eprintid: 10074494 rev_number: 31 eprint_status: archive userid: 608 dir: disk0/10/07/44/94 datestamp: 2019-05-21 09:15:56 lastmod: 2021-09-19 23:03:23 status_changed: 2019-05-21 09:15:56 type: article metadata_visibility: show creators_name: Fung, SSM creators_name: Stewart, RMK creators_name: Dhallu, SK creators_name: Sim, DA creators_name: Keane, PA creators_name: Wilkins, MR creators_name: Tuft, SJ title: Anterior Segment Optical Coherence Tomographic Angiography Assessment of Acute Chemical Injury ispublished: pub subjects: MOOR divisions: UCL divisions: B02 divisions: C07 divisions: D08 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: PURPOSE: To compare routine clinical examination with optical coherence tomography angiography (OCTA) for the assessment of limbal conjunctival ischemia following a chemical burn. SETTING: Validity analysis. METHODS: We assessed ten participants (15 eyes) with an acute chemical injury. Clinical photographs were used to determine the extent of any limbal conjunctival epithelial defect and ischemia. These were compared with the extent of limbal ischemia identified on OCTA images of the ocular surface. Quantitative and longitudinal analysis using the OCTA software were also performed. Correlations with visual outcome were sought using clinical and OCTA-derived variables. RESULTS: The extent of clinically determined limbal ischemia was less than that identified with OCTA (2.3±3.6 clock hours v 5.1±4.2 clock hours, p = 0.003), which in turn was less than the size of limbal conjunctival epithelial defect (7.3±5.1 clock hours, p = 0.03). Longitudinal OCTA analysis showed that mean vessel area increased by 0.2 ±0.1% during the study, corresponding to a rate of vascular recovery of 0.9mm^{2}/day. Significant correlations were found between visual outcome at 3 months and limbal conjunctival fluorescein staining (r = 0.67, p = 0.006), and limbal conjunctival ischemia on OCTA (r = 0.76, p = 0.001). CONCLUSIONS: OCTA can objectively identify and monitor the recovery of limbal ischemia following an acute ocular chemical injury. OCTA confirms that limbal ischemia is usually more extensive than is suggested by clinical examination, and the former is highly correlated with visual outcome. OCTA therefore is a useful tool in the management of ocular chemical injury. date: 2019-09 date_type: published official_url: https://doi.org/10.1016/j.ajo.2019.04.021 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1657714 doi: 10.1016/j.ajo.2019.04.021 pii: S0002-9394(19)30202-8 lyricists_name: Keane, Pearse lyricists_name: Sim, Dawn lyricists_name: Tuft, Stephen lyricists_name: Wilkins, Mark lyricists_id: KPEAR28 lyricists_id: DASYS88 lyricists_id: SJTUF57 lyricists_id: MRWIL52 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: American Journal of Ophthalmology volume: 205 pagerange: 165-174 event_location: United States issn: 1879-1891 citation: Fung, SSM; Stewart, RMK; Dhallu, SK; Sim, DA; Keane, PA; Wilkins, MR; Tuft, SJ; (2019) Anterior Segment Optical Coherence Tomographic Angiography Assessment of Acute Chemical Injury. American Journal of Ophthalmology , 205 pp. 165-174. 10.1016/j.ajo.2019.04.021 <https://doi.org/10.1016/j.ajo.2019.04.021>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10074494/7/Keane_Anterior%20segment%20optical%20coherence%20tomographic%20angiography%20assessment%20of%20acute%20chemical%20injury_AAM.pdf