Optical Coherence Tomography and ImageJ Software for objective assessment of optical density of anterior chamber iris cyst

Aim: To report the optical characteristics of the fluid in an anterior chamber iris cyst. Method: A 26-year-old male presented with blurring of vision in his right eye for two months, without any other associated ocular complaints. His visual acuity was 6/ 9 on Snellen’s chart. On slit lamp examination, a small translucent pigmented cyst was noted inferiorly in the anterior chamber, struck on to the cornea at 6 o’clock periphery, without any feeder vessel. Anterior segment optical coherence tomography (OCT) revealed a cystic lesion with hyperreflective walls and hypo reflective lumen attached to the cornea, compressing the endothelium. Results: The optical density (OD) of the cyst fluid was determined using ImageJ, an open code Java-based image processing software. The OD of cyst fluid was found comparable to the anterior chamber fluid. Conclusion: Ultrasound biomicroscopy (UBM) and OCT are useful tools for the diagnosis of cystic lesions of the anterior segment. The innovative use of an OCT image and the ImageJ software to determine the optical density of the iris cyst may aid in the diagnosis and follow-up of such cases.