Pahuja Natasha, Shetty Rohit, Jayadev Chaitra, Nuijts Rudy, Hedge Bharath, Arora Vishal
Department of Cornea & Refractive Surgery, Narayana Nethralaya 121/C, Chord Road, 1st "R" Block, Rajajinagar, Bangalore, Karnataka 560 010, India.
Department of Ophthalmology, Maastricht University Medical Center, Netherlands.
Biomed Res Int. 2015;2015:572698. doi: 10.1155/2015/572698. Epub 2015 Apr 6.
To compare the penetration of riboflavin using a microscope-integrated real time spectral domain optical coherence tomography (ZEISS OPMI LUMERA 700 and ZEISS RESCAN 700) in keratoconus patients undergoing accelerated collagen crosslinking (ACXL) between epithelium on (epi-on) and epithelium off (epi-off).
Intraoperative images were obtained during each of the procedures. Seven keratoconus patients underwent epi-on ACXL and four underwent epi-off ACXL. A software tool was developed using Microsoft.NET and Open Computer Vision (OpenCV) libraries for image analysis. Pre- and postprocedure images were analyzed for changes in the corneal hyperreflectance pattern as a measure of the depth of riboflavin penetration.
The mean corneal hyperreflectance in the epi-on group was 12.97 ± 1.49 gray scale units (GSU) before instillation of riboflavin and 14.46 ± 2.09 GSU after AXCL (P = 0.019) while in the epi-off group it was 11.43 ± 2.68 GSU and 16.98 ± 8.49 GSU, respectively (P = 0.002). The average depth of the band of hyperreflectance in the epi-on group was 149.39 ± 15.63 microns and in the epi-off group it was 191.04 ± 32.18 microns.
This novel in vivo, real time imaging study demonstrates riboflavin penetration during epi-on and epi-off ACXL.
使用集成显微镜的实时光谱域光学相干断层扫描技术（蔡司OPMI LUMERA 700和蔡司RESCAN 700）比较在接受加速角膜胶原交联（ACXL）的圆锥角膜患者中，上皮在位（epi-on）和上皮去除（epi-off）情况下核黄素的渗透情况。
在每个手术过程中获取术中图像。7例圆锥角膜患者接受了上皮在位ACXL，4例接受了上皮去除ACXL。使用Microsoft.NET和开源计算机视觉（OpenCV）库开发了一个软件工具用于图像分析。分析术前和术后图像中角膜高反射模式的变化，以此作为核黄素渗透深度的指标。
上皮在位组在滴注核黄素前角膜平均高反射率为12.97±1.49灰度单位（GSU），ACXL后为14.46±2.09 GSU（P = 0.019）；而上皮去除组分别为11.43±2.68 GSU和16.98±8.49 GSU（P = 0.002）。上皮在位组高反射带的平均深度为149.39±15.63微米，上皮去除组为191.04±32.18微米。
这项新颖的体内实时成像研究展示了上皮在位和上皮去除ACXL过程中核黄素的渗透情况。
