Keratoconus causes progressive morphological changes in the corneal epithelium (EPI), Bowman’s membrane (BM) and anterior stroma. However, it is still not well understood if KC originates in the corneal epithelium and propagates to the anterior stroma through disruptions of the BM, or vice versa. In this study we used a sub-micrometer axial resolution OCT system to image in-vivo the cellular structure of the EPI layer and the fibrous structure of the BM and the anterior stroma in mild to advanced keratoconics, as well as healthy subjects. The imaging study was approved by the University of Waterloo Human Research Ethics Committee. The OCT system operates in the 800 nm spectral region at 34 kHz image acquisition rate and provides 0.95 um axial and < 2 um lateral resolution in corneal tissue, which is sufficient to visualize the cellular structure of the corneal epithelium and the fibrous structure of the BM. In some subjects, localized thinning and thickening of the EPI layer was observed, while there was no visible damage to the BM or anterior stroma. In other subjects, localized breakage of the stromal collagen fibrils was observed with no significant morphological changes of the corneal EPI.
Kostadinka Bizheva, Bingyao Tan, Erik Mason, Kirsten Carter, Lacey Haines, and Luigina Sorbara, "Cellular structure of the healthy and keratoconic human cornea imaged in-vivo with sub-micrometer axial resolution OCT (Conference Presentation)," Proc. SPIE 10045, Ophthalmic Technologies XXVII, 100450K (Presented at SPIE BiOS: January 28, 2017; Published: 16 May 2017); https://doi.org/10.1117/12.2253170.5370275050001.
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