Utilization of Anterior Segment Optical Coherence Tomography Enhanced High Resolution Corneal In Measuring Pterygium Thickness

Mohd Radzi Hilmi  -  Department of Optometry and Vision Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Kuantan, Pahang, Malaysia, Malaysia
Khairidzan Mohd Kamal*  -  Department of Ophthalmology, Kulliyyah of Medicine, International Islamic University Malaysia (IIUM), Kuantan, Pahang, Malaysia, Malaysia
Mohd Zulfaezal Che Azemin  -  Department of Optometry and Vision Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Kuantan, Pahang, Malaysia, Malaysia
Azrin Esmady Ariffin  -  Faculty of Optometry and Vision Science, SEGi University, Petaling Jaya, Selangor, Malaysia

(*) Corresponding Author

Introduction: As various pterygium morphologies have been advocated as contributing factor on corneal astigmatism, little support in the literature available in establishing techniques in measuring pterygium thickness as clinical indicator.

Objective: The aim of this study was to describe a quantitative method in determining pterygium thickness using anterior segment optical coherence tomography (AS-OCT).

Methods: Anterior segment imaging was performed using enhanced high resolution cornea (EHRC) of Visante™ AS-OCT in 120 primary pterygium eyes. Prior to imaging, corneal topography assessment was performed on each pterygium eye in order to identify its topographic location. Based on topography mapping, three meridians (in degrees) were selected as close as possible to the pterygium border, which signify the demarcation of pterygium from the cornea. Reliability testing between intra and inter-observer of AS-OCT imaging modality was examined using intraclass correlation and scatter plot.

Results: The overall (n = 120) mean and standard deviation of pterygium thickness EHRC of AS-OCT modality were 0.48 ± 0.10 mm (confidence interval: 0.45 – 0.50). EHRC of AS-OCT also showed excellent intra and intergrader reliability in measuring pterygium thickness with intraclass correlation of 0.997 (confidence interval: 0.994 – 0.998).

Conclusions: EHRC of AS-OCT imaging modality is a better choice in assessing pterygium compared to traditional slit-lamp biomicroscopy. This tool is applicable for future work related to better understanding on the role thickness in pterygium morphology, its progression and prediction of induced corneal astigmatism and visual impairment due to pterygium.

Keywords: pterygium; anterior segment OCT; AS-OCT; morphology; thickness; reliability

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