September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Assessment of vitreous inflammation before and after corticosteroid therapy in patients with uveitic cystoid macular edema using optical coherence tomography
Author Affiliations & Notes
  • Hussein Ibrahim
    Academic Unit of Ophthalmology, University of Birmingham, Birmingham, United Kingdom
  • Robert John Barry
    Academic Unit of Ophthalmology, University of Birmingham, Birmingham, United Kingdom
    Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
  • Mussarat Allie
    Department of Visual Function, Birmingham and Midland Eye Centre, Birmingham, United Kingdom
  • Philip Ian Murray
    Academic Unit of Ophthalmology, University of Birmingham, Birmingham, United Kingdom
    Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
  • Pearse Andrew Keane
    Department of Ophthalmology, Moorfields Eye Hospital, London, United Kingdom
  • Tariq Aslam
    Department of Ophthalmology, Manchester Royal Eye Hospital, Manchester, United Kingdom
    University of Manchester, Manchester, United Kingdom
  • Alastair K Denniston
    Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
    Academic Unit of Ophthalmology, University of Birmingham, Birmingham, United Kingdom
  • Footnotes
    Commercial Relationships   Hussein Ibrahim, None; Robert Barry, None; Mussarat Allie, None; Philip Murray, None; Pearse Keane, None; Tariq Aslam, None; Alastair Denniston, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4235. doi:
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      Hussein Ibrahim, Robert John Barry, Mussarat Allie, Philip Ian Murray, Pearse Andrew Keane, Tariq Aslam, Alastair K Denniston; Assessment of vitreous inflammation before and after corticosteroid therapy in patients with uveitic cystoid macular edema using optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4235.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Our group previously demonstrated that optical coherence tomography (OCT) could be used to provide an objective, quantitative measure of vitreous haze in patients with uveitic cystoid macular edema (CME). We have since developed custom software (VITAN) to enable automated analysis of vitreous signal intensity. In a retrospective, observational clinical study, we used VITAN to generate OCT-derived vitreous haze scores in patients with uveitic CME before and after corticosteroid therapy to see whether vitreous changes anticipate CME development and resolution.

Methods : Thirty-four patients with uveitic CME were included in this study. Clinical data and OCT images (acquired using Heidelberg Engineering Spectralis spectral domain OCT scanners) were retrospectively collected and organised into 79 disease-treatment episodes. An episode was defined as starting, i.e. baseline, when a patient’s OCT image related to a date in which they had active CME and had received corticosteroid therapy; subsequent data and images were longitudinally organised into 4, 12, 26, and 52-weeks; an episode was defined as ending if the next OCT image was taken after 52-weeks or if the patient received corticosteroid therapy. Only data from the study eye, which had CME at baseline, was included. Vitreous signal intensity was calculated for each image using VITAN and corresponding clinical scores for visual acuity, anterior chamber cells, and central macular thickness were recorded. Changes over time in OCT-derived vitreous haze and the other clinical measures were analysed using paired samples t-tests.

Results : Significant improvements were observed in all four measures – OCT-derived vitreous haze, visual acuity, anterior chamber cells, and central macular thickness – between baseline and 4-weeks (p<0.002 for all comparisons). Between 4 and 52-weeks a significant difference was only observed in the OCT-derived vitreous haze (p=0.026), with change moving back towards baseline.

Conclusions : Results contribute to a growing body of evidence suggesting that OCT and VITAN can provide valid quantitative measures of vitreous inflammation in CME and uveitis. With OCT-derived vitreous haze deteriorating ahead of all other measures, this pilot study highlights the potential application of these technologies in monitoring uveitic disease activity and predicting flares of CME.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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