Persistent loss of marginal corneal arcades after chemical injury

Abstract

Changes in the limbal microvasculature following a chemical eye injury are essential for prognosis and management. At the slit lamp, it can be difficult to assess, here using fluorescein and indocyanine green angiography we show that anterior segment angiography may be informative to assess objectively the limbal microvascular changes over the follow-up period. Chemical injury to the ocular surface is an ophthalmic emergency that may result in damage to the marginal corneal arcades (MCA), limbal microvasculature, and limbal epithelial stem cell niche.Accurate evaluation and monitoring of this microvasculature is essential for prognosis and management, if assessed at the slit lamp it can be challenging.Fluorescein and indocyanine green angiography (FA and ICGA), and to a lesser extent optical coherence tomography angiography (OCTA), have been shown to be informative in the diagnosis of these vascular changes. There is little information, however, on long term longitudinal changes to the MCA and limbal vasculature following a chemical injury, which may be of importance in planning clinical and surgical interventions that depend on a healthy supportive peri-limbal microvasculature. We report the vascular changes that occur in a patient over a 6-year time period following a chemical injury.