Background To compare and analyze the imaging differences between anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in acute keratoconus. Method The features of AS-OCT and UBM images of acute keratoconus patients in Hebei Eye Hospital were analyzed retrospectively. Result From May 2016 to December 2020, 38 patients (38 eyes) with acute keratoconus were treated in Hebei Eye Hospital. Both AS-OCT and UBM images showed rupture of the posterior elastic layer of cornea, edema and thickening of stroma layer, and cracks formed in it to communicate with anterior chamber. AS-OCT image showed that corneal epithelium was intact, and 26 cases had subcutaneous effusion. UBM images showed delamination of the posterior elastic layer interface in 26 cases. Paired t test showed that there was significant difference between preoperative and postoperative best corrected visual acuity in all patients (t = 11.861, P < 0.05). There was no significant difference in preoperative and postoperative best corrected visual acuity between group 1 and group 2 by independent sample t test (t = 0.751, P> 0.05, t = 0.219, P > 0.05). There was significant difference in the height of rupture between group 1 and group 2 (t =-7.533, P < 0.001). Pearson correlation analysis showed that there was a significant correlation between fracture size and fracture height (r = 0.766, P < 0.001), but no correlation between fracture size and post-elastic layer delamination (r =-0.107, P > 0.05). No corneal perforation was found in 38 cases (38 eyes). In the healing stage after deep lamellar keratoplasty, obvious stroma scar appeared, accompanied by corneal stroma thickening and corneal flattening. Conclusion AS-OCT and UBM can complement each other, provide accurate corneal imaging images and parameter measurement, and predict and evaluate the development of the disease.
Objective To compare and analyze the differences between anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in imaging acute keratoconus. Method The features of AS-OCT and UBM images of acute keratoconus patients in Hebei Eye Hospital were analyzed retrospectively. Result From May 2016 to September 2021, 43 patients (43 eyes) with acute keratoconus were treated at Hebei Eye Hospital. Both AS-OCT and UBM images showed a ruptured Descemet’s membrane, edema, thickening of the stromal layer, and fissures forming in it to connect to the anterior chamber. AS-OCT images showed an intact corneal epithelium, with 29 cases presenting with epithelial edema formation. UBM images showed Descemet’s membrane detachment with a break in 28 cases. Pearson correlation analysis showed a significant correlation between the Descemet’s membrane rupture size and rupture height (r = 0.763, P < 0.001) but no correlation between rupture size and rupture with delamination of collagen lamellae (r = 0.090, P > 0.05). No corneal perforation was found in the 43 eyes. In the healing stage after deep lamellar keratoplasty, there was significant stromal scarring with a pan-stromal scar, significant stromal thickening, and cornea flattening. Conclusion AS-OCT and UBM can complement each other in providing accurate corneal images and parameter measurements for predicting and evaluating disease progression.
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