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
{"title":"Tooth-in-eye standardized longitudinal radiological CT monitoring: Clinical impact in a fourteen-year series","authors":"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","doi":"10.1016/j.ejrad.2025.112242","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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 <em>peri</em>-optic erosions despite clinical stability. Three other patients underwent prophylactic OOKP exchange to salvage vision.</div></div><div><h3>Conclusions</h3><div>Lifelong, standardized three-prong CT monitoring for OOKP resorption value-adds to clinical evaluation, assisting decision-making for early intervention to avert irrevocable blindness.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"190 ","pages":"Article 112242"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X25003286","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
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.
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.