Tooth-in-eye standardized longitudinal radiological CT monitoring: Clinical impact in a fourteen-year series

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-16 DOI:10.1016/j.ejrad.2025.112242

Zhuyi Rebekah Lee , Felicia Teo , Sharon Kuan , Evan C Edmond , Stephanie Fook-Chong , Robert Chun Chen , Jean Chai , Andrew Tay , Donald Tan , Ling Ling Chan

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引用次数: 0

Abstract

Purpose

Report the natural history of laminar resorption quantitatively and qualitatively on serial CT after sight-restoring osteo-odonto-keratoprosthesis (OOKP) surgery, conduct OOKP survival analysis, and describe how standardized CT monitoring using a three-prong approach aids clinical evaluation and management, including decision-making for prophylactic OOKP exchange.

Method

CT data of OOKPs consecutively recruited over a 14-year period since program inception were retrospectively evaluated for laminar resorption on (1) linear measurements, (2) volumetry, (3) cross-sectional imaging and three-dimensional rendering. Findings in relation to ophthalmic complications on clinical follow-up were described, and OOKP Kaplan-Meier survival analysis performed.

Results

40 OOKPs (38 patients, mean age 39.9 years, 22 men) underwent a total of 197 serial CTs (average 3.9 scans per OOKP at 1.4-year intervals over 5.5-year follow-up). They charted a wide time range to first significant CT resorption (4.7 months-10.0 years): median time 3.6 years, and moderate/severe resorption < 5 years in 8/9 (88.9 %) OOKPs. Survival analysis showed steady laminar resorption beyond 2.3 years in Stevens-Johnson syndrome (SJS) patients, compared to less progressive resorption in non-SJS patients. Manual linear measurements were more sensitive than automated volumetry to laminar resorption, especially for the more commonly affected thinner and superior/inferior poles. Moderate/severe resorption culminated in OOKP failure and ocular loss in three patients; two showed preceding telltale peri-optic erosions despite clinical stability. Three other patients underwent prophylactic OOKP exchange to salvage vision.

Conclusions

Lifelong, standardized three-prong CT monitoring for OOKP resorption value-adds to clinical evaluation, assisting decision-making for early intervention to avert irrevocable blindness.

查看原文本刊更多论文

眼内牙标准化纵向放射CT监测：14年系列的临床影响

目的通过系列CT定量和定性地报道视力恢复骨-牙-角膜假体（OOKP）手术后椎板吸收的自然史，进行OOKP生存分析，并描述使用三管其下的标准化CT监测如何辅助临床评估和管理，包括预防性OOKP交换的决策。方法回顾性评估自项目开始以来连续招募的14年OOKPs的ct数据(1)线性测量，(2)体积测量，(3)横断面成像和三维渲染。在临床随访中描述了眼部并发症的相关发现，并进行了OOKP Kaplan-Meier生存分析。结果40例OOKP（38例患者，平均年龄39.9岁，22例男性）共接受了197次连续ct检查（平均3.9次扫描/ OOKP，间隔1.4年，随访5.5年）。他们绘制了第一次显著CT吸收的时间范围（4.7个月-10.0年）：中位时间3.6年，中度/重度吸收<；8/9 (88.9%) OOKPs为5年。生存分析显示，史蒂文斯-约翰逊综合征（SJS）患者2.3年以上椎板吸收稳定，而非SJS患者椎板吸收进展较慢。手工线性测量比自动体积法对层流吸收更敏感，特别是对于更常见的薄极和上/下极。中度/重度吸收最终导致3例患者OOKP衰竭和视力丧失；其中两例尽管临床稳定，但仍有明显的视周糜烂。另外3例患者接受了预防性的OOKP置换以恢复视力。结论终身、标准化的三针CT监测对OOKP吸收有临床评价价值，有助于早期干预决策，避免不可逆转失明。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.