In Vivo Morphologic Characteristics of Salzmann Nodular Degeneration With Ultra-High-Resolution Optical Coherence Tomography

Abstract

Purpose To examine the in-vivo morphological properties of Salzmann nodular degeneration with ultra-high-resolution optical coherence tomography (OCT). Design Interventional case series. Methods Setting Single-center, academic practice. Study Population 19 eyes of 12 patients with Salzmann nodular degeneration were recruited to participate in the study. Observational Procedure Subjects were imaged using novel, custom-built ultra-high-resolution OCT. Images were used to describe in-vivo characteristics of subepithelial nodules. Morphometric measurements were made with custom-built software. Ultra-high-resolution OCT findings were compared with histopathological findings in three patients. Main outcome measures To demonstrate in-vivo morphological characteristics of Salzmann nodular degeneration with ultra-high-resolution OCT. Results Ultra-high-resolution OCT images demonstrate intraepithelial fibrous nodules with epithelial thinning and corneal surface elevation. Bowman’s layer could be differentiated in 9 of 12 patients. The difference between the mean thickness of epithelium above the nodule and the thickness of normal epithelium was statistically significant (p < 0.0001). The correlation between thickness of the epithelium and thickness of the nodule was statistically significant (r = -0.48; p < 0.0001). The correlation between thickness of the nodule and total surface thickness (thickness of the epithelium + thickness of the nodule) was statistically significant (r = 0.98; p < 0.0001). Ultra-high-resolution OCT findings were consistent with histopathological results. Conclusions Ultra-high-resolution OCT can be used to non-invasively image the cornea in Salzmann nodular degeneration. This new imaging technique helps us to demonstrate different in-vivo morphological characteristics of Salzmann nodular degeneration.

Salzmann nodular degeneration associated with epithelial ingrowth after LASIK treated with superficial keratectomy

“…High-resolution anterior segment OCT confirmed that the nodules were subepithelial and not within the LASIK flap interface, as has been suggested by other authors 2. Histological analysis of the nodule was consistent with that previously described for Salzmann nodules4 5 and confirmed the findings from OCT 6. Given the success of superficial keratectomy in symptomatic patients,7 we offered this treatment to the patient and it was completed without complication.…”

Optical coherence tomography in cornea and refractive surgery

“…This novel system demonstrates new morphological properties of corneal disorders. In Salzmann nodular degeneration, the presence of an intact Bowman layer was suggested to be a predictor of the strength of the adhesion of the superficial lesion to the underlying stroma [73]. This finding has been suggested to be useful in presurgical planning of the excision of the nodules in Salzmann nodular degeneration.…”

“…However, UHR-OCT can be used to analyze in vivo morphology of the cornea without tissue sampling [73,74]. This novel system demonstrates new morphological properties of corneal disorders.…”

Salzmannsche noduläre Hornhautdegeneration

“…4). Diese Spaltungsschicht ist besonders gut auch in optischen Hornhautschnittbildern erkennbar, die man mit OCTTechniken gewinnen kann [17]. Nach der Abpräparation verbleibt nur eine geringfügig raue Hornhautoberfläche, die man dann noch leicht touchierend mit einer Diamantschleifscheibe nachbehandeln kann [2].…”