Value of Anterior Segment Ocular Coherence Tomography (AS-OCT) in Dryness Evaluation in Vitiligo

Abstract

Abstract Background Vitiligo is an acquired depigmentation disorder of the skin and mucous membranes with an autoimmune proposed pathogenesis. The concurrence of vitiligo and ocular abnormalities has been investigated in different studies, some of which have focused on ocular surface and dry eye evaluation in vitiligo. Aim of the Work Our study aimed at evaluating the tear film changes in patients with vitiligo using clinical assessment, severity indices and AS-OCT, and comparing these findings with healthy matching controls. Patients and Methods A case control observational study that included 60 eyes (the right eye of 30 patients with vitiligo and the right eye of 30 healthy age and sex matched controls). For every patient full dermatological assessment was done and drug history taken. Every study subject was evaluated regarding their dry eye symptomatology using the (OSDI) score questionnaire, clinical effect of dry eye in various tests (Schirmer’s test, TBUT, CFS using Oxford scheme), and using the AS OCT in measuring tear film height. Results We found that vitiligo patients had a lower tear film height when compared with controls (but statistically insignificant). Patients with vitiligo were more symptomatic regarding their dry eye symptoms assessed by OSDI score, they had a shorter tear breakup time than the control group, and a higher CFS grade using Oxford scheme indicating tear film instability. Conclusion Our study revealed lower, but statistically insignificant TFH as compared to the control group. TBUT was shorter, CFS was more evident and Schirmer’s test (although did not reach statistical significance) was shorter in vitiligo patients which revealed a tendency for dry eye syndrome. Supporting these findings, the OSDI score was higher in vitiligo patients. These results indicated worse symptomatology of dry eye in vitiligo patients and lack of stability of their tear film. The findings were supported by multiple previous studies mentioned earlier.