Anterior Segment Optical Coherence Tomography Angiography in Patients Following Cultivated Oral Mucosal Epithelial Transplantation

• Published in: American journal of ophthalmology Vol. 208; no. C; pp. 242 - 250
• Main Authors: Kiritoshi, Shoko, Oie, Yoshinori, Nampei, Kanako, Sato, Shinnosuke, Morota, Misa, Nishida, Kohji
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2019; Elsevier Limited; Elsevier
• Subjects: Adult; Aged; Anterior Eye Segment - diagnostic imaging; Cell Culture Techniques; Cell Transplantation - adverse effects; Corneal Neovascularization - diagnostic imaging; Corneal Neovascularization - etiology; Epithelial Cells - transplantation; Female; Fluorescein Angiography; Follow-Up Studies; Humans; Limbus Corneae - pathology; Male; Medical imaging; Medicine; Middle Aged; Mouth Mucosa - cytology; Ophthalmology; Stem Cells - pathology; Tomography, Optical Coherence; University graduates; United States > US; Japan; California
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2019.08.006

To analyze corneal neovascularization using anterior segment optical coherence tomography angiography (AS-OCTA) in patients following cultivated oral mucosal epithelial sheet transplantation (COMET). Observational case series. Nine eyes in 7 patients were analyzed. Four images of corneal quadrant were obtained by AS-OCTA from each patient during follow-up post-COMET in the Department of Ophthalmology at Osaka University Hospital. The depth of corneal neovascularization was evaluated using en face and B-scan images. Each quadrant image was classified as 1 of the following 5 types: stromal, predominantly stromal, epithelial, predominantly epithelial, or avascular. The image quality of slit-lamp photography and AS-OCTA was graded from 0 to 4. Manually segmented images of the epithelial and stromal vessels were obtained. Main Outcome Measures: Depth and image quality of corneal neovascularization following COMET. Six patients were male and 1 was female. The mean patient age was 61.3 ± 19.1 years. Thirty-six quadrant images were obtained, of which 4 (11.1%) were stromal, 16 (44.4%) were predominantly stromal, 3 (8.3%) were epithelial, 11 (30.6%) were predominantly epithelial, and 2 (5.6%) were avascular. The image quality obtained by AS-OCTA was significantly better than that obtained by slit-lamp photography (2.38 ± 0.94 vs 2.03 ± 0.90; P = .021). Segmentation images clearly demonstrated both epithelial and stromal vasculatures individually. AS-OCTA is useful for evaluation of depth of corneal neovascularization and has the potential to distinguish between conjunctivalization and stromal neovascularization following COMET. Findings on AS-OCTA could contribute to clinical decision making, given that retreatment is required for conjunctivalization after COMET. •Depth of corneal neovascularization after cultivated oral mucosal epithelial sheet transplantation (COMET) was analyzed using anterior segment optical coherence tomography angiography (AS-OCTA).•Epithelial neovascularization were clearly distinguished from stromal neovascularization.•Corneal neovascularization occurred in the epithelium and stroma in 75% of cases.•The image quality by AS-OCTA was significantly better than that by slit-lamp photography.•AS-OCTA can be applicable for evaluation of treatment efficacy after COMET.