title: Fourier-domain optical coherence tomography imaging in corneal epithelial basement membrane dystrophy: a structural analysis.
abstract: OBJECTIVE
  To investigate the features of corneal epithelial basement membrane dystrophy using spectral-domain optical coherence tomography (SD OCT) and to examine the reliability of SD OCT in distinguishing epithelial basement membrane dystrophy from the normal cornea.
  
  
  METHODS
  Diagnostic test study.
  
  
  METHODS
  Forty-five individuals with epithelial basement membrane dystrophy and 45 age- and sex-matched controls with normal corneas were examined, and SD OCT scans of their corneas were performed. In vivo confocal microscopy was performed to confirm or rule out the diagnosis of epithelial basement membrane dystrophy. The structural corneal changes occurring in eyes with epithelial basement membrane dystrophy based on SD OCT findings were described.
  
  
  RESULTS
  Epithelial abnormalities were observed in 86 of 87 eyes with epithelial basement membrane dystrophy (45 patients) on SD OCT scans. The 2 main features were the presence of an irregular and thickened epithelial basement membrane duplicating or insinuating into the corneal epithelium layer, or both, and the presence of hyperreflective dots. In some cases, we detected hyporeflective spaces between the corneal epithelial layer and the Bowman layer similar to a corneal epithelial detachment. This corneal epithelial detachment sometimes was associated with a cleavage with a stair-step appearance within the corneal epithelial layer. We found a perfect correlation between in vivo confocal microscopy and SD OCT findings in the diagnosis of epithelial basement membrane dystrophy (κ = 0.98).
  
  
  CONCLUSIONS
  SD OCT provides an accurate assessment of the structural changes occurring in eyes with epithelial basement membrane dystrophy. These changes, visible on SD OCT scans, are easily detectable and permit an accurate diagnosis, especially in patients with no biomicroscopically visible corneal changes.
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France. Electronic address: mohamed.elsanharawi@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Sanharawi
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Otman
authors.initials: O
authors.lastname: Sandali
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Elena
authors.initials: E
authors.lastname: Basli
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Nacim
authors.initials: N
authors.lastname: Bouheraoua
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Barbara
authors.initials: B
authors.lastname: Ameline
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Goemaere
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Cristina
authors.initials: C
authors.lastname: Georgeon
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Taous
authors.initials: T
authors.lastname: Hamiche
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Borderie
authors.affiliation: Department of Ophthalmology V, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Laroche
mesh_terms: D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000473:pathology; D055952:Cogan Syndrome / Q000175:diagnosis*; D019573:Epithelium, Corneal / Q000473:pathology; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult