| Lacrimal duct disease is one of the common ophthalmic diseases.With the increasing attention to lacrimal duct disease,punctum and canaliculus disease has also begun to receive attention.In recent years,with the development of science and technology,more and more ophthalmic examination equipment has been used in the diagnosis and treatment of lacrimal diseases,including OCT,UBM,dacryocystography,transcanalicular endoscopy and so on.OCT is a new optical diagnostic technique,which can perform tomography of microscopic structure of living eye tissue.It has the characteristics of non-contact,non-traumatic,high resolution,easy operation and easy cooperation.It is especially suitable for the detection of punctum and related diseases.The purpose of this study is to accumulate OCT data of normal punctum by observing and analyzing the imaging characteristics of normal punctum and pathological punctum in OCT images,and to provide more accurate imaging basis for the diagnosis and treatment of punctum diseases.Objective:To study the imaging characteristics of normal punctum and punctum lesions in OCT images,accumulate OCT data of normal punctum,and provide imaging basis for the diagnosis and treatment of punctum diseases.Methods:This study is divided into two parts,the first part: OCT examination and measurement of punctum in normal people.Cross-sectional study.A total of 44 cases(65 eyes)of normal lacrimal punctum structure volunteered for examination were collected,the inferior lacrimal punctum of the subjects was taken as the study site.All the subjects were examined by slit lamp microscopy and OCT,measurements of maximum punctal diameter under slit lamp,external punctal diameter from OCT images,punctal diameter at 100?m and 200?m depth from OCT images were performed.Analysis of the difference in the diameter of different parts of punctum from OCT images.The second part: A preliminary study of OCT imaging characteristics of lacrimal punctum lesions.25 patients(28 eyes)with epiphora and punctum lesions were enrolled in the Lacrimal Disease Research Center of the Third Medical Center of PLA General Hospital,including 7 cases(9 eyes)with punctum membrane obstruction,1 case(1 eye)with punctum agenesis,1 case(1 eye)with mass prolapse from punctum,1 case(1 eye)with slit puncta,2 cases(2 eyes)with peri puncta mass,4 cases(4 eyes)with chronic dacryocystitis,and primary punctum stenosis were found 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:The first part: In normal people,maximum punctal diameter under slit lamp was(703.1±259.5)?m,external punctal diameter from OCT images was(527.2±131.4)?m,punctal width at 100?m and 200?m depth from OCT images were(231.5±100.3)?m and(157.2±92.0)?m respectively.There were significant differences between groups(F = 216.104,P = 0.000).The second part: Two types of complete membrane obstruction and incomplete membrane obstruction of punctum were observed in OCT images of 7 patients with punctum membrane obstruction.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 mass prolapse from punctum.OCT of punctum in a patient with slit puncta 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 punctum in 4 patients with chronic dacryocystitis showed that pus floated in tear with lump-like medium-low reflex.In 9 patients with primary lacrimal puncture stenosis,OCT could clearly image the changes of punctum lumen in different degrees and shapes.Conclusion:OCT is feasible for the examination of normal and pathological punctum,and can provide imaging basis for the diagnosis and treatment of punctum diseases. |
PDF Full Text Request