Optical Coherence Tomography Angiography in Herpetic Leucoma

Background: Herpes simplex virus (HSV) keratitis remains a leading infectious cause of blindness worldwide. This study instends to investigate the potential of Optical Coherence Tomography Angiography (OCTA) device to image and describe quantitatively the vascularization in eyes diagnosed with herpetic leucoma and to discuss and review the usefulness of this technique in this pathology. Methods: : A Cross-sectional study was made, including 17 eyes of 15 patients with leucoma secondary to herpetic keratitis. All eyes underwent anterior segment Slit-Lamp photography (SLP), and Optical Coherence Tomography Angiography (OCT) with en-face, b-scans and c-scans imaging. The vessel density (VD) was analyzed in the inferior, nasal and temporal corneal margin in all patients, and in the central area, in eyes with central corneal neovascularization (CoNV). The measurements were calculated after binarization with ImageJ software, using OCTA scans with 6x6 mm in a depth of 800 μm. Results: : Patients included had a mean age 53.267±21.542 (years±SD). The mean total vessel area was 50.907±3.435%. VD was higher in the nasal quadrant (51.156±4.276) but there were no significant differences between the three analyzed areas (p=0.940). OCTA was able to identify abnormal vessels when SLP apparently showed no abnormal vessels; OCTA was able to distinguish between larger and smaller vessels even in central cornea; OCTA scans allowed the investigation of several corneal planes and the relation of them with clinical findings. Conclusions: : OCTA can be useful in both qualitative and quantitative follow-up of patients and may become a non-invasive alternative to objectively monitor treatment response in eyes with corneal vascularization due to herpetic infection.