Purpose
To assess the use of ultra high resolution optical coherence tomography (UHR-OCT) in the diagnosis of ocular surface lesions.
Design
Prospective, non-comparative, interventional case series.
Participants
Fifty four eyes of 53 consecutive patients with biopsy proven ocular surface lesions; 8 primary acquired melanosis, 5 amelanotic melanoma, 2 nevi, 19 ocular surface squamous neoplasia, 1 histiocytosis, 6 conjunctival lymphoma, 2 conjunctival amyloidosis, and 11 pterygia.
Intervention
UHR-OCT imaging of the ocular surface lesions.
Main Outcome Measures
Clinical course and photographs, UHR-OCT image and histopathological findings.
Results
UHR-OCT images of all examined ocular surface lesions showed close correlation with the obtained histopathological specimens. When clinical differential diagnosis of ocular surface lesions was broad, UHR-OCT images provided optical signs that guided towards a more specific diagnosis and management. In cases of amelanotic melanoma, conjunctival amyloidosis, and primary histiocytosis and in one case of ocular surface squamous neoplasia, UHR-OCT was instrumental in guiding the diagnosis. In those cases, UHR-OCT suggested that the presumed clinical diagnosis was incorrect and favored a diagnosis which was later confirmed by histopathological examination.
Conclusions
Correlations between UHR-OCT and histopathology confirm that UHR-OCT is an adjunctive diagnostic modality that can provide a non-invasive means to help and guide diagnosis and management of ocular surface lesions.
Purpose-(1) To demonstrate the capability of ultra high resolution anterior segment optical coherence tomography (UHR-OCT) to image Descemet's membrane (DM) and measure its thickness in vivo. (2) To evaluate the use of DM characteristics and thickness in the diagnosis of Fuchs' dystrophy.
Design-Case-Control StudyParticipants-20 eyes of 12 Fuchs' dystrophy patients, 20 eyes of 13 young normal and 20 eyes of 15 elderly normal subjects.Methods-Subjects were imaged using novel custom-built UHR-OCT. Images were used to describe the characteristics of DM. Custom-made software was used to measure DM thickness and central corneal thickness (CCT). Specimens of DM obtained from Fuchs' dystrophy patients who underwent endothelial keratoplasty (EK) were histopathologically examined. Regression analyses were used to assess the correlation of DM thickness measured by UHR-OCT in vivo and by light microscopy and to determine the intergroup correlations between age, CCT and DM thickness.
Main Outcome Measures-DM characteristics and thickness, CCT and age.Results-Using UHR-OCT, DM appeared in normal young subjects as a single opaque smooth line and in normal elderly subjects as a band of two smooth opaque lines with a translucent space in between. In Fuchs' dystrophy, DM appeared as a thickened band of two opaque lines; the anterior line was smooth while the posterior line had a wavy and irregular appearance with areas of localized thickenings. DM thickness measured in vivo by UHR-OCT correlated significantly to that measured by light microscopy in five Fuchs' dystrophy eyes that underwent EK. The average central thicknesses of DM in normal young, in normal elderly and in Fuchs' dystrophy eyes were 10 ± 3 μm, 16 ± 2 μm, and 34 ± 11 μm respectively (P < 0.001). There was a significant correlation between age and DM thickness only in normal groups. In Fuchs' dystrophy patients, there was a significant correlation between CCT and DM thickness which was non-significant for normal groups.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.