Anterior Segment Optical Coherence Tomography as a Follow Up Tool in Infectious Keratitis

Background: Infectious keratitis, a severe corneal condition, requires early empiric therapy due to a 48-hour diagnosis delay that can worsen outcomes. Anterior segment optical coherence tomography (AS-OCT) improves management by offering detailed scans of inflammation depth, stromal infiltration, and corneal thickness, enhancing diagnosis and treatment.Objectives: To detect changes of AS-OCT in following up and prognosis of infectious keratitis.Patients and methods: This study at Qena University Hospital involved 30 patients with infectious keratitis. Excluding those with retinal, corneal, or optic nerve diseases, patients were assessed on presentation and at 7, 14, 28 days, and 6 weeks using AS-OCT for corneal and infiltration thickness, alongside visual acuity and slit lamp examination.Results: The mean age was 35.07 ± 6.53 years, with 43.33% male and 56.67% female. Bacterial infections (53.33%, n=16) showed significant improvement in best spectacle-corrected visual acuity (BSCVA) at 1, 2, 4, and 6 weeks (P<0.0001). Fungal infections (33.33%, n=10) improved at 2, 4, and 6 weeks (P<0.0015), while viral infections (13.33%, n=4) showed little change. Corneal thickness significantly decreased after one week, especially in bacterial infections. Infiltration thickness decreased notably for bacterial infections at 2, 4, and 6 weeks (P<0.0001), with no significant differences among infection types (P>0.05).Conclusion: AS-OCT monitors infectious keratitis, enhancing BSCVA and lowering corneal and infiltration thickness, especially for bacterial and fungal infections. AS-OCT showed bigger bacterial infection changes, but it applied to all infections, demonstrating its role in quantitative therapy and better patient outcomes through accurate, non-invasive follow-up.