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Introduction of quantitative and qualitative optical coherence tomography findings, induced by collagen cross-linking for keratoconus

Poster Details

First Author: M.Chalikia GREECE

Co Author(s):    A. Kanellopoulos   G. Asimellis           

Abstract Details


To introduce a novel, non-invasive technique to determine the depth and extent of anterior corneal stroma changes induced by collagen cross-linking (CXL) using quantitative analysis on high-resolution anterior-segment optical coherence tomography (OCT) post-operative images.

Setting: Eye Institute, Athens, Greece


Two groups of corneal cross-sectional images obtained with the Optovue RTVue (Optovue Inc. Fremont, CA) anterior-segment Optical Coherence Tomography (OCT) system were studied: The first (control) group consisted of corneas unoperated, otherwise healthy, save for possible refractive error. All images were recorded during scheduled exam visits. The second group consisted of keratoconic (KCN) corneas previously operated with collagen cross-linking (CXL). All images were recorded during scheduled post-operative procedure visits. The two groups of images were investigated for possible quantitative evidence of changes induced due to cross-linking. Such evidence was considered intrastromal hyper-reflective areas (defined as the area consisting of pixels with luminosity greater than the mean + 2Ṫstandard deviation of the entire stromal cross section) within the corneal stroma, and correlation between the extent and depth of the hyper-reflected area was assessed.


In the second group (KCN patients treated with CXL), in all images there was evidence of intrastromal hyper-reflective area. Its areal extent ranged from 0.2 to 8.8% of the cross-sectional area (mean ±standard deviation 3.46 ±1.92%). The hyper-reflective area horizontal extent ranged from 4.42 to 99.2 % (56.2 ±23.35%) of the imaged corneal range, while the axial extent (vertical in the image) ranged from 40.00 to 86.67% (70.98 ±7.85%). There was significant statistical difference (P< 0.02) when compared to the control group, in which, by application of the same criteria the same hyper-reflective area ranged from 0.00% to 2.51% (0.74 ±0.63%).


We introduce a novel, non-invasive technique utilizing anterior segment OCT images to quantitatively assess the depth and surface area (quantitative effect) of CXL on corneal stroma. ?

Financial Disclosure:

... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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