Label-Free In Vivo Imaging of Corneal Lymphatic Vessels Using Microscopic Optical Coherence Tomography

Horstmann, Jochen; Schulz‐Hildebrandt, Hinnerk; Bock, Felix; Siebelmann, Sebastian; Lankenau, Eva; Hüttmann, Gereon; Steven, Philipp; Cursiefen, Claus

doi:10.1167/iovs.17-22286

Cited by 40 publications

(21 citation statements)

References 33 publications

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“…Moreover, Horstmann et al developed a custom-built high-resolution MI-OCT system that can detect corneal lymphatic vessels [ 113 ]. These are precocious clues for corneal neovascularization, which is the principal limiting factor for corneal transplant survival.…”

Section: Discussionmentioning

confidence: 99%

“…These are precocious clues for corneal neovascularization, which is the principal limiting factor for corneal transplant survival. Lymphatic vessels are usually not clinically visible; therefore, this device opens up the possibility of non-invasive monitoring of corneal lymphangiogenesis, allowing the implementation of proactive therapy to extend graft survival [ 113 ].…”

Section: Discussionmentioning

confidence: 99%

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What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

Posarelli

Sartini

Casini

et al. 2020

JCM

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Background: Optical coherence tomography (OCT) has recently been introduced in the operating theatre. The aim of this review is to present the actual role of microscope-integrated optical coherence tomography (MI-OCT) in ophthalmology. Method: A total of 314 studies were identified, following a literature search adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. After full-text evaluation, 81 studies discussing MI-OCT applications in ophthalmology were included. Results: At present, three microscope-integrated optical coherence tomography systems are commercially available. MI-OCT can help anterior and posterior segment surgeons in the decision-making process, providing direct visualization of anatomic planes before and after surgical manoeuvres, assisting in complex cases, and detecting or confirming intraoperative complications. Applications range from corneal transplant to macular surgery, including cataract surgery, glaucoma surgery, paediatric examination, proliferative diabetic retinopathy surgery, and retinal detachment surgery. Conclusion: The use of MI-OCT in ophthalmic surgery is becoming increasingly prevalent and has been applied in almost all procedures. However, there are still limitations to be overcome and the technology involved remains difficult to access and use.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

Posarelli

Sartini

Casini

et al. 2020

JCM

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“…However, there are reports of detection of corneal lymphatics using IVCM 164 and more recently microscopic OCT (mOCT). 165 In both techniques, lymphatics were characterized as vessel-like structures with sparse, slowly moving immune cells.…”

Section: Discussionmentioning

confidence: 99%

Current and emerging therapies for corneal neovascularization

et al. 2018

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The cornea is unique because of its complete avascularity. Corneal neovascularization (CNV) can result from a variety of etiologies including contact lens wear; corneal infections; and ocular surface diseases due to inflammation, chemical injury, and limbal stem cell deficiency. Management is focused primarily on the etiology and pathophysiology causing the CNV and involves medical and surgical options. Because inflammation is a key factor in the pathophysiology of CNV, corticosteroids and other anti-inflammatory medications remain the mainstay of treatment. Anti-VEGF therapies are gaining popularity to prevent CNV in a number of etiologies. Surgical options including vessel occlusion and ocular surface reconstruction are other options depending on etiology and response to medical therapy. Future therapies should provide more effective treatment options for the management of CNV.

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“…By using this novel method, we can principally selectively destroy corneal blood and/or lymphatic vessels and thereby decrease the amount of tissue destruction caused by fine needle diathermy. Furthermore, it was recently published that high-resolution OCT imaging allows for non-contact imaging of pathologic corneal lymphatic vessels thereby also enabling a more selective and tissue-sparing destruction of corneal lymphatic vessels in patients in the future 32 . However, in this study, we used the suture-induced corneal neovascularization assay in the murine model which caused strong circumferential neovascularization.…”

Section: Discussionmentioning

confidence: 99%

Fine Needle-Diathermy Regresses Pathological Corneal (Lymph)Angiogenesis and Promotes High-Risk Corneal Transplant Survival

Schneider

Scholz

et al. 2018

Sci Rep

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Pathological corneal hem- and lymphangiogenesis are prime risk factors for corneal graft rejection. Fine needle-diathermy (FND) is an option to regress corneal blood vessels; however, whether this treatment besides clinically visible blood vessels also affects invisible lymphatic vessels is so far unknown. Here we test the hypothesis that FND destroys not only blood but also lymphatic vessels, thereby promotes corneal high-risk graft survival. The effect of FND was studied in vivo using BALB/c mice and the model of suture-induced corneal neovascularization. Mice were divided into three groups: FND, ANTI (anti-inflammatory therapy) and NON (control). Five, 7, 10 and 20 days after cauterization, corneas were harvested and stained with LYVE-1, CD31 to quantify (lymph)angiogenesis. The long-term survival of allografts was compared between the three groups. FND caused significant regression of both blood and lymphatic vessels compared to the control group at all time points (p < 0.05) with the most obvious effect at day 7 (p < 0.01). Graft survival was significantly prolonged when transplants were placed into the FND pretreated group (p < 0.0001). The effect of the anti-inflammatory therapy alone was less effective compared to FND (p < 0.05). This novel lymphangioregressive effect of FND can be used clinically to precondition high-risk recipients to promote graft survival.

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Label-Free In Vivo Imaging of Corneal Lymphatic Vessels Using Microscopic Optical Coherence Tomography

Abstract: Corneal lymphatic vessels can be imaged using mOCT. This novel approach opens new options for noninvasive clinical imaging of corneal lymphatic vessels for diagnostic and therapeutic indications.

Cited by 40 publications

References 33 publications

What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

What Is the Impact of Intraoperative Microscope-Integrated OCT in Ophthalmic Surgery? Relevant Applications and Outcomes. A Systematic Review

Current and emerging therapies for corneal neovascularization

Fine Needle-Diathermy Regresses Pathological Corneal (Lymph)Angiogenesis and Promotes High-Risk Corneal Transplant Survival

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