Corneal Reverberations On Ocular Ultrasound

To evaluate the characteristic AS-OCT  findings in decompensated corneas  with reverberations observed on ocular ultrasound similar to IOL reverberations.

The study was performed in a tertiary eye care centre in North Delhi, India.

30 eyes with decompensated cornea were studied. Clinical photography, ultrasonography, and AS-OCT were performed in all the cases. The AS-OCT characteristics were studied in patients with corneal reverberations and those without. Ultrasonography was performed with a 10MHz probe at a gain of 82 db with persisting reverberations noted till 60db.

Group A comprised of eyes showing a reproducible reverberations originating from the cornea and reaching  till the retina similar to IOL reverberations in axial sections. Group B comprised of eyes which did not show reverberations on ultrasonography.

Group A comprised of 21 eyes while group B had 9 eyes. Eyes with PBK, healed keratitis, failed DSAEK, graft infection and rejection were included.

Mean corneal thickness on ASOCT was 921 µm  and 837 µm in group A and B respectively. A distinct margin from hyperreflective decompensated cornea to iso-reflective cornea was noted in group A eyes. Group B eyes did not have a drastic change from decompensated to normal cornea. There was a vast difference in the reflectivity between the decompensated and normal cornea in group A, whereas there was  uniformly blending in group B.

The sharp difference in reflectivity between anterior and posterior part  of the cornea in group A with a sharp demarcation line  acted as a strong reflector resulting in acoustic reverberations. Corneal reverberations have not been reported in literature till date.