Utility Of Anterior Segment Optical Coherence Tomography (Asoct) Biomarkers In Predicting Future Recurrences In Recurrent Corneal Erosion Syndrome.

To study anterior segment optical coherence tomography(ASOCT) findings  and anterior segment optical coherence tomography based epithelial mapping(ASOCT- EPI) changes in patients with recurrent corneal erosion syndrome (RCES)and to determine the  predictors of future recurrence amongst them.

Retrospective observational study (Jan 2022-23). All patients with symptoms suggestive of RCES were enrolled in the study . They were divided into 2 groups based on their reported history of recurrence. “GROUP F” : Frequent recurrence group i.e those patients who complained of  at least 1 episode of recurrence in a month and “GROUP R”: Rare recurrence group (R): comprising of patients reporting limited recurrence since initial incident/symptoms once or less every 2-3 months.

RCES area charted on slit lamp evaluation was then scanned by ASOCT and ASOCT-epithelial (EPI) mapping.ASOCT changes are classified into Epithelial (E), Basement membrane-Bowmans(BM-BM)complex, and stromal(S).ASOCT-EPI mapping identified corneal epithelial thickening termed as hot spots and its correspondence to RCES area documented by slitlamp evaluation was assessed. Patients with corneal disease/surgery history were excluded

Thirty-six patients were enrolled. Majority were females with left eye predilection. The most common cause of injury was fingernail (25 %).Among the ASOCT findings, E and BM-BM changes were noted in most patients,but a statistically significant difference between the two groups was noted for BM-BM changes only (more commonly seen in the F group with a p-value of 0.038).Stromal changes were rare.Our findings demonstrate that mere slit- lamp examination through which only epithelial changes can be recorded but not BM-BM changes, is incapable of deleniating patients at increased risk of frequent recurrent episodes.ASOCT-EPI hot spots matched clinically drawn RCES areas in majority of patients and demarcate the area of loose epithelium clearly.

Slit-lamp examination of epithelial erosion is inadequate for follow-up of RCES. AS-OCT biomarkers help identify patients needing early surgical intervention to reduce RCES morbidity.