Preliminary Study On OCT Features Of Primary Punctal Stenosis And Its Correlation With Epiphora

Objective:To observe the anterior optical coherence tomography(OCT)features of primary lacrimal stenosis with lacrimal overflow and its correlation with epiphora。Methods:From September 2020 to January 2021,44 patients(62 eyes)with primary punctal stenosis and overflow tears were collected as case group and43 normal volunteers(57 eyes)as control group.Anterior OCT scanning was performed on all subjects’ lower lacrimal punctum,and the outer punctal diameter,narrowest punctal diameter,punctal depth,tear well diameter,tear well depth,punctal reserve(PR)and PR ratio of the lower lacrimal punctum were measured.The parameters of lower lacrimal punctum were compared between normal volunteers and patients with primary lacrimal punctum stenosis and overflow tears.Munk score was performed on patients with primary punctal stenosis and overflow tears,and then the degree of primary punctal stenosis was correlated with the severity of epiphora.Results:1.The numerical value conforms to the normal distribution and is expressed with mean standard deviation;otherwise,it is expressed with median and quartile.The outer diameter of lacrimal punctum(458.19±63.58μm),depth of lacrimal well(188.95±87.50 μm)and PR ratio(0.32± 0.18)in the case group were significantly lower than those in the normal group(655.53± 82.62 μm),depth of lacrimal well(275.30±144.34 μm),PR ratio(0.46±0.23).The narrowest punctal diameter(47.50(32.25,66.80),punctal depth(265.50(204.25,328.77)),punctal reserve(71.53(46.12,111.37))were significantly smaller than that of normal group(81.95(59.00,114.72),punctal depth(468.76(420.50,588.88),punctal reserve(182.16(131.36,309.84)),P<0.05.However,there was no significant difference in tear well diameter between the two groups(P>0.05).2.In the case group,the degree of lacrimation was negatively correlated with the outer punctal diameter(correlation coefficient =-0.448,P < 0.01),positively correlated with the depth of tear well(correlation coefficient =0.335,P < 0.01),and negatively correlated with the PR and PR ratio(correlation coefficients were-0.520 and-0.566,respectively,P < 0.01).Conclusion:By quantifying the characteristics of OCT images,it was found that the outer diameter of tears,the diameter of narrow spot,the depth of tear well,PR and PR ratio were all smaller than those of the normal control group,but the diameter of tear well had no significant difference,and the outer diameter of tears,PR and PR ratio were negatively correlated with the degree of overflow.