Correlation of Anterior Segment Optical Coherence Tomography and Slit-Lamp Imaging in Infectious Keratitis

Farida Elzawahry; Costanza Rossi; Dalia Said; Harminder S Dua

doi:10.1097/ICO.0000000000003788

Correlation of Anterior Segment Optical Coherence Tomography and Slit-Lamp Imaging in Infectious Keratitis

Cornea. 2025 Jan 10. doi: 10.1097/ICO.0000000000003788. Online ahead of print.

Authors

Farida Elzawahry^{1

2}, Costanza Rossi^{1

3}, Dalia Said¹, Harminder S Dua¹

Affiliations

¹ Academic Ophthalmology, School of Medicine, AU1, University of Nottingham, Nottingham, United Kingdom.
² National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt; and.
³ Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy.

PMID: 39791940
DOI: 10.1097/ICO.0000000000003788

Abstract

Purpose: Anterior segment optical coherence tomography (AS-OCT) is increasingly being used to complement slit-lamp biomicroscopy in the evaluation of corneal infections. Our purpose was to analyze, compare, and correlate the clinical signs elicited by these 2 methods in patients with infectious keratitis (IK).

Methods: Slit-lamp photomicrographs (diffuse and slit beam) and AS-OCT scans were obtained from 20 consecutive patients (21 eyes) with IK. AS-OCT horizontal line scans representing the top, middle, and bottom of the lesions were analyzed and compared with findings seen on slit-lamp photographs. Epithelial defects, thickness, irregularity; presence of infiltrate and its depth; corneal edema or melting; vascularization; Descemet membrane detachment; and presence of keratic precipitates were analyzed with both imaging techniques. AS-OCT features included hyperreflectivity, hyporeflectivity, shadowing, and tissue morphology. Statistical analysis was performed using GraphPad Prism 8.2.1.

Results: AS-OCT was significantly more likely to detect corneal thickening (P < 0.001), epithelial hyperplasia (P = 0.027), infiltrate depth (P < 0.001), presence of inflammatory plaque (P = 0.0002), DM-endothelial complex undulations (P < 0.001), keratic precipitates (P = 0.0006), and Descemet membrane detachment (0.000), than slit-lamp imaging.

Conclusions: AS-OCT can be a helpful adjunctive test in the evaluation of patients with IK. AS-OCT complements slit-lamp biomicroscopy and photography in the diagnosis and monitoring of IK and may serve an important role in telemedicine compared with slit-lamp photography alone.