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M. T. Feng, R. Ursea; Anterior Segment Optical Coherence Tomography in the Evaluation of Anterior Scleritis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):300.
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To correlate anterior segment optical coherence tomography (AS-OCT) findings in anterior scleritis with clinical diagnosis and response to therapy.
Retrospective, observational case series. Eyes with anterior scleritis were imaged using Visante AS-OCT (Carl Zeiss Meditec, Dublin, CA). Scleral thickness, extent and location of involvement, and additional irregularities noticed were recorded and correlated with clinical impression.
10 eyes of 8 patients were imaged. AS-OCT identified localized scleral changes consistent with clinical diagnosis of subtype and location in 9 of 10 eyes (90%, p=0.021). Scleral thinning was confirmed and measured in necrotizing (n=2) scleritis. Non-necrotizing (n=8) cases showed a pattern of alternating hyper- and hypo-reflective layers within the sclera. AS-OCT changes were subtle in diffuse non-necrotizing cases. Mean follow up was 3.5 months (SD 2.1), during which scleritis recurred in 2 eyes. Increased thickening and layering were apparent on imaging during episodes of flare. With treatment, the observed layering diminished but scleral thickness persisted longer despite a quiet clinical picture.
AS-OCT is a useful and noninvasive tool in the evaluation of anterior scleritis and its response to therapy. Imaging demonstrates that reversal of anatomical scleral changes can lag behind clinical resolution. Therefore, AS-OCT data offer important clues in determining treatment endpoints.
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