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Priyanka Kumar, Sumit Sharma, Kimberly Baynes, Peter K Kaiser, Careen Y Lowder, Sunil K Srivastava; Analysis of Anterior Chamber Inflammation in Pediatric Uveitis by Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6182.
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© ARVO (1962-2015); The Authors (2016-present)
We previously reported the results of using Spectral Domain- Anterior Segment Optical Coherence Tomography (AS-OCT) to analyze anterior chamber (AC) inflammation in adult eyes with uveitis. That study found a high degree of correlation between clinical grading of AC inflammation with the number of inflammatory cells in the AC as determined by an AS-OCT 3D volume scan. However, it was noted that cells were not easily detected in pediatric patients on the RTVue-100. The purpose of this study was to determine the feasibility of utilizing the higher resolution and higher speed Avanti RTVue-XR AS-OCT to image and grade AC inflammation in pediatric eyes with uveitis.
Observational, case series of 34 eyes from 18 patients presenting to uveitis clinic with active uveitis. AS-OCT images were taken with the Avanti RTVue-XR (Optuvue Inc, Fremont, CA). The number of cells in the AC graded by clinical exam by a uveitis specialist (based on the SUN grading nomenclature) was correlated to the number of cells identified on AS-OCT 3D volume scans.
34 eyes from 18 patients with pediatric uveitis were imaged on the Avanti RTVue-100. 14 had 0+ cell, 14 had 0.5+ cell, 3 had 1+ cell, and 3 had 2+ cell. We found an average of 51.64 cells per volume scan for 0+ cell, 79.50 cells for 0.5+ cell, 170 cells for 1+ cell, and 402.67 cells for 2+ cell. The average cell density (cells/mm3) corresponding to each clinical grade was 1.14 for patients 0+ cell, 1.53 for 0.5+ cell, 3.23 for 1+ cell, and 7.53 for 2+ cell. One-way ANOVA analysis showed a statistically significant correlation between degree of clinical grading and AC cells identified by AS-OCT, (F-ratio 11.29, p< 0.001).
The high speed and resolution of the Avanti RTVue-XR unit allows for imaging of inflammatory cells in pediatric eyes with a high degree of correlation to clinical grading by a uveitis specialist. The results of this study could bring the use of AS-OCT into the clinical realm for managing low-grade or clinically undetectable anterior segment inflammation.
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