Increasing prevalence and severity of conjunctivochalasis with aging detected by anterior segment optical coherence tomography

Abstract

Purpose: To evaluate the impact of aging on conjunctivochalasis in an objective manner using anterior segment optical coherence tomography.

Design: Prospective clinical trial.

Methods: Sixty eyes of 30 healthy volunteers (15 men, 15 women; age range, 24-75 years) without any ophthalmic diseases were recruited for the study. Subjects were organized into 3 sex-matched groups, each including 10 subjects according to their ages: 20-39 years (Group 1), 40-59 years (Group 2), 60-75 years (Group 3). Cross-sectional area of conjunctivochalasis was measured at 3 locations (temporal, central, and nasal) using Fourier-domain optical coherence tomography. Tear meniscus height was also measured in all images where a typical triangular-shaped tear meniscus was obtained.

Results: In terms of the cross-sectional area of conjunctivochalasis, there were statistically significant differences among 3 groups at temporal and nasal locations (P < .001). At the central location, whereas there were no subjects in Groups 1 and 2, solely 3 eyes revealed conjunctivochalasis in Group 3. The severity of conjunctivochalasis affecting the temporal and nasal bulbar conjunctiva was strongly correlated with age (η(2) = 0.81, P < .001 and η(2) = 0.78, P < .001). Lower central tear meniscus height was compared among the groups and a significant increase with age was observed (P < .001).

Conclusion: Fourier-domain optical coherence tomography provides an objective and quantitative approach for assessing the stages of conjunctivochalasis. The current study objectively confirms that conjunctivochalasis can be observed even in younger, healthy eyes; its severity increases with age; and it may alter tear distribution along the lower lid.