Anterior segment optical coherence tomography: a diagnostic instrument for conjunctivochalasis.
OBJECTIVE
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.


METHODS
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.
Gumus
Koray
K
Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas 77030, USA.
Crockett
Charlene Hong
CH
Pflugfelder
Stephen C
SC
D000368:Aged; D000369:Aged, 80 and over; D002425:Cautery; D003228:Conjunctiva / Q000378:metabolism / Q000473:pathology*; D003229:Conjunctival Diseases / Q000175:diagnosis* / Q000601:surgery; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D011391:Prolapse; D011446:Prospective Studies; D015203:Reproducibility of Results; D013666:Tears / Q000378:metabolism; D041623:Tomography, Optical Coherence