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Corneal Higher-Order Aberrations in Infectious Keratitis.

Eisuke Shimizu1, Takefumi Yamaguchi1, Yukari Yagi-Yaguchi1

  • 1Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan; Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

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Summary

Higher-order aberrations (HOAs) were significantly larger in eyes with infectious keratitis, including Acanthamoeba keratitis, bacterial keratitis, and fungal keratitis, compared to healthy eyes. These increased HOAs correlated with poorer visual acuity.

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Area of Science:

  • Ophthalmology
  • Corneal Disease
  • Optometry

Background:

  • Infectious keratitis, including Acanthamoeba keratitis (AK), bacterial keratitis (BK), and fungal keratitis (FK), can lead to significant corneal scarring and visual impairment.
  • Characterizing corneal higher-order aberrations (HOAs) is crucial for understanding the visual consequences of these infections.

Purpose of the Study:

  • To quantify and compare corneal higher-order aberrations (HOAs) in patients with Acanthamoeba keratitis (AK), bacterial keratitis (BK), and fungal keratitis (FK).
  • To investigate the relationship between corneal HOAs, corneal opacity, and visual acuity in these conditions.

Main Methods:

  • A retrospective case series analyzed 63 eyes of patients with corneal scarring from AK, BK, or FK, alongside 18 normal subjects.
  • Corneal HOAs of anterior, posterior, and total cornea were measured using anterior segment optical coherence tomography.
  • Corneal topography maps determined HOA patterns, and slit-lamp examinations graded corneal opacity.

Main Results:

  • Eyes with infectious keratitis exhibited significantly larger total corneal HOAs (AK: 1.15 ± 2.06 μm, BK: 0.91 ± 0.88 μm, FK: 1.39 ± 1.46 μm) compared to normal controls (0.09 ± 0.01 μm).
  • Asymmetric patterns were the most frequent HOA topographic pattern across all keratitis types.
  • Visual acuity strongly correlated with HOAs of the anterior surface (R=0.764), posterior surface (R=0.745), and total cornea (R=0.669).

Conclusions:

  • Increased corneal HOAs are a significant finding in infectious keratitis and are associated with reduced visual acuity.
  • Asymmetric HOA patterns are prevalent in infectious keratitis, highlighting the irregular corneal changes caused by these infections.