To characterize the in vivo morphological features of Acquired Corneal Subepithelial Hypertrophy (ACSH) using anterior segment optical coherence tomography (AS-OCT) and clarify its histopathological composition, highlighting its clinical significance.
Approach:
Key Findings:
Most patients were male, with blurred vision as the primary symptom.
ACSH was categorized into three subtypes: paracentral patchy opacification (PPO, 41.7%), peripheral sectorial nodules (PSN, 41.7%), and central diffuse mass (CDM, 16.7%).
AS-OCT revealed hyperreflective lamellar deposits between the epithelium and stroma.
The maximum thickness of fibrosis correlated strongly with corneal surface thickness (r = 0.96; p < 0.0001).
Histopathological findings indicated that corneal injury may drive subepithelial fibrosis through abnormal tissue repair.
Interpretation:
AS-OCT enables reliable identification of ACSH and differentiation from corneal leucoma and haze, while histopathological observations provide insights into potential pathogenic mechanisms.
Limitations:
The study is limited by its retrospective design and small sample size, which may affect the generalizability of the findings.
Only five specimens underwent immunofluorescence analysis, limiting the breadth of histopathological insights.
Conclusion:
Findings may inform clinical strategies to prevent ACSH, such as using topical medications or contact lenses to enhance epithelial healing after anterior segment surgery or injury, thereby improving patient outcomes.
