Anterior Segment Optical Coherence Tomography in Congenital Corneal Opacities

Purpose: To evaluate the clinical usefulness of anterior segment (AS) optical coherence tomography (OCT) in diagnosis and follow-up of children with congenital corneal opacities. Design: Noncomparative case series. Participants: Seven consecutive patients with bilateral congenital corneal opacity between 2 days and 2.5 years of age. Methods: In addition to basic outpatient examination, eyes were imaged using AS OCT. Anterior segment structures and corneal thicknesses were evaluated from the images. Three children also underwent evaluation under anesthesia, including measurement of corneal thickness with ultrasound pachymetry. Main Outcome Measures: Evaluation of the type and severity of the congenital corneal opacity based on the findings in AS OCT. Results: Thirteen of the 14 eyes could be imaged using AS OCT. The youngest patient studied was only 2 days old. Three distinct phenotypes were found based on the AS OCT findings. Three patients with iridocorneal adhesions were deduced to have type 1 Peters' anomaly, and 2 patients with lenticulocorneal adhesions were deduced to have type 2 Peters' anomaly. The 2 youngest patients had complete corneal opacity with features of corneal staphyloma and marked changes in the AS structures during the first months of life. Conclusions: Anterior segment OCT was a valuable method in the diagnosis and follow-up of patients with congenital corneal opacities. As a fast and noncontact technique, it was applicable even for neonates. It allowed early characterization of the type and the extent of the AS disorder. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2012;119:2450-2457 (C) 2012 by the American Academy of Ophthalmology.