EXPERIENCE OF USING OPTICAL COHERENCE TOMOGRAPHY IN CORNEAL INJURIES

Abstract

Background. Eye trauma is one of the most common causes of monocular visual impairment and blindness worldwide. Modern classification divides eye trauma into two groups: open (penetrating) and closed (non-penetrating) eye trauma. During the diagnostic phase, it is important to thoroughly examine and establish the correct diagnosis according to the existing classification, which affects the further patient management and treatment outcomes. Optical coherence tomography (OCT) allows for real-time imaging of eye tissues with high resolution. In our study, we present our experience in using optical coherence tomography in cases of traumatic corneal injuries as an additional method for assessing the depth and extent of damage and monitoring corneal erosion healing. Aim. To utilize optical coherence tomography of the anterior segment of the eye for the diagnosis and assessment of corneal wound healing processes. Materials and Methods. The research involved 46 patients with non-penetrating corneal injuries who were observed at the clinics of Bogomolets National Medical University. A control group consisting of 15 healthy patients was also included in the study. Data collection included patient demographic information, occupation, mechanism and duration of the trauma, the presence of recurrences, and the period of seeking medical assistance. All patients underwent visual acuity assessment, biomicroscopy, evaluation of the conjunctiva and corneal condition, and fluorescein testing. Using Optical Coherence Tomography (OCT) of the anterior segment, we monitored corneal thickness and the size of the epithelial defect before and after treatment. Results. In optical coherence tomography of traumatic corneal erosion, in most cases, a defect in the epithelium of irregular shape with uneven edges, an irregular mixed anterior surface of the stroma, non-uniform reflectivity of the stroma, and corneal thinning were visualized. After treatment, the results corresponded to corneal epithelialization: thick intact epithelium, hyperreflective stroma, and a demarcation line confirming the wound healing process. After treatment, the corneal thickness was restored to (529 ± 144 μm), which is comparable to the thickness of a healthy cornea. Conclusion. Optical Coherence Tomography (OCT) is an informative supplementary diagnostic method for corneal injuries, allowing for the assessment of corneal morphology, including the condition of the basal membrane, corneal thickness, and epithelialization. Based on these findings, we can predict the course of corneal trauma and its potential consequences, enabling us to adjust treatment strategies to prevent the development of fibrosis and minimize the long-term effects of the injury.