# Optical Coherence Tomography-Aided Differential Diagnosis and Treatment of Irregular Corneas

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2022 · $373,450

## Abstract

PROJECT SUMMARY
To see well, the cornea must maintain near perfect clarity and shape. Several disease processes can distort
corneal shape and degrade vision. These include ectasia/keratoconus (stromal thinning and bulging), primary
epithelial deformation (contact lens-related warpage, dry eye, epithelial basement membrane dystrophy), and
stromal changes (scar, stromal dystrophy, surgery). Some of these conditions can appear similar on standard
anterior topography and yet require very different treatments. Therefore a goal of this project is to use optical
coherence tomography (OCT), a 3-dimensional imaging technology with micrometer-level resolution, to
differentiate between different types of corneal shape irregularities. The unique ability of OCT to measure
epithelial thickness and posterior topography will be used to develop new metrics for staging and monitoring of
ectasia and primary epithelial deformation. We will also improve the treatment of corneal stromal irregularities
by combining OCT planning and topography-guided excimer laser ablation, which has only recently become
available in the U.S. Our overall goal is to improve the early detection, differential diagnosis, staging,
monitoring, and treatment of irregular corneas by using advanced optical imaging and laser technologies to
achieve the following Specific Aims:
 (1) Develop an OCT-based system to classify and evaluate corneal shape irregularities. Standard corneal
topography only measures the anterior corneal surface and cannot by itself differentiate between different
causes of irregularities. In a cross-sectional clinical study, we will develop mathematical analyses of OCT maps
of corneal anterior and posterior topography, epithelium, and pachymetry to improve the early detection,
classification, and staging of irregularities including ectasia, epithelial deformations, and stromal changes.
 (2) Develop OCT metrics for more sensitive detection of keratoconus progression. Standard anterior
topographic parameters such as maximum keratometry have poor reproducibility and poor detection sensitivity
in early disease. Our preliminary results show that OCT epithelial and posterior topographic measurements are
more sensitive to early keratoconus and have better repeatability. This could enable more timely identification
of patients who need collagen crosslinking to stabilize the cornea. Early detection of progression will be tested
in a longitudinal study of patients with subclinical keratoconus.
 (3) Develop OCT-and-topography guided phototherapeutic keratectomy (PTK) for irregular corneas. We
have demonstrated that transepithelial PTK with OCT planning can significantly improve vision for patients with
scarred or irregular corneas. We propose to further improve operative results using the newly available
topography-guided excimer laser, which has been approved for laser-assisted in situ keratomileusis (LASIK) in
normal eyes but has not yet been tested in PTK. We plan to conduct a clini...

## Key facts

- **NIH application ID:** 10407569
- **Project number:** 5R01EY029023-05
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Yan Li
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $373,450
- **Award type:** 5
- **Project period:** 2018-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10407569

## Citation

> US National Institutes of Health, RePORTER application 10407569, Optical Coherence Tomography-Aided Differential Diagnosis and Treatment of Irregular Corneas (5R01EY029023-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10407569. Licensed CC0.

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