Anterior Segment Optical Coherence Tomography Findings In Necrotizing Stromal Herpetic Keratitis.

To prove the efficiency of Anterior segment optical coherence tomography (AS-OCT) in evaluating tomographic corneal changes in necrotizing stromal herpetic keratitis.

Department of ophthalmology, Mohamed Taher Maamouri hospital, Nabeul, Tunisia

We report the anterior segment optical coherence tomography findings in two patients who presented with necrotizing stromal herpetic keratitis.

Our two patients were 30 and 45 year old males. The second had a previous episode of stromal necrotizing herpetic keratitis complicated by a corneal perforation plugged by the iris. Both patients presented with blurry vision and red eye. Slit lamp examination showed corneal edema, a paracentral stromal infiltrate with an overlying epithelial ulceration. AS-OCT analysis of epithelial structure showed three types of changes: epithelial defect, epithelial thickening and subepithelial hyporeflective cystic spaces. The stromal alterations included thickening, thinning, hyperreflective lesions and hyporeflective cystic spaces. Retrocorneal inflammatory plaques viewed as hyperreflective lesions adherent to the endothelium were seen

AS-OCT is a useful tool in the assessment of patients presenting with herpetic keratitis. It allows an objective evaluation of corneal changes and highlights microstructural corneal alterations that cannot be seen through slit lamp examination.