Abstract
OBJECTIVE: To compare the diagnostic accuracy of anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM) in evaluating Kayser-Fleischer (KF) rings in patients with Wilson disease (WD). METHODS AND ANALYSIS: A prospective observational study enrolled 36 subjects (16 women) and 36 controls (16 women). All participants underwent both AS-OCT and IVCM, and the results were analyzed using McNemar's test to assess diagnostic concordancet. RESULTS: KF rings were not detected either with AS-OCT or with IVCM in any of the controls. Among the WD patients, seven subjects who did not show KF rings on AS-OCT were found to have them on IVCM (p < 0.05), six of whom were identified diagnosed with hepatic WD. CONCLUSION: Both AS-OCT and IVCM can provide objective assessment of KF rings. IVCM offers better accuracy compared to AS-OCT, particularly for hepatic WD.