Abstract
Spectral-domain optical coherence tomography (SD-OCT) has been used to observe the morphology of the palisades of Vogt (POV) with satisfactory resolutions. In this study, we used SD-OCT to examine the microstructure of the POV in ocular surface disorders with limbal involvement. We detect subclinical limbal pathologies based on five parameters, including (1) decreased epithelial thickness, (2) loss of the sharp stromal tip, (3) loss of the smooth epithelial-stromal interface, (4) dilated stromal vessels, and (5) decreased POV density. Eighteen eyes of 10 patients with advancing wavelike epitheliopathy (AWE) and 15 eyes of 9 patients with phlyctenular keratitis/ocular rosacea were recruited. SD-OCT could detect abnormal changes in the POV in 100% of the lesion sites. In presumed-healthy areas of the diseased eyes diagnosed by slit-lamp biomicroscopy, SD-OCT detected abnormal changes in the POV in 100% of the eyes in both groups. In patients with unilateral disease, abnormal changes in the POV were detected by SD-OCT in 50% and 100% of presumed-healthy eyes diagnosed by slit-lamp biomicroscopy in the AWE group and phlyctenular keratitis/ocular rosacea group, respectively. SD-OCT is powerful in detecting POV changes in ocular surface disorders and can provide useful information that cannot be provided by slit-lamp biomicroscopy.
Highlights
Spectral-domain optical coherence tomography (SD-OCT) has been used to observe the morphology of the palisades of Vogt (POV) with satisfactory resolutions
In patients with phlyctenular keratitis/ ocular rosacea, subepithelial infiltration was frequently observed at the leading area of advancing corneal neovascularization in superior or inferior quadrants
The POV structure could be identified through slit-lamp biomicroscopy in only 20% of the healthy eyes[16,17]
Summary
Spectral-domain optical coherence tomography (SD-OCT) has been used to observe the morphology of the palisades of Vogt (POV) with satisfactory resolutions. In presumed-healthy areas of the diseased eyes diagnosed by slit-lamp biomicroscopy, SD-OCT detected abnormal changes in the POV in 100% of the eyes in both groups. In patients with unilateral disease, abnormal changes in the POV were detected by SD-OCT in 50% and 100% of presumed-healthy eyes diagnosed by slit-lamp biomicroscopy in the AWE group and phlyctenular keratitis/ocular rosacea group, respectively. Compared with IVCM, spectral-domain OCT (SD-OCT) with a corneal anterior module long adaptor lens can provide the cross-sectional images of the POV of both radial and tangential orientations with a satisfactory magnification and resolution. 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 POV10. The use of SD-OCT can enable early detection of limbal damage in the cornea with potential limbal involvement, leading to proper intervention and prognosis prediction while treating patients with potential LSCD
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