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N. Yokoi, N. Tearo, K. Maruyama, A. Watanabe, A. Matsuda, S. Kinoshita; Conjunctivochalasis and Cystic Changes of Conjunctiva Observed by Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2801.
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Conjunctivochalasis and cystic changes of the conjunctiva which include pathologically classifiable epithelial inclusion cyst, lymphangiectasia, or glandular retention cyst, can be manifested as folds or cysts of conjunctiva and are often associated with non-specific ocular symptoms. However, their subconjunctival structures cannot be observed well by slit-lamp biomicroscopy. Therefore, to observe in vivo subconjunctival structures of those conjunctival diseases, optical coherence tomography (OCT) was used.
Thirty-two eyes of 24 cases with severe conjunctivochalasis (5 males and 19 females; mean age: 67 yrs) and 14 eyes of 14 cases with cystic changes of the conjunctiva (6 males and 8 females; mean age: 68 yrs) were observed by OCT (VisanteTM OCT; Carl Zeiss Meditec), and 4 cysts were surgically removed from 4 of the latter 14 cases and investigated pathologically.
In conjunctivochalasis, subconjunctival structures were imaged clearly by OCT in 22 eyes (68.8%) and the observed findings were classified into one of the following 4 types: 1) tissue breakdown within the subconjuctiva (7 eyes), 2) cystic changes presumably corresponding to lymphangiectasia (6 eyes), 3) subconjunctival detachment from the sclera (4 eyes), or 4) a mixture of types 1-3 (5 eyes). For eyes involving cystic changes of the conjunctiva, the interior of all cysts were successfully imaged and classified as either having some reflex image (7 eyes) or devoid of reflex image (7 eyes); 1 treated cyst devoid of reflex and 3 treated cysts having some reflex were demonstrated as those corresponding to lymphangiectasia, and epithelial inclusion cysts, respectively.
OCT may be useful to assess the in vivo subconjunctival pathologies in both conjunctivochalasis and cystic changes of conjunctiva; and it may be expected that the former comprises a variety of subconjunctival structural changes and the latter can be classified based on the interior reflex image of the cysts.
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