The association between conjunctival and scleral thickness and ocular surface ultraviolet autofluorescence

Ultraviolet autofluorescence (UVAF) imaging is used to visualise ocular surface changes due to sunlight exposure and so is considered to be a biomarker for UV damage. The conjunctival and scleral thicknesses of participants with and without ocular surface UVAF were measured to examine the UVAF associated tissue thicknesses. The presence of UVAF on the ocular surface was associated with significant differences in tissue thickness including thinner conjunctival epitheliums and thicker scleras but predominantly thickening of the conjunctival stroma. Participants were also classified into four groups according to the presence and absence of UVAF on both the temporal and nasal conjunctivas. It was noted that for those that had only nasal UVAF, the temporal conjunctival stroma was significantly thicker even without the presence of UVAF. Some participants with temporal UVAF had signs of pinguecula observed with slit lamp examination and some had OCT SLO enface imaging darkening. These findings highlight the potential of techniques other than slit lamp examination, including tissue thickness measurement and UVAF photography, in the detection of early UV-related changes to the ocular surface.