Association of Changes in Thickness of Limbal Epithelial and Stroma with Corneal Scars Detected by High-Resolution Anterior Segment Optic Coherence Tomography

Abstract

Aim To investigate the corneal central and limbal thickness in cornea scar patients using high-resolution anterior segment optical coherence tomography (AS-OCT) and to determine the changes in the limbal region due to the corneal scar. Also, to evaluate tear film parameters in scar patients.

Methods Thirty patients with central corneal scar and 30 control subjects. The control subjects were healthy individuals who came to our clinic for routine ophthalmological examination. They were enrolled in this matched case-control study. Central epithelial thickness (ET), stromal thickness (ST), limbal epithelial thickness (LET), and limbal stromal thickness (LST) were analyzed using high-resolution AS-OCT. For evaluation of the ocular surface, the following techniques were used: tear break-up time (BUT) employing standard sterile strips of fluorescein sodium, Schirmer test-I (SCH), and the Ocular Surface Disease Index (OSDI) Questionnaire.

Results The mean central ET of the patient group was 51.5 ± 12.4 µm, while the mean central ET of the control group was 59.2 ± 9.0 µm. There was a statistically significant difference between patients and controls (p = 0.008). The mean LST of the patients was 747.9 ± 115.7 µm, and the mean LST of the controls was 726.3 ± 79.7 µm. There was a statistically significant difference between patients and controls according to BUT (p = 0.009) and SCH (p = 0.04). However, there was no significant difference between OSDI results of patients and controls (p = 0.08).

Conclusion Corneal monitoring with high-resolution AS-OCT is a simple, noninvasive, useful technique for corneal scar patients. Cornea scars cause decreased ET. This result could be associated with lower tear film parameters in scar patients. The scar length is associated with higher intraocular pressure (IOP) values. Decreased LET and increased LST were detected in scar patients.

Zusammenfassung

Ziel Untersuchung der zentralen Hornhaut- und Limbusdicke bei Patienten mit Hornhautnarben mittels hochauflösender Vordersegment-OCT (AS-OCT) und Bestimmung der durch die Hornhautnarbe verursachten Veränderungen der Limbusregion. Auch zur Beurteilung der Tränenfilmparameter bei Narbenpatienten.

Methoden 30 Patienten mit zentraler Hornhautnarbe und 30 Kontrollpersonen. Die Kontrollpersonen waren gesunde Personen, die zur routinemäßigen ophthalmologischen Untersuchung in unsere Klinik kamen. Sie wurden in diese abgestimmte Fall-Kontroll-Studie aufgenommen. Mittels hochauflösender AS-OCT wurden die zentrale Epitheldicke (ET), die Stromadicke (ST) und die limbale Epithel- (LET) und Stromadicke (LST) analysiert. Zur Beurteilung der Augenoberfläche wurden durchgeführt: Tränenaufreißzeit mit standardmäßiger steriler Fluorescein-Natrium-Streifenanwendung, Schirmer-Test I, Ocular-Surface-Disease-Index-Fragebogen (OSDI).

Ergebnisse Die mittlere zentrale ET der Patientengruppe betrug 51,5 ± 12,4 µm, die mittlere zentrale ET der Kontrollgruppe 59,2 ± 9,0 µm. Es gab einen statistisch signifikanten Unterschied zwischen Patienten und Kontrollen (p = 0,008). Die mittlere LST der Patienten betrug 747,9 ± 115,7 µm und die mittlere LST der Kontrollen betrug 726,3 ± 79,7 µm. Es gab einen statistisch signifikanten Unterschied zwischen Patienten und Kontrollen gemäß BUT (p = 0,009), SCH (p = 0,04), jedoch gab es keinen signifikanten Unterschied zwischen den OSDI-Ergebnissen von Patienten und Kontrollen (p = 0,08).

Schlussfolgerung Die Hornhautüberwachung mit hochauflösendem AS-OCT ist eine einfache, nicht invasive und nützliche Technik für Patienten mit Hornhautnarben. Hornhautnarben verursachten eine verringerte Epitheldicke. Dieses Ergebnis könnte mit niedrigeren Tränenfilmparametern bei Narbenpatienten in Verbindung gebracht werden. Die Narbenlänge ist mit höheren IOP-Werten (IOP: Intraokulardruck) verbunden. Bei Narbenpatienten wurden ein vermindertes limbisches Epithel und eine erhöhte Dicke des limbalen Stromas festgestellt.

Key words

cornea - information technology - anatomy

Schlüsselwörter

Kornea - Informationstechnologie - Anatomie

Publication History

Received: 20 September 2021

Accepted: 03 May 2022

Accepted Manuscript online:
03 May 2022

Article published online:
31 July 2023

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