Advanced Anterior Eye Segment Imaging for Ichthyosis

The purpose of this study was to describe ocular surface and anterior eye segment findings in various types of ichthyoses. Methods: This was a single-center prospective observational study. The study group consisted of five patients (P1-P5) aged 13–66 years. Multimodal imaging was performed, including slit-lamp examination, swept-source optical coherence tomography (SS-OCT), and in vivo confocal microscopy (IVCM). Results: All patients were diagnosed with moderate to severe dry eye disease (DED). Corneas showed a significant pattern of irregularity, with a significant difference between the corneal thickness at the apex (CAT) and corneal thinnest thickness (CTT), ranging from 5 to 375 µm. Three patients were diagnosed with ectasia patterns based on SS-OCT. All patients showed abnormalities in at least one Fourier index parameter for at least one eye at 3 or 6 mm, on keratometric, anterior, or posterior analyses. IVCM examination revealed changes in all corneal layers. Conclusions: By combining the results of multimodal im-aging, we were able to detect preclinical abnormalities, distinguish characteristic changes com-mon to ichthyosis, and reveal the depth and characteristics of corneal abnormalities. Therefore, patients with ichthyosis should be examined for DED and ectatic disorders early in clinical prac-tice.