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Ashleigh Levison, Careen Y Lowder, Kimberly Baynes, Sunil K Srivastava; The use of anterior segment spectral domain Optical Coherence Tomography in evaluation of patients with anterior scleritis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4872.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the findings on spectral domain optical coherence tomography (SD-OCT) in patients with anterior scleritis. To determine the feasibility of using SD-OCT to image and grade the degree of scleral inflammation.
This is an IRB approved, prospective, observational, case series of patients with anterior scleritis. Patients underwent slit lamp examination by a uveitis specialist and the degree of scleral inflammation was recorded. Spectral domain OCT imaging was then performed of the conjunctiva and scleral tissue using the RTVue-100. The images were interpreted by investigators trained in the interpretation of OCT. Thirteen patients were imaged with a total of sixteen images obtained. Three patients had clinical slit lamp photography performed at the same time the OCT images were obtained. Two patients underwent repeat OCT images at subsequent visits.
Of the 13 patients imaged, 10 patients had evidence of intrascleral fluid. Eight of the 13 patients had evidence of nodules in the scleral while these nodules had only been documented in 4 of those 8 patients on clinical exam. En face imaging revealed in five of the 13 patients clear evidence of vessels that traveled deep into the sclera, many of which had significant fluid surrounding the engorged vessels. In one patient where there was a significant improvement clinically between visits when OCT images were obtained, there was significantly less intrascleral fluid seen on OCT with less scleritis activity. In the two patients imaged with scleromalacia there is very apparent scleral thinning but obvious evidence of conjunctiva overlying the scleral thinning.
Consistent findings seen on OCT in patients with scleritis include intrascleral fluid, nodules, and deep scleral vessels with surrounding fluid. SD-OCT imaging provided various objective measures that could be used in the future to monitor and grade patients with scleritis. Further investigation is currently underway to further assess the utility of SD-OCT in monitoring patient’s disease activity.
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