Furundaoturan Onur, Palamar Melis, Barut Selver Ozlem
Department of Ophthalmology, Ege University Medical Faculty Hospital, Izmir, Turkey.
Graefes Arch Clin Exp Ophthalmol. 2023 Jan;261(1):155-159. doi: 10.1007/s00417-022-05735-1. Epub 2022 Jul 20.
To evaluate the limbal ischemia objectively in ocular surface chemical injuries by using anterior segment optical coherence tomography angiography (AS-OCTA).
In this cross-sectional study, acute ocular surface chemical injury patients with less than 1 week injury history were enrolled. Demographic data of the patients were noted, and detailed ophthalmological examination with Dua classification was performed. AS photographs and AS-OCTA images were obtained and used for the assessment of limbal ischemia. To visualize the limbal vasculature, the device was focused manually to get a sharp image for all 4 quadrants of the limbus. The absence of vasculature was regarded as "ischemia," and the amount of the ischemia was defined in clock hours. The limbal ischemia detected in clinical evaluation with biomicroscopy was compared with the AS-OCTA detected ischemia amount to make a conclusion for the correlation.
Nineteen eyes of 18 patients with acute ocular surface chemical injury were enrolled to the study (2 female, 16 male). The mean age was 35.1 ± 10 (18-55), and the mean best corrected visual acuity was 0.75 ± 1 (0.1-3.1) LogMAR. The causative agents were acid in 6 and alkaline in 12 patients. Limbal ischemia detected by using AS-OCTA was greater ((5.8 ± 2.6 (2-10) clock hours) than that detected in biomicroscopy (4.8 ± 2.4 (2-12) clock hours). The difference was statistically significant (p < 0.0005).
AS-OCTA has a significant importance on limbal vascularity visualization; therefore, its use for more objective and sensitive evaluation of limbal ischemia in ocular surface chemical injuries seems to have a crucial impact. AS-OCTA images may reveal the extension of limbal ischemia more precisely than clinical evaluation with biomicroscopy. However, future studies with higher number of patients are needed to come to a specific conclusion.
运用眼前节光学相干断层扫描血管造影（AS-OCTA）客观评估眼表化学伤中的角膜缘缺血情况。
在这项横断面研究中，纳入了受伤史少于1周的急性眼表化学伤患者。记录患者的人口统计学数据，并采用杜阿分类法进行详细的眼科检查。获取AS照片和AS-OCTA图像用于评估角膜缘缺血情况。为了观察角膜缘血管系统，手动聚焦设备以获取角膜缘所有4个象限的清晰图像。血管系统缺失被视为“缺血”，缺血量以钟点数定义。将生物显微镜临床评估中检测到的角膜缘缺血情况与AS-OCTA检测到的缺血量进行比较，以得出相关性结论。
18例急性眼表化学伤患者的19只眼纳入研究（2例女性，16例男性）。平均年龄为35.1±10（18 - 55）岁，平均最佳矫正视力为0.75±1（0.1 - 3.1）LogMAR。致伤物为酸性的有6例患者，碱性的有12例患者。使用AS-OCTA检测到的角膜缘缺血（（5.8±2.6（2 - 10）钟点数））比生物显微镜检测到的（4.8±2.4（2 - 12）钟点数）更严重。差异具有统计学意义（p < 0.0005）。
AS-OCTA在观察角膜缘血管方面具有重要意义；因此，其用于更客观、敏感地评估眼表化学伤中的角膜缘缺血似乎具有关键作用。AS-OCTA图像可能比生物显微镜临床评估更精确地显示角膜缘缺血的范围。然而，需要更多患者参与的未来研究才能得出具体结论。
