Citation:Tao H, Wang YS, Wang F, Wang HB, Dong WL, Bai F, Wang P, Zhou XB, Wang LH, Liu C. Diagnosis of lacrimal punctum lesions using optical coherence tomography: a preliminary study. Int J Ophthalmol 2020;13(6):902-906,doi:10.18240/ijo.2020.06.07
Diagnosis of lacrimal punctum lesions using optical coherence tomography: a preliminary study
Received:March 09, 2020  Revised:April 13, 2020
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DOI:10.18240/ijo.2020.06.07
Key Words:lacrimal punctum lesions  epiphora  optical coherence tomography  diagnosis
Fund Project:Supported by High-level Talents Training Foundation of the Armed Police Force (No.GCCRC-02-2017).
                             
AuthorInstitution
Hai Tao Lacrimal Center of Ophthalmology, the Third Medical Center, Chinese PLA General Hospital, Beijing , China
Ying-Shuang Wang Lacrimal Center of Ophthalmology, the Third Medical Center, Chinese PLA General Hospital, Beijing , China; Department of Ophthalmology, Affiliated Hospital of Chengde Medical College, Chengde , Hebei Province, China
Fei Wang Lacrimal Center of Ophthalmology, the Third Medical Center, Chinese PLA General Hospital, Beijing , China
Hai-Bin Wang Department of Ophthalmology, Affiliated Hospital of Chengde Medical College, Chengde , Hebei Province, China
Wei-Li Dong Department of Ophthalmology, Affiliated Hospital of Chengde Medical College, Chengde , Hebei Province, China
Fang Bai Lacrimal Center of Ophthalmology, the Third Medical Center, Chinese PLA General Hospital, Beijing , China
Peng Wang Lacrimal Center of Ophthalmology, the Third Medical Center, Chinese PLA General Hospital, Beijing , China
Xi-Bin Zhou Lacrimal Center of Ophthalmology, the Third Medical Center, Chinese PLA General Hospital, Beijing , China
Li-Hua Wang Lacrimal Center of Ophthalmology, the Third Medical Center, Chinese PLA General Hospital, Beijing , China
Chuan Liu Lacrimal Center of Ophthalmology, the Third Medical Center, Chinese PLA General Hospital, Beijing , China
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Abstract:
      AIM: To study the imaging characteristics of lacrimal punctum lesion with optical coherence tomography (OCT), and provide imaging basis for the diagnosis and treatment of lacrimal punctum diseases.

    METHODS: A total of 25 patients (28 eyes) with epiphora and lacrimal puncta lesions were enrolled. Lacrimal puncta lesions included: punctum membrane obstruction in 7 cases (9 eyes), punctum agenesis in 1 case (1 eye), a mass protruded from the punctum in 1 case (1 eye), slit puncta in 1 case (1 eye), peri-puncta mass in 2 cases (2 eyes), chronic dacryocystitis in 4 cases (4 eyes), and primary puncta stenosis in 9 cases (10 eyes; 3 eyes mild, 4 eyes moderate and 3 eyes severe). All patients were examined by slit lamp microscopy and OCT to observe the morphological characteristics of abnormal punctum.

    RESULTS: Two types of complete membrane obstruction and incomplete membrane obstruction of puncta were observed in OCT images of 7 patients. No lacrimal punctum and lacrimal canalicular cavity were found in 1 case with punctum agenesis. OCT images showed that a narrow lumen remained in the lacrimal puncta in 1 patient with a mass protruded from the punctum. OCT of punctum in a patient with slit punctum after stent placement showed stent and abnormal lacrimal structure. No abnormal intraluminal structure was found in 2 cases of peri-puncta mass after OCT scan, and the lacunar space was narrower than that of the contralateral eye. OCT of puncta in 4 patients with chronic dacryocystitis showed that pus floated in tear with lump-like medium-low reflex. In 9 patients with primary lacrimal puncta stenosis, OCT image could clearly show the changes of puncta lumen in different degrees and shapes.

    CONCLUSION: OCT is feasible for the examination of pathological punctum, and can provide imaging basis for the diagnosis and treatment of punctum disease.

PMC FullText Html:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270249/
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