Machine learning quantitative OCT derived fibrosis indicators for corneal haze evaluation

Photorefractive Keratectomy (PRK) is a widely used laser-assisted refractive surgical technique. In some cases, it leads to temporary subepithelial fibrosis linked to visual haze, but objective and quantitative tools to monitor these symptoms are lacking. We here present a machine learning-based method for the classification of corneal images from spectral domain optical coherence tomography images recorded in vivo on standard clinical devices and use it to extract quantitative fibrosis indicators. Because of the transient nature and relative rarity of significant post-PRK haze, we trained the model on corneas presenting Fuchs' Endothelial Corneal Dystrophy, causing similar, but permanent, fibrotic changes, and applied it to images from patients who have undergone PRK surgery. Our study shows that the model output (probability of pathological classification) combined with OCT-derived quantitative fibrosis descriptors provides an interpretable and explainable indicator of corneal healing for post-operative follow-up.