To study the morphological patterns of pterygia and pingueculae
using high-resolution anterior segment spectral domain optical coherence
tomography (SD-OCT).
Methods: Prospective cross-sectional study of 25 eyes presented with pterygia
and pingueculae was conducted, and the eyes were examined by anterior segment
SD-OCT.
Results: We examined 25 eyes, including 13 eyes with primary pterygia, six
eyes with recurrent pterygia, one case with a pseudopterygium and five eyes
with pingueculae. Primary pterygia revealed elevation of the corneal epithelium
by a wedge-shaped mass of tissue separating the corneal epithelium from
the underlying Bowman’s membrane, which became wavy and interrupted. We
found satellite masses of pterygium tissue advanced under the epithelium
beyond the clinically seen pterygium margins. In recurrent pterygia, we
detected that the central tip of the pterygium was more advanced and creeping
beneath the basal corneal epithelium than the primary pterygium. In pseudopterygium,
the SD-OCT images showed that the overgrowing membrane was
not really attached to the underlying cornea. In cases of pingueculae, SDOCT
revealed a wedge-shaped mass that was nearly similar in pattern to that
of the pterygia but stopped at the limbal region. Immediately after removal of
pterygia, we noticed many remnants of the pterygia masses over the corneal
stroma in spite of the clinically clear appearance of cornea.
Conclusions: SD-OCT provided us with high-resolution images of the pterygium
and the pinguecula and showed clearly the anatomical relationship
between the corneal tissues and these lesions. The use of this new modality of
imaging may help to decrease the current recurrence rates after pterygium
excision through using the anterior segment SD-OCT in the evaluation of
these lesions.