Vogt’s Striae in Keratoconus

Vogt's Striae in Keratoconus

Vogt’s striae are vertical folds at the level of the posterior stroma and Descemet’s membrane , seen in patients of Keratoconus. They occur in the area of
maximal thinning and are best seen with a wide slit-lamp beam. These are stress lines that can be made to disappear
with gentle pressure at the limbus.

Vogt’s striae are vertical folds in the deep cornea that
are seen on slit lamp examination

It may be asymmetric depending on the degree of keratoconus in each eye. There is a positive correlation between the orientation of the lines with the steepest axis of the cornea. Vogt’s striae occur due to mechanical stress forces on collagen lamellae radiating from the cone apex in Keratoconus. The striae can temporarily disappear with external pressure to the globe.

Vogt’s Striae are found in 65% of patients with keratoconus.

Striae can be diagnosed with slit-lamp, optical coherence tomography (OCT), full-field optical coherence microscopy (FFOCM), and confocal microscopy (CM). OCT has the least sensitivity in detecting striae as the width of the striae is at the lateral resolution limit for OCT. Striae appear as dark bands on CM, FFOCM, and OCT because the undulated lamellae reflect light away.

Vogt’s striae are similar in appearance but must be differentiated from Descemet’s membrane folds. Descemet’s membrane folds can result after surgery to treat keratoconus, such as deep anterior lamellar keratoplasty. Descemet’s membrane folds tend to improve with time and do not have a lasting impact on vision. Descemet’s folds can also occur due to a pterygium.

Vogt’s striae must also be differentiated from Haab’s striae in congenital glaucoma and Descemet tears due to obstetric trauma.

Vogt’s striae versus Haab’s striae

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