Purpose: To describe a case of Lisch epithelial corneal dystrophy (LECD) and present its unique characteristics on high-resolution optical coherence tomography (HR-OCT).
Methods: A 78-year-old man with whorled corneal epithelial opacities in the right eye was referred for the evaluation of ocular surface squamous neoplasia. Clinical evaluation, photographs, and HR-OCT images of the cornea involved were obtained and scrapings of the affected cornea were sent for histopathologic analysis.
Results: Clinically, the patient presented with an opalescent whirling epithelium in a linear pattern encroaching on the visual axis. HR-OCT showed normal thickness epithelial hyperreflectivity of involved cornea without stromal involvement, along with sharply demarcated borders of unaffected tissue. Histopathologic findings demonstrated vacuolated periodic acid-Schiff (PAS) positive cells throughout the epithelial layers consistent with LECD.
Conclusions: HR-OCT was able to provide useful information to rule out ocular surface squamous neoplasia and confirm the clinical impression of LECD at the time of clinical examination. HR-OCT shows promise as an adjunctive diagnostic tool for ocular surface lesions and pathologies.