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PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 4  |  Page : 800-801

Anterior segment optical coherence tomography of Haab striae in an adult


Department of Ophthalmology, Max Multi Speciality Centre, Panchsheel Park, New Delhi, India

Date of Submission13-Dec-2020
Date of Acceptance30-Apr-2021
Date of Web Publication09-Oct-2021

Correspondence Address:
Dr. Neha Goel
D-91, Third Floor, Anand Niketan, New Delhi - 110 021
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3676_20

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  Abstract 


Keywords: Anterior segment optical coherence tomography, congenital glaucoma, Haab striae


How to cite this article:
Goel N. Anterior segment optical coherence tomography of Haab striae in an adult. Indian J Ophthalmol Case Rep 2021;1:800-1

How to cite this URL:
Goel N. Anterior segment optical coherence tomography of Haab striae in an adult. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Oct 21];1:800-1. Available from: https://www.ijoreports.in/text.asp?2021/1/4/800/327631



A 32-year-old female presented for a routine check-up. Visual acuity was 6/6 OD (+1/-0.75/90) and 6/9 OS (+1.25/-1/90). Slit-lamp examination revealed horizontal, semi-translucent, parallel lines indicative of multiple Haab striae in otherwise clear corneas bilaterally [Figure 1]a and [Figure 1]b and [Figure 2]a and [Figure 2]b. The horizontal corneal diameters were 12.75 mm OD and 13 mm OS. Intraocular pressure was 14 mmHg OU (Goldmann applanation tonometry). Gonioscopy showed prominent iris processes OU. Fundus examination was unremarkable with a cup disc ratio of 0.3 OU.
Figure 1: (a) Slit lamp photograph of the right eye showing updrawn pupil with horizontal Haab striae with intervening corneal opacification (b) Retroillumination displayed the Haab striae more prominently (c) Horizontal and (d) vertical anterior segment optical coherence tomography scans revealed excrescences from the posterior corneal surface into the anterior chamber corresponding to the Haab striae with intervening dense tissue abutting the posterior corneal surface in the region of the opacification

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Figure 2: (a) Slit lamp photograph of the left eye showing multiple horizontal and circumferential Haab striae with intervening corneal opacification (b) The Haab striae were more prominent on retro-illumination (c) Horizontal and (d) vertical anterior segment optical coherence tomography scans demonstrated rounded excrescences from the posterior corneal surface into the anterior chamber corresponding to the Haab striae with a fine layer of dense tissue in between

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Anterior segment optical coherence tomography using RTVue-100°CT (Optovue, Inc., Fremont, California, USA) with a corneal adaptor module demonstrated protruding excresences from the posterior corneal surface with intervening dense irregular tissue [Figure 1]c and [Figure 1]d and [Figure 2]c and [Figure 2]d. The central corneal thickness using ultrasonic pachymetry was 512 OD and 516 OS.

The patient was diagnosed as resolved congenital glaucoma bilaterally, eduacted about the nature of her condition and advised regular follow-up.


  Discussion Top


Haab striae are breaks in the Descemet membrane (DM) and a typical finding in 50% children with congenital glaucoma.[1] These corneal abnormalities can result in irregular astigmatism with amblyopia as sequelae.[2] They pose a diagnostic challenge when encountered in adulthood with clear corneas, normal IOP and optic discs, in the absence of documented congenital glaucoma.

AS-OCT allows corneal imaging approaching histological resolution non invasively. Literature pertaining to AS-OCT evaluation of Haab striae in adults is scarce.[2],[3] The appearance corroborates with the histopathological description of chronic changes following DM ruptures, where the edges curl and thicken.[1] Contact of the ruptured DM edges with the overlying corneal stroma entraps keratocytes and induces proliferation, which appears as the intervening tissue.[1] Early appearance of Haab striae in infants differs, with thin edges of the broken DM bulging into the anterior chamber, without contacting the stroma.[4]

This case supports the practical utility of AS-OCT in assessing corneal lesions and confirming the clinical diagnosis of Haab striae owing to a specific appearance in equivocal cases.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Cibis GW, Tripathi RC. The differential diagnosis of Descemet's tears (Haab's striae) and posterior polymorpous dystrophy bands. A clinicopathologic study. Ophthalmology 1982;89:614-20.  Back to cited text no. 1
    
2.
Patil B, Tandon R, Sharma N, Verma M, Upadhyay AD, Gupta V, et al. Corneal changes in childhood glaucoma. Ophthalmology 2015;122:87-92.  Back to cited text no. 2
    
3.
Benito-Pascual B, Pascual-Prieto J, Martínez-de-la-Casa JM, Sáenz-Francés F, Santos-Bueso E. Haab striae: Optical coherence tomographic analysis. J Fr Ophtalmol 2019;42:11-5.  Back to cited text no. 3
    
4.
Spierer O, Cavuoto KM, Suwannaraj S, Chang TC. Anterior Segment Optical Coherence Tomography Imaging of Haab Striae. J Pediatr Ophthalmol Strabismus 2015;52 Online: e55-8.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

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