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Clinical Features of Pingueculitis Revealed by Anterior Segment Optical Coherence Tomography Findings

Song, Han M.D.; Rand, Gabriel M. M.D.; Kwon, Ji-Won M.D., Ph.D.

doi: 10.1097/ICL.0000000000000574
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Purpose: To investigate clinical features and treatment outcomes of pingueculitis with morphological assessments using anterior segment optical coherence tomography (AS-OCT).

Methods: In this retrospective observational study, we examined 22 eyes of 22 patients with pingueculitis. All patients were treated with the same 2-week course of prednisolone acetate 1% drops four times per day. The clinical parameters evaluated were surface dimensions determined by slitlamp biomicroscopy, cross-sectional dimensions determined by AS-OCT, and symptom scores determined by patient surveys. Pretreatment and 1-month posttreatment values were compared with Wilcoxon signed-rank tests. Patients were followed up to 1 year after treatment.

Results: Twenty-two eyes from 22 patients (4 men and 18 women) with an average age of 37.7±8.8 (range, 27–57) years and an average duration of symptoms of 22 (range, 5–60) days were included. The average follow-up period was 14.7±0.8 (range, 12–22) months. Mean pretreatment horizontal length, vertical length, conjunctival thickness, and cross-sectional area were 2.4±0.69 mm, 2.0±0.6 mm, 1.82±0.60 μm, and 5.14±2.05 mm2, respectively. Mean posttreatment horizontal length, vertical length, conjunctival thickness, and area were 1.93±0.5 mm, 1.52±0.6 mm, 1.03±0.46 μm, and 2.33±0.83 mm2, respectively. Mean pretreatment and posttreatment dry eye symptom scores were 3.27±0.77 and 1.13±0.38, respectively. The median pretreatment and posttreatment changes were statistically significant by Wilcoxon signed-rank tests for horizontal length (P<0.001), vertical length (P<0.001), conjunctival thickness (P=0.003), cross-sectional area (P=0.003), and dry eye symptom scores (P<0.001).

Conclusion: Anterior segment optical coherence tomography allows the quantification of differences in the pingueculitis measurements before and after treatment. In this retrospective study, a short course of topical steroids effectively treated the inflammation in a sustained manner. Anterior segment optical coherence tomography demonstrated significant reduction in the thickness and cross-sectional area of the pinguecula and a conversion back to a homogeneous conjunctival stroma.

Department of Ophthalmology (H.S., J.-W.K.), Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea; and Department of Ophthalmology and Visual Sciences (G.M.R.), Montefiore Medical Center, Bronx, NY.

Address correspondence to and reprints should be addressed to Ji-Won Kwon, M.D., Ph.D., Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, 14 Bun gil 55, Hwasu-Ro, Deokyang-Gu, Goyang-Si, Gyeonggi-Do, 10475, Korea; e-mail: eyeminerva@gmail.com

The authors have no funding or conflicts of interest to disclose.

Accepted December 15, 2018

© 2019 Contact Lens Association of Ophthalmologists, Inc.