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Trystan Macdonald, Pearse Andrew Keane, Sreekantam Sreekanth, Dawn A Sim, Philip Ian Murray, Alastair K Denniston; Quantitative Analysis of Vitreous Inflammation using Optical Coherence Tomography in Patients Receiving Sub-Tenon’s Triamcinolone for Uveitic Cystoid Macular Edema. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6166.
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© ARVO (1962-2015); The Authors (2016-present)
To obtain measurements of vitreous signal intensity from optical coherence tomography (OCT) image sets in patients with uveitic cystoid macular edema (CME), before and after treatment with sub-Tenon’s triamcinolone, with the aim of developing a novel, objective, quantitative biomarker of treatment response.
In this retrospective longitudinal case-series, 13 patients (13 eyes), with CME secondary to intermediate, posterior, or panuveitis, were included. In each case, uveitic CME was treated with sub-Tenon’s triamcinolone injection, and spectral domain OCT images were acquired before and at first follow-up visit after treatment. Clinical and demographic characteristics were recorded in each case. Spectral domain OCT images were analyzed using custom software. This software provided an “absolute” measurement of vitreous signal intensity, which was then compared to that of the retinal pigment epithelium (RPE), generating an optical density ratio with arbitrary units (“VIT/RPE-Relative Intensity”).
Mean patient age at baseline was 47.32 ± 15.78 years. First follow-up examination after treatment occurred at 54 ± 18 days (median: 51 days; range 28-98 days). VIT/RPE-Relative Intensity was significantly reduced following treatment with triamcinolone (baseline: 0.1455 ± 0.0853 versus first follow-up: 0.0565 ± 0.0311, p = 0.0030).
OCT-derived measurements of vitreous signal intensity may be useful as an outcome measure in patients with uveitis. It may be possible for such measures to serve as objective, quantitative disease activity endpoints, for the assessment of differential pharmacodynamic effects and clinical outcomes in clinical trials for uveitic CME.
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