Armarnik Sharon, Mimouni Michael, Goldenberg Dafna, Segev Fani, Meshi Amit, Segal Ori, Geffen Noa
Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
Sackler Faculty Of Medicine, Tel Aviv University, Tel Aviv, Israel.
Graefes Arch Clin Exp Ophthalmol. 2019 Jun;257(6):1247-1252. doi: 10.1007/s00417-019-04309-y. Epub 2019 Apr 18.
The purpose of the study was to describe findings demonstrated by anterior segment spectral domain optical coherence tomography (AS-OCT) in various types of deeply embedded corneal foreign bodies.
In this experimental study, an ex vivo model of calf eyes was used and seven different foreign bodies were deeply embedded in the cornea, consisting of five different materials: glass, plastic, metal, wood, and pencil graphite. The eyes were photographed and then scanned by AS-OCT. The images were analyzed to determine distinguishing characteristics for each material.
Various materials presented unique characteristics in AS-OCT. The opaque materials (pencil graphite, metals, and wood) demonstrated a hyper-reflective anterior border, whereas the posterior border signal could not be clearly identified due to the shadowing effect. Moreover, a chain of signals was characteristic of both pencil graphite and metals though a "mirroring effect" was unique for metals. Wood, as an opaque material, appears as a hyper-reflective mass with a spectrum of penetrability depending on the degree of concentration. Transparent materials demonstrated hyper-reflective sharp borders when surrounded by air or fluid, as opposed to when being embedded purely in the corneal stroma.
This study shows that AS-OCT was used to systematically define a novel set of distinguishing characteristics specific to various materials extruding from the cornea, fully embedded in the cornea, and intruding into the anterior chamber. Hopefully, the described characteristics of each material can aid clinicians in diagnosing the type of the material embedded and the depth of its involvement in ocular injury.
本研究旨在描述眼前节谱域光学相干断层扫描(AS - OCT)在各种类型的深层角膜异物中的表现。
在本实验研究中,使用小牛眼的离体模型,将七种不同的异物深深嵌入角膜,这些异物由五种不同材料组成:玻璃、塑料、金属、木材和铅笔石墨。对眼睛进行拍照,然后用AS - OCT进行扫描。对图像进行分析以确定每种材料的鉴别特征。
各种材料在AS - OCT中呈现出独特的特征。不透明材料(铅笔石墨、金属和木材)显示出高反射性的前缘,而后缘信号由于阴影效应无法清晰识别。此外,铅笔石墨和金属都有信号链的特征,不过“镜像效应”是金属独有的。木材作为不透明材料,表现为高反射性团块,其穿透性取决于浓度程度。透明材料在被空气或液体包围时显示出高反射性的锐利边界,而不是纯粹嵌入角膜基质时。
本研究表明,AS - OCT可用于系统地定义一组新的鉴别特征,这些特征特定于从角膜突出、完全嵌入角膜以及侵入前房的各种材料。希望每种材料所描述的特征能够帮助临床医生诊断嵌入材料的类型及其在眼外伤中的累及深度。