Name

Apport de l’OCT du segment antérieur dans la prise en charge des abcès cornéens

We aim to describe the role of anterior segment optical coherence tomography (AS-OCT)  in the management of bacterial corneal abscess.

Case report.

A 21‑year‑old female presented with sudden painful and redness of her left eye 24 hours after her first time wearing of contact lenses. Best corrected visual acuity was 20/25 in left eye. Slit‑lamp biomicroscopy revealed a paracentral corneal abscess with stromal infiltration and grade 2 anterior chamber cells. Intraocular pressure and fundus were normal. AS-OCT showed epithelium defect, stromal infiltration and posterior bowing of the endothelium due to edema. Klebsiella pneumonia was isolated after corneal scraping. After topic and systemic antibiotic, AS-OCT showed restitution of the epithelium defect, decrease of stromal infiltration and corneal thickness.

Bacterial abscess, an infective and inflammatory condition of the cornea, is routinely assessed with slit-lamp biomicroscopy. Recently in vivo assessment of microbial keratitis has become possible with AS-OCT. It helps in evaluation of microbial keratitis and assessing treatment response objectively.  It can be used to monitor in vivo the clinical course of corneal abscess. This modality provides cross-sectional scans of the cornea and assessment of the depth of inflammation with measurements of stromal infiltration thickness and corneal thickness in the infiltrated area. Infiltrate is seen as hyperreflective areas in corneal stroma on high‑resolution scans.

Anterior optical coherence tomography can help in the evaluation of the microbial keratitis and assessing treatment response more objectively.