Anterior-segment optical coherence tomography for the detection and therapeutic monitoring of corneal disorders

Background: Over recent years a revolutionary trend happened on imaging technologies to diagnose and monitor treatment of a varied group of ophthalmic pathologies. Recent reports have analyzed the microstructural changes of various ocular surface and corneal disorders, particularly ocular surface squamous neoplasia (OSSN) and keratoconus using anterior-segment optical coherence tomography (AS-OCT). Aim of this short communication is to elaborate on clinical applications AS-OCT for the detection and therapeutic monitoring of corneal disorders. Methods: We performed an English literature search without a time limit and intending to identify articles related to the AS-OCT applications in the detection and therapeutic monitoring of corneal disorders. The most relevant articles were selected.  practical points of selected papers and advantages and disadvantages of AS-OCT were retrieved from them and summarized. Results:.Many records reported the AS-OCT applications for diagnosing many ocular surface disorders, the microstructural changes of different inflammatory, infectious, degenerative, and dystrophic corneal disorders. Its applications in identifying disease activity and therapeutic monitoring of various corneal pathologies, including stromal edema associated with angle-closure glaucoma, Fuchs endothelial dystrophy, infectious keratitis, and bullous keratopathy, are promising. The percentage of diagnostic sensitivity, specificity, and accuracy of artificial intelligence methodologies applied to AS-OCT imaging analysis today has reached 94% to 100%. Moreover, AS-OCT is very useful for analyzing the extension of scar and leukoma depth for surgical planning of partial or total corneal transplantation. Conclusions: There is a clear prospect for expanding application of corneal OCT imaging technology, a rapid, non-invasive, and now a promising lower-cost device, which is becoming an in-office standard-of-care tool for the assessment of different corneal and ocular surface pathologies. KEYWORDS anterior-segment optical coherence tomography, AS-OCT, ocular surface disorders, corneal disorders, ocular surface squamous neoplasia, OSSN, keratoconu