Corneal Shape In Disciform Keratitis Before And After Treatment Using Anterior Segment Optical Coherence Tomography
Published 2025 - 43rd Congress of the ESCRS
Reference: PO497 | Type: Free paper | DOI: 10.82333/q368-zt36
Authors: Leonard Goussard Heydenrych* 1 , Eric Abdullayev 2 , Benjamin Lambright 3
1Cornea and External Eye Disease,Port Elizabeth Provincial Hospital, Cape Eye Hospital and University of Cape Town ,Cape Town,South Africa, 2Innovation,Lions World Vision Institute,Tampa,United States, 3Innovation,West Coast Eye Institute,Lecanto,United States
Purpose
Disciform keratitis is a host immune response to herpes virus antigens that accumulate in the corneal stroma. Disciform keratitis results in circular stromal infiltration and central corneal edema, accompanied by keratic precipitates, leading to decreased visual acuity. However, the morphological changes in the cornea throughout the disease course remain poorly understood.
We analyzed corneal morphology before and after treatment in patients with disciform keratitis using anterior segment optical coherence tomography (AS-OCT).
Setting
This study was conducted at Osaka University Hospital, Osaka, Japan.
Methods
We included patients diagnosed with disciform keratitis who were treated at a university hospital and underwent AS-OCT evaluation (CASIA SS-1000; Tomey, Aichi, Japan) before and after treatment. Central corneal thickness, maximum corneal thickness, and anterior and posterior elevations at the thickest lesion were assessed before and after treatment using AS-OCT. The Wilcoxon signed-rank test was used for the statistical analysis of the differences in the parameters before and after treatment.
Results
A total of 15 eyes from 15 patients were enrolled (8 women, 7 men; mean age: 57.4 ± 14 years).
The average corrected LogMAR visual acuity significantly improved from 0.50 ± 0.61 before treatment to 0.18 ± 0.40 after treatment (p = 0.025). Both the average central corneal thickness and maximal corneal thickness significantly reduced after treatment (659 ± 102 µm to 525 ± 43 µm, p < 0.01; 832 ± 128 µm to 611 ± 52 µm, p < 0.01, respectively).
Anterior elevation did not significantly change (0.23 ± 15 µm to -4.5 ± 8.1 µm, p = 0.309); the absolute value of posterior elevation significantly decreased from -67 ± 47 µm to -20 ± 23 µm (p < 0.01).
Conclusions
In disciform keratitis, morphological changes were minimal on the anterior corneal surface, whereas corneal edema caused posterior protrusion of the stroma. Edema-related shape changes predominantly occurred posteriorly because the posterior stroma is likely to be more susceptible to deformation due to its lower rigidity than the anterior stroma. Treatment effectively reduced posterior protrusion, leading to favorable visual outcomes.