Long-Term Monitoring of Corneal Grafts Via Anterior Segment OCT Pachymetry Maps

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-01-31 DOI:10.1016/j.xops.2025.100724

Anastasia Neokleous MD, MSc , Neofytos Michail MD , Fedonas Herodotou MD , Aikaterini Athanasiadou MSc , Stylianos Christodoulou MD, MSc , Dimitris Kola MD , Klea Panayidou PhD , Georgina Hadjilouka MD, PhD , Sotiria Palioura MD, PhD

{"title":"Long-Term Monitoring of Corneal Grafts Via Anterior Segment OCT Pachymetry Maps","authors":"Anastasia Neokleous MD, MSc , Neofytos Michail MD , Fedonas Herodotou MD , Aikaterini Athanasiadou MSc , Stylianos Christodoulou MD, MSc , Dimitris Kola MD , Klea Panayidou PhD , Georgina Hadjilouka MD, PhD , Sotiria Palioura MD, PhD","doi":"10.1016/j.xops.2025.100724","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the efficacy of anterior segment OCT (AS-OCT) in the long-term monitoring of corneal grafts and its integration into a hybrid remote care model for early detection and management of graft rejection or failure.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Participants</h3><div>Seventy-four patients (93 eyes) who underwent corneal transplantation from October 2021 to December 2023, with a follow-up period of ≥6 months.</div></div><div><h3>Methods</h3><div>Serial AS-OCT pachymetry maps and cross-sectional scans were performed at fixed postoperative intervals, and the findings were correlated with clinical signs of graft rejection or failure on slit lamp examination for thickness changes >50 μm. A hybrid remote AS-OCT screening protocol was initiated 1 week postoperatively.</div></div><div><h3>Main Outcome Measures</h3><div>Diagnostic accuracy of AS-OCT, measured by specificity and sensitivity, in detecting graft rejection or failure through changes in corneal and graft thickness.</div></div><div><h3>Results</h3><div>Anterior segment OCT demonstrated high diagnostic accuracy with a specificity of 97.6% and a sensitivity of 88.9% in detecting graft rejection or failure. The mean central corneal thickness increase in cases resulting in graft rejection or failure was 82.7 ± 21.5 μm, a thickness change that is not discernible by slit lamp examination alone. The utility of AS-OCT in a hybrid remote monitoring model was demonstrated through 3 detailed case studies, highlighting improved clinical workflow and patient convenience without compromising postoperative outcomes.</div></div><div><h3>Conclusions</h3><div>Serial AS-OCT imaging serves as a robust, objective, and quantitative tool for postoperative surveillance of corneal grafts, significantly benefiting patient outcomes by allowing timely interventions. Integration of AS-OCT into a hybrid remote screening protocol supports comprehensive monitoring, complementing direct clinical evaluations and optimizing postoperative care.</div></div><div><h3>Financial Disclosure(s)</h3><div>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</div></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 4","pages":"Article 100724"},"PeriodicalIF":3.2000,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666914525000223","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To assess the efficacy of anterior segment OCT (AS-OCT) in the long-term monitoring of corneal grafts and its integration into a hybrid remote care model for early detection and management of graft rejection or failure.

Design

Prospective cohort study.

Participants

Seventy-four patients (93 eyes) who underwent corneal transplantation from October 2021 to December 2023, with a follow-up period of ≥6 months.

Methods

Serial AS-OCT pachymetry maps and cross-sectional scans were performed at fixed postoperative intervals, and the findings were correlated with clinical signs of graft rejection or failure on slit lamp examination for thickness changes >50 μm. A hybrid remote AS-OCT screening protocol was initiated 1 week postoperatively.

Main Outcome Measures

Diagnostic accuracy of AS-OCT, measured by specificity and sensitivity, in detecting graft rejection or failure through changes in corneal and graft thickness.

Results

Anterior segment OCT demonstrated high diagnostic accuracy with a specificity of 97.6% and a sensitivity of 88.9% in detecting graft rejection or failure. The mean central corneal thickness increase in cases resulting in graft rejection or failure was 82.7 ± 21.5 μm, a thickness change that is not discernible by slit lamp examination alone. The utility of AS-OCT in a hybrid remote monitoring model was demonstrated through 3 detailed case studies, highlighting improved clinical workflow and patient convenience without compromising postoperative outcomes.

Conclusions

Serial AS-OCT imaging serves as a robust, objective, and quantitative tool for postoperative surveillance of corneal grafts, significantly benefiting patient outcomes by allowing timely interventions. Integration of AS-OCT into a hybrid remote screening protocol supports comprehensive monitoring, complementing direct clinical evaluations and optimizing postoperative care.