Objective quantification of corneal haziness using anterior segment optical coherence tomography

Purpose: To quantify normal corneal transparency by anterior segment optical coherence tomography (AS-OCT) by measuring the average pixel intensity. To analyze the variation in the average pixel intensity in mild and severe grades of corneal opacities. Methods: This is an observational, cross-sectional study of 38 eyes from 19 patients with mild or severe grades of corneal opacities greater than 3 mm and a normal contralateral cornea. AS-OCT was performed centered on the opacity with a 3 mm cruciate protocol. A similar image is taken of the contralateral clear cornea in the same quadrant. The average pixel intensity was calculated in a standardized manner using MATLAB software. Result: The average pixel intensity of the normal cornea was 99.6 ± 10.9 [standard deviation (SD)]. The average pixel intensity of the mild and severe corneal opacities was 115.5 ± 9.1 and 141.1 ± 10.3, respectively. The differences were statistically significant. Conclusions: AS-OCT images can be used to quantify corneal transparency. Average pixel intensity is a measure that varies significantly with varying corneal opacification.