A Fine Line: Identifying the Dua’s Layer in Anterior Segment Optical Coherence Tomography Imaging

Abstract The Dua’s layer, also known as the pre-Descemet’s layer, is situated in the posterior cornea between the stroma and Descemet’s membrane. This ultra-thin layer has various clinical implications such as in lamellar corneal surgeries. Successful imaging of this layer using routine modalities like anterior segment optical coherence tomography presents a remarkable challenge due to its thinness and location in the posterior cornea. The pre-Descemet’s layer has been identified in anterior segment optical coherence tomography in cases of Descemet’s membrane detachment. We present a case of pseudophakic bullous keratopathy, wherein the anterior segment optical coherence tomography image has captured the pre-Descemet’s layer as a continuous hyper-reflective line between the posterior stroma and the Descemet’s membrane.