Ophthalmology Department, Cochin Hospital, Paris University, Paris, France.
Stein Eye Institute, David Geffen School of Medicine, University of California in Los Angeles, 100 Stein Plaza, Los Angeles, CA, 90095, USA.
BMC Ophthalmol. 2020 May 25;20(1):205. doi: 10.1186/s12886-020-01466-1.
Anterior segment optical coherence tomography (AS OCT) is a helpful tool used to diagnose and manage many corneal conditions, but its use has not been reported in case of peripheral ulcerative keratitis (PUK). The aim of this study is to describe AS OCT findings in cases of PUK.
Retrospective observational case series of six eyes presenting with a PUK and proven systemic vasculitis. Clinical course, slit lamp photographs, and AS OCT findings were the main outcomes.
The AS OCT findings were found to correlate with the ocular disease's level of activity. In the acute stage, an absence of corneal epithelium, a scrambled appearance of the anterior stroma and a heterogeneous stromal reflectivity were observed. During the reduction of disease level activity, an irregular hyporeflective epithelium, a smoother anterior stroma, and a homogenous hyperreflective stroma were seen. At the healed stage, a filling of the corneal defect by a hyporeflective thick epithelium, the persistence of the hyperreflective underlying stroma, and a demarcation line were observed. The mean total corneal thickness at last follow-up was significantly thicker (509 ± 147 μm) compared with the mean corneal thickness at onset (408 ± 131 μm; P = 0.03).
AS OCT provides an assessment of structural changes occurring in PUK, useful for its diagnosis and monitoring.
眼前节光学相干断层扫描（AS OCT）是一种用于诊断和治疗许多角膜疾病的有用工具，但在边缘性溃疡性角膜炎（PUK）的情况下尚未报道其使用。本研究旨在描述 PUK 病例的 AS OCT 发现。
回顾性观察性病例系列，纳入 6 只患有 PUK 并证实为系统性血管炎的眼睛。主要结局为临床病程、裂隙灯照片和 AS OCT 发现。
AS OCT 发现与眼部疾病的活动水平相关。在急性期，观察到角膜上皮缺失、前基质杂乱无章和基质反射率不均匀。在疾病活动水平降低时，可见不规则低反射上皮、前基质更平滑和基质均匀高反射。在愈合阶段，观察到角膜缺陷由低反射厚上皮填充、高反射下基质的持续存在和分界线。末次随访时的平均总角膜厚度（509±147μm）明显厚于发病时的平均角膜厚度（408±131μm；P=0.03）。
AS OCT 提供了对 PUK 发生的结构变化的评估，有助于其诊断和监测。
