title: High-Resolution Optical Coherence Tomography in the Differentiation of Inflammatory Versus Noninflammatory Peripheral Corneal Thinning.
abstract: OBJECTIVE
  To evaluate whether high-resolution optical coherence tomography (HR-OCT) can aid in differentiation of inflammatory versus noninflammatory causes of peripheral corneal thinning.
  
  
  METHODS
  Retrospective chart review of 10 patients with peripheral corneal thinning and their respective slit-lamp photographs and HR-OCT images.
  
  
  RESULTS
  Ten patients were identified who had peripheral corneal thinning and HR-OCT images. Five had a clinical history consistent with Terrien marginal degeneration (TMD), whereas 5 had thinning believed to be inflammatory in origin. In the eyes with presumed TMD, patients denied pain or inflammation. HR-OCT images demonstrated stromal thinning in the presence of an intact epithelium. The stroma underneath the epithelium in the area of thinning had a similar reflectivity pattern as the nonaffected cornea. There was epithelial marsupialization evident in 2 of the 5 images. In the 4 patients with a clinical history of inflammation (bulbar hyperemia and pain), and in the 1 patient with active inflammation at the time of HR-OCT imaging, HR-OCT also demonstrated thinning with an intact epithelium. In contrast to the TMD group, in the group with signs of inflammation, a dense hyperreflective band was noted in the stroma directly below the epithelium in the area of thinning, suggestive of scarring and/or cellular infiltration.
  
  
  CONCLUSIONS
  In patients with a clinical history of inflammation and corneal thinning, HR-OCT revealed a hyperreflective band directly under the epithelium in the area of thinning, which was not seen in patients with presumed noninflammatory melts and thinning.
authors.affiliation: *Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and †Department of Ophthalmology, Miami Veterans Administration Medical, Miami, FL.
authors.forename: Marianeli
authors.initials: M
authors.lastname: Rodriguez
authors.forename: Nilufer
authors.initials: N
authors.lastname: Yesilirmak
authors.forename: Priyanka
authors.initials: P
authors.lastname: Chhadva
authors.forename: Brian
authors.initials: B
authors.lastname: Goldhagen
authors.forename: Carol
authors.initials: C
authors.lastname: Karp
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015715:Corneal Edema / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity