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.