In Vivo Imaging of Radial Keratoneuritis in Patients with Acanthamoeba keratitis by Anterior-Segment Optical Coherence Tomography

Yamazaki, Natsuko; Kobayashi, Akira; Yokogawa, Hideaki; Ishibashi, Yutaka; Oikawa, Yosaburo; Tokoro, Masaharu; Sugiyama, Kazuhisa

doi:10.1016/j.ophtha.2014.04.043

Cited by 38 publications

(30 citation statements)

References 14 publications

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“…Recent reports have described the visualization of Acanthamoeba cysts in the basal epithelial cell layer as highly reflective round particles, and radial keratoneuritis as highly reflective bands or lines of various widths. 23 Although we did not identify clear hyperreflective clusters, the stromal hyperreflectivity was more intense in the subepithelial area, which can be related to the presence of Acanthamoeba cysts.…”

Section: Discussioncontrasting

confidence: 59%

Anterior Segment Optical Coherence Tomography in the Early Management of Microbial Keratitis: A Cross-Sectional Study

et al. 2020

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Introduction: Infectious keratitis is an important cause of visual loss. The purpose of this study was to investigate anterior segment optical coherence tomography patterns in infectious keratitis and evaluate the role of this tool in the early management of this disorder.Material and Methods: In this cross-sectional study, we included patients with proven infectious keratitis, either by culture or therapeutic trial. Subjects underwent baseline anterior segment optical coherence tomography (Spectralis® anterior segment module, Heidelberg Engineering, Germany) performed by the same operator. We used anterior segment optical coherence tomography vertical and horizontal raster default scans with 6.0 mm scan lines.Results: Twenty-five patients (14 men and 11 women) were included. The most common risk factors identified were ocular trauma (11 cases) and contact lens wear (7 cases). Fifteen patients presented bacterial infection; three, fungal infection; two parasitic infection; and five cases presented a negative microbiological culture. Anterior segment optical coherence tomography depicted nine distinct morphological patterns.Discussion: Anterior segment optical coherence tomography allows the depth of corneal involvement to be assessed. When the only patterns identified were hyperreflective stromal lesion and stromal edema, the visual outcome was better. Cystic spaces were present in severe bacterial keratitis.Conclusion: Anterior segment optical coherence tomography can complement biomicroscopy, allowing for a better characterization of corneal involvement at presentation that can help in staging and providing useful prognostic information.

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Section: Discussioncontrasting

confidence: 59%

Anterior Segment Optical Coherence Tomography in the Early Management of Microbial Keratitis: A Cross-Sectional Study

et al. 2020

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“…Fourier domain ASOCT can demonstrate corneal nerve abnormalities (radial keratoneuritis) such as during active acanthamoeba keratitis (Yamazaki et al, 2014) and can be used to assess treatment response. However, current instrumentation has insufficient resolution to resolve corneal nerve architecture changes where the sole abnormality is loss of corneal sensation.…”

Section: Anterior Segment Optical Coherence Tomography (Asoct)mentioning

confidence: 99%

Neurotrophic keratopathy

Dua

Said

Messmer

et al. 2018

Progress in Retinal and Eye Research

276

356

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Neurotrophic Keratopathy (NK) refers to a condition where corneal epitheliopathy leading to frank epithelial defect with or without stromal ulceration (melting) is associated with reduced or absent corneal sensations. Sensory nerves serve nociceptor and trophic functions, which can be affected independently or simultaneously. Loss of trophic function and consequent epithelial breakdown exposes the stroma making it susceptible to enzymatic degradation. Nerve pathology can range from attrition to aberrant re-generation with corresponding symptoms from anaesthesia to hyperaesthesia/allodynia. Many systemic and ocular conditions, including surgery and preserved medications can lead to NK. NK can be mild (epithelium and tear film changes), moderate (non-healing epithelial defect) or severe (stromal melting and perforation). Moderate and severe NK can profoundly affect vision and adversely impact on the quality of life. Medical management with lubricating agents from artificial tears to serum/plasma drops, anti-inflammatory agents, antibiotics and anti-proteases all provide non-specific relief, which may be temporary. Contact lenses, punctal plugs, lid closure with botulinum toxin and surgical interventions like tarsorrhaphy, conjunctival flaps and amniotic membrane provide greater success but often at the cost of obscuring sight. Corneal surgery in a dry ocular surface with reduced sensation is at high risk of failure. The recent advent of biologicals such as biopolymers mimicking heparan sulfate; coenzyme Q10 and antisense oligonucleotide that suppress connexin 43 expression, all offer promise. Recombinant nerve growth factor (cenegermin), recently approved for human use targets the nerve pathology and has the potential of addressing the underlying deficit and becoming a specific therapy for NK.

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“…Denervation causes a decrease in epithelial vitality and has an impact on the permeability and wound healing, which can lead to epithelial breakdown, persistent epithelial defects, and stromal ulceration. 42 , 43 Further etiologies of neurotrophic keratopathy are infections like herpes keratitis, which causes, as one of the most frequent diseases, nerve loss and decreased nerve function, 44 , 45 and acanthamoeba keratitis with cysts, nerval changes, and radial keratoneuritis 46 – 48 or status post laser-assisted in situ keratomileusis surgery. 49 In addition, nerve density plays a role in corneal sensation and tear film production.…”

Section: Discussionmentioning

confidence: 99%

Stromal Nerve Imaging and Tracking Using Micro-Optical Coherence Tomography

Elhardt

Wertheimer

Wartak

et al. 2020

Trans. Vis. Sci. Tech.

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Citation: Elhardt C, Wertheimer CM, Wartak A, Zhao J, Leung HM, Kassumeh SA, Yin B, Tearney GJ, Birngruber R. Stromal nerve imaging and tracking using micro-optical coherence tomography. Trans Vis Sci Tech. 2020;9(5):6, https://doi.org/10. 1167/tvst.9.5.6 Purpose: To image, track and map the nerve fiber distribution in excised rabbit corneas over the entire stromal thickness using micro-optical coherence tomography (μOCT) to develop a screening tool for early peripheral neuropathy.Methods: Excised rabbit corneas were consecutively imaged by a custom-designed μOCT prototype and a commercial laser scanning fluorescence confocal microscope. The μOCT images with a field of view of approximately 1 × 1 mm were recorded with axial and transverse resolutions of approximately 1 μm and approximately 4 μm, respectively. In the volumetric μOCT image data, network maps of hyper-reflective, branched structures traversing different stromal compartments were segmented using semiautomatic image processing algorithms. Furthermore, the same corneas received βIIItubulin antibody immunostaining before digital confocal microscopy, and a comparison between μOCT image data and immunohistochemistry analysis was performed to validate the nerval origin of the tracked network structures.Results: Semiautomatic tracing of the nerves with a high range of different thicknesses was possible through the whole corneal volumes, creating a skeleton of the traced nerves. There was a good conformity between the hyper-reflective structures in the μOCT data and the stained nerval structures in the immunohistochemistry data. Conclusions:This article demonstrates nerval imaging and tracking as well as a spatial correlation between μOCT and a fluorescence corneal nerve standard for larger nerves throughout the full thickness of the cornea ex vivo.Translational Relevance: Owing to its advantageous properties, μOCT may become useful as a noncontact method for assessing nerval structures in humans to screen for early peripheral neuropathy.

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In Vivo Imaging of Radial Keratoneuritis in Patients with Acanthamoeba keratitis by Anterior-Segment Optical Coherence Tomography

Abstract: High-resolution Fourier-domain AS-OCT provides novel and detailed visual information of radial keratoneuritis in patients with early-stage AK. Visualization of radial keratoneuritis by AS-OCT may be a useful adjunct to the diagnosis and follow-up of early-stage AK.

Cited by 38 publications

References 14 publications

Anterior Segment Optical Coherence Tomography in the Early Management of Microbial Keratitis: A Cross-Sectional Study

Anterior Segment Optical Coherence Tomography in the Early Management of Microbial Keratitis: A Cross-Sectional Study

Neurotrophic keratopathy

Stromal Nerve Imaging and Tracking Using Micro-Optical Coherence Tomography

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