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Localization of Corneal Neovascularization Using Optical Coherence Tomography Angiography

Chan, Szy Yann MD*; Pan, Chung Ting MD; Feng, Yun MD*

doi: 10.1097/ICO.0000000000001931
Clinical Science
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Purpose: This article explores the application of optical coherence tomography angiography (OCTA) in assessing corneal neovascularization (CoNV) and investigates the features of CoNV in eyes with corneal transplantation.

Methods: A pilot, case series, observational study was conducted to enroll patients who underwent corneal transplantation including penetrating keratoplasty (PKP) and deep lamellar keratoplasty (DLKP) with or without additional keratolimbal allograft transplantation. All patients were followed with a series of ophthalmologic examinations including slit-lamp photography and were then imaged with the anterior segment OCTA.

Results: The study included 15 eyes of 14 patients (12 men; mean age of 37.4 ± 13.3 years), of which 9 eyes had undergone PKP and 6 eyes DLKP. OCTA was able to clearly identify the features of CoNV in eyes with significant CoNV and to confirm the presence of CoNV in eyes suspected of having CoNV. Four types of CoNV (superficial, stromal, fringe, and recipient-bed CoNV) were discovered by OCTA based on their location and depth. Superficial CoNV was mainly discovered in eyes that had undergone PKP (88.9% ± 11.1%), whereas the recipient-bed CoNV, once thought to be located in the host–graft interface, was discovered to grow in the host cornea only in eyes that had undergone DLKP (83.3% ± 16.7%). Comparing the assessment by 2 masked observers revealed a kappa value of 0.94, indicating excellent agreement.

Conclusions: OCTA can be useful to visualize CoNV, which may be valuable in assessing corneal graft rejection.

*Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; and

Department of Ophthalmology, Peking University International Hospital, Beijing, China.

Correspondence: Yun Feng, MD, Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China (e-mail: superjune@sina.com).

This study was supported by a grant from the National Natural Science Foundation of China (No. 81700799).

The authors have no conflicts of interest to disclose.

S. Y. Chan and C. T. Pan share the first authorship.

Received November 27, 2018

Received in revised form January 30, 2019

Accepted February 08, 2019

Online date: March 19, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.