Abstract
Purpose :
To explore the diagnostic value of quantitative limbal palisades of Vogt complex (PVC) parameters by en face optical coherence tomography (OCT) for limbal stem cell deficiency (LSCD).
Methods :
Retrospective analysis of limbal en face OCT images of 11 eyes of 11 patients with LSCD and 10 eyes of 10 healthy controls. PVC was defined as the hyporeflective tissue within the anatomical limbus, including the palisades of Vogt and the surrounding limbal epithelium. Three-dimensional en face scans through the PVC, of 9µm depth each, were assessed to determine the anterior and superficial borders (end of Bowman’s layer) and the posterior and deep borders (transition of hyper-hyporeflective sclera-limbus). The area and volume of each scan were measured manually with ImageJ. Minimum and maximum depth were determined as the first and last appearance of the PVC on the OCT device, respectively. Statistical models were performed to account for different limbal scans of the same eye and age. Slit-lamp grading (0: no loss, 1: <50% loss and 2: ≥50% loss of palisades of Vogt) were correlated to en face OCT parameters.
Results :
Mean age was 54.1±19.9 and 39.5±13.6 years in the LSCD and control groups, respectively (p>0.05). There was no statistically significant difference between gender and limbus location (nasal, temporal, superior, inferior) within groups (p=0.61 and p=0.11, respectively). Compared to controls, the LSCD group showed an overall decreased PVC area (0.41±0.04 and 0.86±0.05 mm2, p=0.001), maximum area (1.27±0.29 and 2.27±0.19 mm2, p=0.013) and volume (0.06±0.01 and 0.09±0.01 mm3, p=0.001) on en face OCT. The comparison for each limbal location is shown in Figure 1. PVC area, maximum area and volume showed a strong inverse correlation with slit-lamp grading (r=-0.586, r=-0.519 and r=-0.586, respectively; p<0.001).
Conclusions :
PVC parameters were significantly decreased in LSCD patients compared to healthy controls. All limbal locations with LSCD showed significant PVC changes compared to their respective control regions. En face OCT is a promising non-invasive and quantitative tool for the diagnosis of LSCD.
This is a 2021 ARVO Annual Meeting abstract.