Fourier Domain Optical Coherence Tomography With 3D and En Face Imaging of the Punctum and Vertical Canaliculus: A Step Toward Establishing a Normative Database.

PURPOSE

To report the features of Fourier domain optical coherence tomography imaging of the normal punctum and vertical canaliculus.

METHODS

Prospective, interventional series of consecutive healthy and asymptomatic adults, who volunteered for optical coherence tomography imaging, were included in the study. Fourier domain optical coherence tomography images of the punctum and vertical canaliculus along with 3D and En face images were captured using the RTVue scanner with a corneal adaptor module and a wide-angled lens. Maximum punctal diameter, mid-canalicular diameter, and vertical canalicular height were calculated. Statistical analysis was performed using Pearson correlation test, and scatter plot matrices were analyzed.

RESULTS

A total of 103 puncta of 52 healthy subjects were studied. Although all the images could depict the punctum and vertical canaliculus and all the desired measurements could be obtained, occasional tear debris within the canaliculus was found to be interfering with the imaging. The mean maximum punctal diameter, mid-canalicular diameter, and vertical canalicular height were recorded as 214.71 ± 73 μm, 125.04 ± 60.69 μm, and 890.41 ± 154.76 μm, respectively, with an insignificant correlation between them. The maximum recorded vertical canalicular height in all the cases was far less than the widely reported depth of 2 mm. High-resolution 3D and En face images provided a detailed topography of punctal surface and overview of vertical canaliculus.

CONCLUSION

Fourier domain optical coherence tomography with 3D and En face imaging is a useful noninvasive modality to image the proximal lacrimal system with consistently reproducible high-resolution images. This is likely to help clinicians in the management of proximal lacrimal disorders.