novel and detailed visual information of radial keratoneuritis in patients with early-stage AK. Visualization of radial keratoneuritis by AS-OCT may be a useful adjunct to the diagnosis and follow-up of early-stage AK.
PURPOSE: To investigate in vivo corneal changes of radial keratoneuritis in early-stage Acanthamoeba keratitis (AK) using anterior-segment optical coherence tomography (AS-OCT). DESIGN: Single-center, prospective clinical study. PARTICIPANTS: Four eyes (4 patients with a mean age of 28.5 years) with early-stage AK showing radial keratoneuritis were included in this study. Definitive diagnosis was made by confirmation of AK cysts using in vivo confocal microscopy and culture. METHODS: Anterior-segment OCT examination was performed on the initial visit and at follow-up visits paying special attention to radial keratoneuritis. MAIN OUTCOME MEASURES: Selected AS-OCT images of the cornea were evaluated qualitatively for the shape and degree of light reflection of abnormal neurons. RESULTS: With the use of AS-OCT, we successfully obtained high-resolution images of putative radial keratoneuritis in all patients as highly reflective bands or lines in the corneal stroma. The depth and width of the highly reflective bands/lines varied from case to case (anterior stroma to mid-stroma, from 20 to 200 μm). Some lines ran obliquely from the deep peripheral stroma toward the anterior stroma, and some were located at different depths (subepithelial and mid-stroma) and ran relatively parallel to the corneal layers. After appropriate treatment, radial keratoneuritis was resolved by both slit-lamp biomicroscopy and AS-OCT in all patients. CONCLUSIONS: High-resolution Fourier-domain AS-OCT provides novel and detailed visual information of radial keratoneuritis in patients with early-stage AK. Visualization of radial keratoneuritis by AS-OCT may be a useful adjunct to the diagnosis and follow-up of early-stage AK.
Authors: Young Min Park; Jong Soo Lee; Ji-Myong Yoo; Jong Moon Park; Seong-Wook Seo; In-Young Chung; Seong Jae Kim Journal: Int J Ophthalmol Date: 2018-08-18 Impact factor: 1.779
Authors: Carolin Elhardt; Christian M Wertheimer; Andreas Wartak; Jie Zhao; Hui Min Leung; Stefan A Kassumeh; Biwei Yin; Guillermo J Tearney; Reginald Birngruber Journal: Transl Vis Sci Technol Date: 2020-04-15 Impact factor: 3.283