Purpose
To report the pathological changes of patients with epithelial basement membrane dystrophy (EBMD), the most common hereditary anterior corneal dystrophy, using in vivo confocal microscopy (IVCM) and high-resolution anterior segment optical coherence tomography (AS-OCT).
Methods
Five patients with EBMD seen in clinical practice were evaluated with a high-resolution spectral-domain AS-OCT (Heidelberg Engineering, Germany) and IVCM using the Heidelberg Retina Tomograph 3 Rostock Cornea Module (Heidelberg Engineering, Germany).
Results
AS-OCT revealed hyperreflective material in the posterior epithelium and anterior stroma. These findings were correlated with IVCM findings that showed multiple linear and curvilinear hyperreflective structures, corresponding to abnormal epithelial basement membrane extending into the corneal epithelium. Additionally, IVCM revealed hyperreflective deposits in the anterior stroma with signs of activation of anterior keratocytes, intraepithelial microcysts, and clusters of epithelial cells in the tear film.
Conclusions
The acquisition of high-resolution imaging of the cornea with IVCM and AS-OCT provides new insights into the microstructural characteristics of EBMD and may be useful modalities in elucidating the pathogenesis and natural course of this corneal dystrophy.
Keywords: 479 cornea: clinical science •
552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) •
596 microscopy: confocal/tunneling