Advances in Corneal Imaging: Current Applications and Beyond

Recent advances in corneal imaging have allowed for more objective diagnosis and disease monitoring, as well as provided valuable guidance for treatment progress. However, there has been limited literature providing comprehensive insight into advances across different imaging modalities. The aim of this review was to provide a brief summary of significant advances in the field of corneal imaging over the past 5 years. A literature search in PubMed was performed on December 11, 2018, using the following key words in various and/or logic combinations: "cornea", "development", "advances", "topography", "Scheimpflug tomography", "ultra-high-speed Scheimpflug", "Corvis ST", "densitometry", "optical coherence tomography", "UHR-OCT", and "intraoperative OCT". The initial search showed a total of 2910 articles. Filters were then applied to select original research studies on humans published in the last 5 years which are available in full text and written in English. A final 55 studies were included for analysis. This review looks into 5 key imaging modalities: topography, tomography, confocal microscopy, densitometry, and angiography. For each imaging modality, the underlying scientific principles and current applications are outlined. Existing limitations and potential future applications for each of them are also discussed in this review. Recent advances in the imaging modalities show immense potential in providing objective, high-resolution, and comprehensive visualization of corneal structures and pathologies. Application to different fields in the future is highly probable but technical, economic, and skill-based limitations must first be overcome. Any attempt to replace traditional imaging techniques with these newer techniques must also be supported with evidence from robust clinical studies.