Corneal Endothelial/Descemets Complex Tomography for the Diagnosis of Pre-Clinical Corneal Graft Rejection | ASCRS
Presentation
Corneal Endothelial/Descemets Complex Tomography for the Diagnosis of Pre-Clinical Corneal Graft Rejection
May 2020
Meeting: 2020 Virtual Annual Meeting
Session: SPS-101 Corneal Procedures & Diagnostics: EK, PK, CXL, Other
Authors: Mohamed Abou Shousha, MD, Taher Eleiwa MD, MSc, Amr Elsawy MSc
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Purpose
Evaluate the utility of central Endothelial/Descemets Complex thickness (cDMT) obtained using anterior segment optical coherence tomography (ASOCT) for the diagnosis of pre-clinical corneal graft rejection.

Methods
In this longitudinal prospective study, 30 patients underwent a high-risk corneal transplant and were imaged using ASOCT (Envisu R2210, Bioptigen, Buffalo Grove, IL) at the 1st, 3rd, 6th, 9th and 12th postoperative month. We measured cDMT using corneal microlayer tomography technique, which segments and produces 3 dimensional bulls-eye and color coded maps of corneal microlayers. The ability of cDMT in diagnosing pre-clinical corneal graft rejection was assessed by correlating measured cDMT at different visits to the clinical diagnosis obtained from a cornea specialist at Bascom Palmer Eye Institute. One-year rates of corneal graft rejection were calculated using cumulative incidence.

Results
In patients with clinically diagnosed corneal graft rejection (43.3%), the cDMT increased significantly 4.7 months (95%CI: 2.8-6.6) prior to the clinical diagnosis of corneal graft rejection, while it remained stable in patients without corneal graft rejection. The 1-year cumulative incidence of corneal graft rejection was 87.5% (hazard ratio = 18, 95% CI: 2-144) in patients with a 3-month cDMT ≥19µm, versus 16.7% for cDMT <19µm (P <0.001).

Conclusion
In high-risk corneal transplants, the increase in cDMT allowed the diagnosis of pre-clinical corneal graft rejection at least 3 months before the clinical diagnosis.
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This presentation is from the session "SPS-101 Corneal Procedures & Diagnostics: EK, PK, CXL, Other" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.

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