In vivo imaging of palisades of Vogt in dry eye versus normal subjects using en-face spectral-domain optical coherence tomography

Abstract

PurposeTo evaluate a possible clinical application of spectral-domain optical coherence tomography (SD-OCT) using en-face module for the imaging of the corneoscleral limbus in normal subjects and dry eye patients.Patients and methodsSeventy-six subjects were included in this study. Seventy eyes of 35 consecutive patients with dry eye disease and 82 eyes of 41 healthy control subjects were investigated. All subjects were examined with the Avanti RTVue® anterior segment OCT. En-face OCT images of the corneoscleral limbus were acquired in four quadrants (inferior, superior, nasal and temporal) and then were analyzed semi-quantitatively according to whether or not palisades of Vogt (POV) were visible. En-face OCT images were then compared to in vivo confocal microscopy (IVCM) in eleven eyes of 7 healthy and dry eye patients.ResultsEn-face SD-OCT showed POV as a radially oriented network, located in superficial corneoscleral limbus, with a good correlation with IVCM features. It provided an easy and reproducible identification of POV without any special preparation or any direct contact, with a grading scale from 0 (no visualization) to 3 (high visualization). The POV were found predominantly in superior (P<0.001) and inferior (P<0.001) quadrants when compared to the nasal and temporal quadrants for all subjects examined. The visibility score decreased with age (P<0.001) and was lower in dry eye patients (P<0.01). In addition, the score decreased in accordance with the severity of dry eye disease (P<0.001).ConclusionEn-face SD-OCT is a non-contact imaging technique that can be used to evaluate the POV, thus providing valuable information about differences in the limbal anatomy of dry eye patients as compared to healthy patients.

Fourier-Domain OCT Imaging of the Ocular Surface and Tear Film Dynamics: A Review of the State of the Art and an Integrative Model of the Tear Behavior during the Inter-Blink Period and Visual Fixation

“…Similarly, the lacrimal punctal region and the anatomy of vertical canaliculus have been directly imaged and analyzed by commercially available OCT systems and a positive correlation has been found between tear meniscus height and size of the lacrimal punctum ( Figure 10) [89,90]. Moreover, corneo-scleral tissue morphology can also be investigated by detecting the Vogt palisades, the blood and lymph vasculature [91,92]. J. Clin.…”

Spectral-Domain Optical Coherence Tomography For Evaluating Palisades of Vogt in Ocular Surface Disorders With Limbal Involvement

“…In the past years, optical coherence tomography (OCT) has become a widely used clinical tool for imaging of the ocular surface, although it was mostly used for the observation of the optic disc and retinal choroidal structure 22 . Recently, studies have used AS-OCT to visualize the POV in healthy 9,13 and pathological conditions [11][12][13] . Although SD-OCT has not yet been able to identify the structure of individual limbal stem cells, research-grade OCT with a high resolution (0.95-μm axial resolution and 2-μm lateral resolution) could visualize individual pigmented cells along brous folds and red blood cells inside the capillaries of the POV 23 .…”

“…Haagdorens et al used tangential cross-sectional images obtained by SD-OCT to observe and quantify limbal crypts and the density of POV (presented as number of palisades per millimeter) and provided useful information for evaluation of the POV 10 . Furthermore, studies have used SD-OCT to grade the abnormality of the POV and demonstrated the power of SD-OCT to grade disease severity in limbal stem cell de ciency (LSCD) [11][12][13] . All these results have demonstrated the value of SD-OCT for evaluation of the POV in diseased eyes.…”

“…Although SD-OCT has been increasingly used to observe the POV 9,[11][12][13][14] , few studies have used this technique to observe changes in the POV of patients with LSCD or potential limbal damage 15,16 . To the best of our knowledge, no study has used SD-OCT to observe presumed-healthy limbal areas in the eyes with ocular surface disorders or the presumed-healthy fellow eyes of patients with unilateral ocular surface disorders diagnosed by slit-lamp biomicroscopy.…”

Objective Imaging Diagnostics for Dry Eye Disease

“…En-face OCT may be useful for observation of changes in the ocular surface, particularly due to its noncontact nature and large scan width [ 42 ]. Ghouali et al [ 43 ] evaluated the palisade of Vogt using this device to determine the changes in the limbal anatomy in DED patients and showed that the visibility score of the palisades was lower in DED patients with a decreased score in accordance with the severity of DED [ 43 ].…”