Anterior Segment Optical Coherence Tomography In Cicatrizing Conjunctivitis Due To Chronic Trachoma And Ocular Cicatricial Pemphigoid

The
aim of this work was to investigate the clinical features and AS-OCT findings in patients with
cicatrizing conjunctivitis attributed to OCP and chronic trachoma.

This prospective observational comparative study was carried out on 30 eyes of  biopsy-proven OCP patients, 30 eyes of trachoma patients diagnosed by an experienced ophthalmologist and 30 eyes of normal participants. All patients were subjected to AS-OCT.

The study was done after approval from the Ethical Committee Fayoum University Hospitals. And informed written consent was obtained. 
Exclusion criteria were Other causes of cicatrizing conjunctivitis including
autoimmune/allergic inflammatory conditions other than OCP such as Steven Johnson syndrome, GVHD, atopic keratoconjunctivitis, and rosacea, physically-induced cicatrizing conjunctivitis such as conjunctival trauma,
and radiation, conjunctival neoplasia and history of eye or eyelid surgery .

All patients were evaluated by a single experienced physician utilizing the SD-OCT (OPTOVUE. Inc, Fremont, CA, USA). 
The ImageJ program utilized to transform qualitative data obtained from AS-OCT scanning into quantitative information.

Females were significantly higher in OCP than trachoma and normal groups (P<0.05).
Redness, burning sensation and watering eye were significantly more frequent in the OCP
group (P<0.05), while grittiness was more in chronic trachoma (P<0.05). clinical presentation
across eye disorder was significantly different among the studied groups (P<0.05). patients’
OCT measurements across eye disorder were significantly different among the three studied
groups (P<0.05). The highest degree of agreement was observed with OCT subepithelial
hyperreflective BM line, κ=0.900 which is a very good agreement. The agreement was lower
for OCT subepithelial diffuse hyperreflectivity (κ=0.674), and OCT subepithelial clefting
(κ=0.622) but still good agreement.

The distinctive clinical and AS-OCT findings offer valuable insights into the
differential diagnosis and management of OCP and chronic trachoma.