Anterior segment optical coherence tomography (AS-OCT) for the visualization and quantification of dose-dependent ocular toxicity

Optical coherence tomography (OCT) is a well-established, non-invasive, high-resolution retinal imaging modality that is gaining widespread popularity in the clinic to assess pathological changes in the anterior segment, such as corneal edema, fibrosis, and neovascularization. We examined the potential of anterior segment (AS-OCT) as a quantitative and qualitative tool for grading ocular injury following chemical exposure. Current clinical ocular toxicity assessment primarily evaluates ocular surface changes, neglecting any deeper damage, and is largely incapable of gauging the depth of damage, a key prognostic determinant. In this work, we demonstrate the capability of AS-OCT to visualize ocular changes, such as Descemet's membrane detachment, corneal swelling, epithelial keratinization, and iris damage. Furthermore, we show consistent differences in the progression of corneal damage following chemical exposure at mild, moderate, and severe dose levels and attempt to quantify some of these changes, such as corneal thickness and neovascularization. In conclusion, AS-OCT combined with OCT angiography (OCTA) is a powerful non-invasive imaging tool for monitoring changes in the eye and provides an improved understanding of the concentration-dependent progression of chemical injury. As such, AS-OCT can guide the clinical management of ocular chemical exposures, as well as advance eye irritation safety testing.