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Hornhautdystrophien in der optischen Kohärenztomographie

Corneal dystrophies in optical coherence tomography

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Zusammenfassung

Hintergrund

Die korneale optische Kohärenztomographie (Anterior-Segment-OCT, AS-OCT) wird in der aktuellen IC3D-Klassifikation von Hornhautdystrophien als Methode zur Verbesserung der klinischen Diagnosefindung und Behandlung beschrieben.

Fragestellung

In dieser Fallserie sollen AS-OCT-Bilder von Hornhautdystrophien auf hornhautmorphologische Veränderungen analysiert werden.

Material und Methoden

Es handelt sich um eine retrospektive, bildmorphologische Fallserie mit 38 Augen. Die AS-OCT-Bilder wurden mit dem hochauflösenden Zeiss Cirrus 5000-OCT (Oberkochen, Deutschland) aufgenommen. Folgende Hornhautdystrophien wurden analysiert: epitheliale Basalmembrandystrophie, Meesmann-Hornhautdystrophie, Reis-Bücklers-Hornhautdystrophie, granuläre Hornhautdystrophie Typ 1, granuläre Hornhautdystrophie Typ 2 und die makuläre Hornhautdystrophie.

Ergebnisse

Die AS-OCT-Bilder zeigen deutlich die typischen Veränderungen der einzelnen Hornhautdystrophien durch Hyper- und Hyporeflektivitäten in den einzelnen Hornhautschichten. Die Befunde in den AS-OCT-Bildern korrelieren gut mit den in der Literatur bereits vorhandenen, histologischen Beschreibungen und liefern zusätzliche Informationen zur Spaltlampenuntersuchung, v. a. hinsichtlich der exakten Lokalisation der Veränderungen.

Diskussion

Die AS-OCT-Bildgebung scheint ein hilfreiches Instrument zur Bestimmung morphologischer Veränderungen bei Patienten mit Hornhautdystrophien zu sein und könnte sowohl die Diagnosestellung als auch die chirurgische Therapieentscheidung erleichtern.

Abstract

Background

Corneal optical coherence tomography (anterior segment OCT, AS-OCT) is described in the current IC3D classification of corneal dystrophies to be a method for improvement of clinical diagnostics and treatment.

Objective

In this case series AS-OCT images of corneal dystrophies were analyzed with respect to morphological changes.

Material and methods

This was a retrospective imaging and morphological case series with 38 eyes. For image acquisition the corneal module of the high-resolution spectral-domain OCT Zeiss Cirrus HD-5000 platform (Oberkochen, Germany) was employed. The following corneal dystrophies were analyzed: epithelial basement membrane dystrophy, Meesmann corneal dystrophy, Reis-Bücklers corneal dystrophy, granular corneal dystrophy type 1, granular corneal dystrophy type 2 and macular corneal dystrophy.

Results

The AS-OCT images showed the typical changes of the dystrophies through hyperreflectivity and hyporeflectivity in the individual corneal layers. The findings in the AS-OCT images correlated well with the histological descriptions in the literature and provided additional information to the slit lamp examination, especially with respect to the exact location of the alterations.

Conclusion

Corneal AS-OCT imaging seems to be a helpful tool for determination of morphological changes in patients with corneal dystrophies and can facilitate both the diagnostics and surgical treatment decisions.

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Authors and Affiliations

  1. Augenklinik, Ludwig-Maximilians-Universität, Mathildenstr. 8, 80336, München, Deutschland

    C. Elhardt, S. G. Priglinger, Y. Karakolova, W. J. Mayer & C. Wertheimer

Authors
  1. C. Elhardt
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  2. S. G. Priglinger
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  3. Y. Karakolova
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  4. W. J. Mayer
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  5. C. Wertheimer
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Correspondence to C. Elhardt.

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Interessenkonflikt

C. Elhardt, S.G. Priglinger, Y. Karakolova, W.J. Mayer und C. Wertheimer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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Die Ergebnisse wurden auf dem DOG-Kongress 2018 in Berlin präsentiert.

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Elhardt, C., Priglinger, S.G., Karakolova, Y. et al. Hornhautdystrophien in der optischen Kohärenztomographie. Ophthalmologe 116, 857–864 (2019). https://doi.org/10.1007/s00347-018-0832-8

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  • DOI: https://doi.org/10.1007/s00347-018-0832-8

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