June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Comparison of anterior segment optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) in diagnosis of anterior scleritis
Author Affiliations & Notes
  • Robert Purgert
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Angela Bessette
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Francesco Pichi
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Careen Lowder
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Robert Purgert, None; Angela Bessette, None; Francesco Pichi, None; Careen Lowder, None
  • Footnotes
    Support  NIH-NEI P30 Core Grant (IP30EY025585-01A1) and an unrestricted grant from Research to Prevent Blindness, Inc., awarded to the Cole Eye Institute
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4859. doi:
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      Robert Purgert, Angela Bessette, Francesco Pichi, Careen Lowder; Comparison of anterior segment optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) in diagnosis of anterior scleritis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4859.

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

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Abstract

Purpose : Optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) are imaging modalities that have individually been used for detecting characteristic inflammatory changes of anterior scleritis. This retrospective study compared OCT and UBM to determine which modality better images the inflammatory changes of scleritis.

Methods : Charts of patients 18 years or older who had both anterior segment OCT and UBM performed on inflamed regions of sclera and/or overlying tissue from January 2016 to the present were reviewed. The Optovue RTVue XR (Optovue Inc., Fremont, CA) and Quantel Medical Aviso S (Quantel Medical Inc., Cournon-d'Auvergne, France) were used to acquire OCT and UBM images, respectively, in these patients. Images were compiled and randomized. Two masked uveitis experts judged each image as being consistent with scleritis or not (Figures 1 and 2), based on previously-published descriptions of scleritis patterns in the OCT (Shoughy et al. Am J Ophthalmol 159 (6), 1045-1049.e1. 2015) and UBM (Zur et al. Acta Ophthalmol 94 (6), e384-e389. 2016) imaging modalities. The study was approved by the Cleveland Clinic Institutional Review Board and performed according to tenets of the Declaration of Helsinki.

Results : Analysis was performed on 12 eyes from 10 patients (mean age 63 +/- 8.4 years; age range 46 to 73; 60% women; 20% with bilateral disease; 90% with scleritis as the original indication for imaging; 30% with underlying systemic inflammatory disease). There was a significantly greater proportion of correct determinations of scleritis by OCT than UBM (0.83 +/- 0.08 vs. 0.58 +/- 0.10; p < 0.05; McNemar’s chi-square). Additionally, OCT demonstrated greater sensitivity for detecting scleritis than UBM (0.91 +/- 0.06 vs. 0.64 +/- 0.10). Finally, OCT promoted a greater percentage agreement among image judges than UBM (84% vs. 50%).

Conclusions : Anterior segment OCT is a more accurate adjunctive tool for diagnosing anterior scleritis than UBM. This finding highlights for clinicians a superior imaging modality to aid in the diagnosis and follow-up of patients with scleritis.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Figure 1: Scleritis inflammatory changes on UBM. Non-homogenous scleral thickening (between arrows) with overlying low-reflectivity episcleral thickening (asterisk).

Figure 1: Scleritis inflammatory changes on UBM. Non-homogenous scleral thickening (between arrows) with overlying low-reflectivity episcleral thickening (asterisk).

 

Figure 2: Scleritis inflammatory changes on OCT. Intrascleral edema (arrow) with subconjunctival fluid (arrowhead).

Figure 2: Scleritis inflammatory changes on OCT. Intrascleral edema (arrow) with subconjunctival fluid (arrowhead).

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