Purpose To describe the use of volumetric optical coherence tomography (OCT) imaging to assist evaluation of a patient referred for autologous limbal stem cell transplant. Methods This is a case report of a fifty year-old patient presenting with unilateral limbal stem cell deficiency who was referred for autologous limbal stem cell transplant. The presence of Salzmann's nodules in the donor eye raised questions about the efficacy of transplantation, prompting examination of both eyes using volumetric OCT imaging to determine whether there were palisades of Vogt (POV) present. Image volumes were acquired in all clock hours and were compared against those of an age-matched normal subject. Results Palisades were found in both eyes, although in both eyes there were fewer palisade ridges, and those that were present were not as distinct as those of the normal subject. The OCT volumes also showed that stromal scarring was present only in the anterior stroma of the intended transplant eye. These findings suggested that the patient may be able to sustain a deep anterior lamellar keratoplasty (DALK) without an autologous transplant, which would spare any insult to the opposing eye and require less surgery to restore vision in the affected eye. Nine months post-surgical follow up revealed significant improvement in visual acuity and no scar tissue development. Conclusion OCT evaluation of the POV provides detailed information to the clinician that may assist in diagnosis and evaluation of patients prior to transplantation. Further development of this technique is necessary to make it clinically available.

Purpose The Palisades of Vogt (POV) constitute the corneal epithelial stem cell niche, but identification of this region in ex-vivo tissue is difficult. Here we introduce a simple, direct method of identifying the POV in unsectioned, ex-vivo human tissue. Methods Twenty-two eyes were studied, four whole and eighteen rims. Orientation of whole eyes was determined and the eyes were marked to maintain their cardinal orientation prior to dissection. Samples were imaged with brightfield, linearly polarized light and transmitted circularly polarized light (CPL) and optical coherence tomography (OCT) volumes were acquired in all twelve clock hours around the limbus. Five samples were also fluorescently labeled to identify the epithelial basement membrane, and whole mounts were imaged with laser scanning confocal microscopy. Images were compared to confirm that the structures visible with polarized light were POV. Results Under CPL the POV presented as amber radial ridges visible in the superior and inferior regions of the tissue. Identification of POV was confirmed by correlating the structures seen under CPL, OCT and laser-scanning confocal microscopy. Conclusions CPL can be used to quickly identify POV regions in donor tissue. This technique can assist in targeted harvesting of stem cell regions for research and tissue for limbal transplant.