Anterior segment optical coherence tomography: a diagnostic instrument for conjunctivochalasis.
Am J Ophthalmol 2010;
150:798-806. [PMID:
20869039 DOI:
10.1016/j.ajo.2010.06.014]
[Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Revised: 06/08/2010] [Accepted: 06/12/2010] [Indexed: 11/19/2022]
Abstract
PURPOSE
To evaluate cross-sectional areas of conjunctivochalasis and tear meniscus using Fourier-Domain RTVue-100 optical coherence tomography (OCT) before and after conjunctival cauterization and to evaluate inter- and intraobserver reliability.
DESIGN
Prospective, nonrandomized, consecutive case study.
METHODS
A total of 12 eyes of 7 patients with conjunctivochalasis (aged 56 to 87) were evaluated. After topical anesthesia, conjunctival cauterization was performed on the inferior bulbar conjunctiva. All patients underwent anterior segment OCT (AS-OCT) imaging prior to and 4 weeks after the procedure. Cross-sectional tear meniscus and conjunctivochalasis areas at 3 locations (nasal, center, and temporal areas) were measured in all patients.
RESULTS
Nonsignificant increases (P = .177) in cross-sectional tear meniscus area as a whole (3 locations combined) were observed following cauterization. Cross-sectional conjunctivochalasis area measurements significantly decreased in all 3 locations after cauterization (P < .001). Mean cross-sectional conjunctivochalasis area decreased from 0.247 ± 0.24 mm(2) to 0.054 ± 0.79 mm(2). For 2 measurements of cross-sectional tear meniscus area by examiner 1, intraclass correlation coefficients ranged from 0.998 to 0.999. Among 2 examiners, Cronbach's alpha reliability coefficients were as high as 0.993 and 0.997 before and after conjunctival cauterization. Regarding the cross-sectional conjunctivochalasis area measurements, intraclass correlation coefficient values were similar to those of the cross-sectional tear meniscus area, but Cronbach's alpha reliability coefficients were slightly less.
CONCLUSIONS
This study indicates the AS-OCT is a useful and reproducible instrument to measure the cross-sectional area of conjunctiva prolapsing into the tear meniscus of patients with conjunctivochalasis. The method can monitor effectiveness of thermoreduction of conjunctivochalasis.
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