Optical coherence tomography (OCT) is a well-established, non-invasive, high-resolution retinal imaging modality that is gaining widespread popularity in the clinic to assess pathological changes in the anterior segment, such as corneal edema, fibrosis, and neovascularization. We examined the potential of anterior segment (AS-OCT) as a quantitative and qualitative tool for grading ocular injury following chemical exposure. Current clinical ocular toxicity assessment primarily evaluates ocular surface changes, neglecting any deeper damage, and is largely incapable of gauging the depth of damage, a key prognostic determinant. In this work, we demonstrate the capability of AS-OCT to visualize ocular changes, such as Descemet’s membrane detachment, corneal swelling, epithelial keratinization, and iris damage. Furthermore, we show consistent differences in the progression of corneal damage following chemical exposure at mild, moderate, and severe dose levels and attempt to quantify some of these changes, such as corneal thickness and neovascularization. In conclusion, AS-OCT combined with OCT angiography (OCTA) is a powerful non-invasive imaging tool for monitoring changes in the eye and provides an improved understanding of the concentration-dependent progression of chemical injury. As such, AS-OCT can guide the clinical management of ocular chemical exposures, as well as advance eye irritation safety testing.
Optical coherence tomography angiography (OCTA) is a well-established retinal imaging modality that is emerging as a fast, non-invasive alternative to fluorescence angiography for assessment of corneal injury and neovascularization caused by chemical injuries, infections, and other sources of corneal damage. OCTA algorithms typically perform operations on multiple scans, or frames, at the same location to identify flowing vasculature. In this work, we describe a novel singleframe algorithm that relies on common image processing operations, allowing for broad application to various OCT systems, as well as reduced acquisition and computation times. We also show the potential of a multi-frame approach, based on the same principle, that allows for enhanced discrimination between flowing and static anatomical features. To demonstrate the capability of our approach, we processed the same image stack with our single-frame and multi-frame algorithms along with other angiography algorithms, such as phase variance, speckle variance, and complex differential variance and found that our algorithms had higher estimated signal-to-noise ratios (SNR) and lower computation times. We applied our algorithms to quantifying corneal neovascularization (CoNV) in a murine model of corneal burn injury through semi-automated measurement of vessel area and compared them to the gold standard of fluorescein angiography. This work provides strong evidence for the power of the single-frame algorithm and its multi-frame variant, as well as the potential of OCTA for quantification of corneal pathology beyond the standard fluorescein angiography approach allowing for more accurate monitoring and staging of corneal injury and wound healing.
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