Anterior Segment Optical Coherence Tomography in Monitoring Therapeutic Response in Viral Disciform Keratitis

Purpose: To describe the characteristic anterior segment optical coherence tomography (ASOCT) features and its role in monitoring therapeutic response in viral disciform keratitis. Methods: A retrospective analysis of records of four eyes of four patients of viral disciform keratitis was performed. The responses to therapy by tablet Acyclovir 400 mg five times a day and topical steroid was monitored by serial ASOCT at each visit. Results: All patients showed marked improvement in visual acuity and ASOCT characteristics after starting treatment. The site of maximum corneal thickness was outlined by ASOCT and evaluated on serial ASOCT. Corneal thickness showed maximum reduction in initial two weeks period with resolution in stromal oedema and smoothening of posterior corneal contour. Hyperreflectivity on ASOCT showed initial increase after resolution of stromal oedema followed by decrease over next two months period. Conclusion: ASOCT evaluation of cornea may provide an important surrogate objective measure for assessment of viral disciform keratitis and monitoring the response to treatment.