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Parvathy Pillai, Lucia Sobrin; Optic nerve spectral domain optical coherence tomography of papillitis secondary to uveitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5203.
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This purpose of this study was to evaluate the association between inflammatory activity in uveitis patients and the amount of optic nerve head elevation measured by Spectralis spectral domain optical coherence tomography (SD-OCT).
Consecutive patients who had papillitis secondary to uveitis and who were examined on the Uveitis and Ocular Immunology Service at the Massachusetts Eye and Ear Infirmary between January 2010 and December 2012 were identified. Patients who had optic nerve imaging by Spectralis SD-OCT (Heidelberg Engineering, Heidelberg, Germany) during and after an episode of active inflammation were included. The SD-OCT optic nerve imaging protocol included a manual measurement of the highest point of optic nerve head elevation in each eye. SD-OCT optic nerve head height and clinical variables including grade of inflammation and anatomic location of uveitis were recorded. A student’s paired t-test was used to assess the association between optic nerve head thickness and intraocular inflammation grade.
Eight eyes from six patients were included in this series. The location of uveitis was anterior in 3 patients, retinal vasculitis in 1 patient, multifocal choroiditis in 1 patient and idiopathic papillitis in 1 patient. Mean maximum optic nerve head thickness in eyes without inflammation was 651 microns (n=8). The mean maximum never fiber layer elevation in optic nerves with inflammation was 916 microns (n=8). There is a statistically significant difference between optic nerve head elevation in inflamed vs. not inflamed eyes (p = 0.016).
Optic nerve elevation in papillitis secondary to uveitis can be quantified using SD-OCT. The amount of optic nerve elevation by SD-OCT in uveitis patients with secondary papillitis correlates with the presence of active intraocular inflammation. Further study is required to determine if optic nerve SD-OCT could be a clinically useful, non-invasive adjunct for monitoring inflammation in uveitis patients.
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