Clinical Case Series: Corneal Dystrophies and Degenerations Analyzed by OCT and Biomicroscopy

Abstract

Relevance: This study addresses the correlation between findings obtained through slit-lamp biomicroscopy and those observed using optical coherence tomography in corneal dystrophies, a topic of considerable interest in both ophthalmology and clinical optometry.

Purpose: To demonstrate the usefulness of Anterior Segment Optical Coherence Tomography (OCT-SA) and biomicroscopy as methods for the detection, diagnosis, and monitoring of different corneal dystrophies, and to interpret the clinical findings identified in each condition in order to establish correlations between them.

Case Reports: The first case involves a patient with Epithelial Basement Membrane Dystrophy (EBMD), also known as Cogan microcystic dystrophy or map-dot-fingerprint dystrophy. In this condition, duplication of the epithelial basement membrane occurs, resulting in characteristic features that can be observed through slit-lamp examination and OCT-SA imaging.
The second case describes a patient with Lattice Corneal Dystrophy, a disorder that primarily affects the corneal stroma. Clinically, a pattern of branching linear opacities is observed, corresponding to irregular hyperreflective areas on OCT-SA images.
The third case concerns a patient with Fuchs Endothelial Corneal Dystrophy, the most common endothelial dystrophy affecting  the   inner   most   layer   of    the   cornea. The     characteristic     pattern     consists     of     central     corneal     guttae     that    progressively extend toward the periphery, corresponding to hyperreflective areas at the endothelial level on OCT-SA examination.
This study was reviewed by an independent Ethics Committee and complies with the applicable principles and guidelines for the protection of human subjects involved in biomedical research.

Conclusions: Biomicroscopic examination enables the initial identification and detection of the characteristic patterns associated with each corneal dystrophy. OCT-SA allows visualization of the affected corneal layers and provides objective documentation, facilitating the monitoring of disease progression and the planning of appropriate treatment. It is a rapid and non-invasive imaging technique. The combined use of both methods is complementary and sequential, allowing the correlation of findings obtained with each technique and enabling an accurate diagnosis.