Morphological analysis of lacrimal punctum using anterior segment optical coherence tomography in different age groups.

Purpose: To evaluate the lacrimal punctal changes in different age groups using anterior segment optical coherence tomography (AS-OCT).

Methods: A cross-sectional observational study was conducted between January 2023 and January 2024 including healthy subjects between 20 and 80 years. The selected eyes from healthy patients were divided into four age groups (21-35 years, 36-50 years, 51-65 years, 66-80 years), and lower lacrimal puncta were analyzed using AS-OCT. Outcome measures included external punctal diameter (EPD, distance between the highest points of the punctal papilla), internal punctal diameter (IPD), vertical canalicular depth (VCD), fluid seen within the punctum, and presence of ampulla.

Results: 128 eyes of 64 patients were included with 32 eyes in each group. The mean EPD ranges from 441.5 ± 74.9 μm to 638 ± 138.8 μm among different age groups. The mean IPD varies between 251 ± 22.2 μm and 335 ± 21.6 μm. The mean VCD ranges from 424.2 ± 127.2 μm to 925 ± 144.1 μm among different age groups. The fluid within the punctum in the age group 21-65 years was 85-91%, which decreased notably to 40% in the 66-80 years age group. Ampulla was present in 11 (8.5%) out of 128 eyes. All the punctal parameters were the highest in the premenopausal age group (≤50 years) compared to the postmenopausal age group (P < 0.001). The values of all punctal parameters were higher in males compared to females.

Conclusion: AS-OCT is a useful tool to evaluate lacrimal punctal structure in vivo. Age-related correlations were found in the punctal quantitative parameters.