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. 2025 May;69(3):351-359.
doi: 10.1007/s10384-025-01182-7. Epub 2025 Mar 8.

Assessment of punctal metrics and tear meniscus height in epiphora: clinical insights and diagnostic potential

Neslihan Sevimli  1 , Ece İren  2 , Güneş Taydaş  2 , Muhammed Kaan Azarbaz  2
Affiliations

Assessment of punctal metrics and tear meniscus height in epiphora: clinical insights and diagnostic potential

Neslihan Sevimli et al. Jpn J Ophthalmol. 2025 May.

Abstract

Purpose: To use anterior segment optical coherence tomography (AS-OCT) to investigate differences in punctal dimensions, tear meniscus height (TMH), and cornea among epiphora patients and healthy individuals; to assess its utility in screening and diagnosing epiphora; and to examine its effects on the cornea.

Study design: Prospective, cross-sectional METHODS: A total of 43 patients (31 women) with epiphora (Munk score >2) and 58 healthy individuals (38 women) without ocular symptoms were enrolled in this study. AS-OCT (Maestro, Topcon) was used to measure TMH, outer punctal diameter (OPD), punctal depth (PD), and corneal epithelial thickness (CET). Corneal topography (Pentacam, Oculus) was used to assess corneal topographic parameters and corneal volume (CV). Correlations among OPD, TMH, and corneal parameters were analyzed.

Results: No significant differences were found in age and sex among the groups (P = .909 and P = .482, respectively). Patients with epiphora exhibited significantly narrower OPD (229.6 ± 150.1 μm) and higher TMH (592.5 ± 315.3 μm) (both P <.001). CV was notably lower in the epiphora group (P = .015). The lower cutoff of OPD for epiphora was found to be 200 μm, and the lower cutoff of TMH for epiphora, 445 μm. Positive correlations were observed between OPD and CV (P = .001).

Conclusions: Patients with epiphora demonstrated narrower OPD, higher TMH, and lower CV than those of healthy individuals. These findings highlight the utility of AS-OCT in assessing epiphora and its effects on corneal health.

Keywords: Anterior segment optical coherence tomography; Corneal volume; Epiphora; Punctal diameter; Tear meniscus height.

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Conflict of interest statement

Conflicts of interest: N. Sevimli, None; E. İren, None; G. Taydaş None; M. K. Azarbaz, None. Consent to publish: The authors affirm that human research participants provided informed consent for the publication of the images in the figures.

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