Wawrzynski James R, Smith Julie, Sharma Anant, Saleh George M
Bedford Hospital NHS Trust , South Wing, Kempston Road, Bedford , United Kingdom .
Orbit. 2014 Dec;33(6):428-32. doi: 10.3109/01676830.2014.949793. Epub 2014 Sep 12.
There are currently no routinely used imaging modalities for the proximal lacrimal system. Optical Coherence Tomography (OCT) is a safe and non-invasive method of high resolution cross-sectional imaging of tissue microstructures using infra-red radiation. In this study we investigate whether OCT may be used to image the punctum and proximal canaliculus.
A cohort of healthy subjects with normal ocular anatomy and no symptoms of epiphora were prospectively invited to enrol. Spectral OCT images of the lower punctae were captured with a Topcon 3D Optical Coherence Tomography 2000 machine. Measurements were made of the maximal punctal diameter, canalicular diameter and canalicular depth. Our data for depth of the vertical canaliculus was compared to the widely quoted figure of 2 mm using a two-tailed t-test to check for a statistically significant difference at p < 0.05.
Thirty-six punctae of 18 subjects were scanned. The punctum was recognisable on the OCT image in all cases. The mean depth, width and cross- sectional area of the visualised canaliculi were 0.753 mm (SD 0.216), 0.110 mm (SD 0.067) and 9.49 × 10(-3)mm(2), respectively. The mean width of the punctum was 0.247 mm (SD 0.078).
We have demonstrated the first in-vivo high resolution images of normal punctal and vertical canalicular anatomy using spectral OCT. There is currently no other practical way to accurately image punctal and proximal canalicular morphology in vivo. OCT is a convenient and readily available tool in most eye clinics with resolution ideally suited for imaging of the punctum and proximal canaliculus.
目前对于近端泪液系统尚无常规使用的成像方式。光学相干断层扫描（OCT）是一种利用红外辐射对组织微观结构进行高分辨率横断面成像的安全且非侵入性的方法。在本研究中，我们探究OCT是否可用于泪点和近端泪小管的成像。
前瞻性地邀请了一组眼部解剖结构正常且无溢泪症状的健康受试者入组。使用拓普康3D光学相干断层扫描2000机器采集下泪点的光谱OCT图像。测量泪点最大直径、泪小管直径和泪小管深度。我们将垂直泪小管深度的数据与广泛引用的2mm数值进行比较，采用双侧t检验以检验在p<0.05时是否存在统计学显著差异。
对18名受试者的36个泪点进行了扫描。在所有病例中，泪点在OCT图像上均可识别。可视化泪小管的平均深度、宽度和横截面积分别为0.753mm（标准差0.216）、0.110mm（标准差0.067）和9.49×10⁻³mm²。泪点的平均宽度为0.247mm（标准差0.078）。
我们利用光谱OCT展示了正常泪点和垂直泪小管解剖结构的首张体内高分辨率图像。目前尚无其他实用方法可在体内准确成像泪点和近端泪小管形态。OCT是大多数眼科诊所中方便且易于获得的工具，其分辨率非常适合泪点和近端泪小管的成像。
