July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Investigation of the correlation of anterior chamber cell quantification by OCT and corneal pseudoguttata in the setting of anterior uveitis
Author Affiliations & Notes
  • Doran Spencer
    Ophthalmology, Shiley Eye Institute, Univ. of Calif., San Diego, La Jolla, California, United States
  • William R Freeman
    Ophthalmology, Shiley Eye Institute, Univ. of Calif., San Diego, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Doran Spencer, None; William Freeman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4215. doi:
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    • Get Citation

      Doran Spencer, William R Freeman; Investigation of the correlation of anterior chamber cell quantification by OCT and corneal pseudoguttata in the setting of anterior uveitis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4215.

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

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Abstract

Purpose : Anterior uveitis (AU) is a disease associated with significant ocular pathology. Recently, corneal endothelial pseudoguttata have been described as a physical finding that associates with AU, as documented by flaremeter evaluation (Spencer, ARVO 2017). However, flaremeter devices are uncommon and unfamiliar to most ophthalmologists. In this study, we seek to demonstrate the novel correlation between anterior segment (AS) evaluation of anterior chamber (AC) inflammation via optical coherence tomography (OCT) imaging, which is a modality omnipresent in ophthalmologic practices, and pseudoguttata. Our goal is to familiarize the greater ophthalmologic community with the utility of recognizing pseudoguttata as a marker of AC inflammation.

Methods : Four AU patients were evaluated, including SUN anterior chamber cell severity and presence of pseudoguttata. Slit lamp photos and specular microscopy images were taken to document the presence of the pseudoguttata. Additionally, we used a Heidelberg Spectralis OCT1 with the AS module and lens to capture images of the AC cells. The cornea setting was used to acquire AC images (60 frames). AC cells were recognized as hyperreflective particles within the AC and were manually counted. Contralateral, unaffected eyes were used as internal controls when appropriate. Additional patients are being actively recruited for evaluation.

Results : All AU patients had SUN scores of trace to 2+. Etiologies included idopathic AU and AU associated with HLA-B27. None of the four were on systemic treatment nor had received local treatment prior to evaluation. Pseudoguttata prominence on slit lamp and specular microscopy was noted to correlate directly with SUN severity, ranging from trace to near confluent. OCT AC images demonstrated AC hyperreflective particles consistent with AC cells and correlated directly with SUN and pseudoguttata severity. Contralateral, unaffected eyes demonstrated no abnormalities.

Conclusions : We have described the novel correlation AC cells in AU, as evaluated by AS OCT, and pseudoguttata. These findings serve to validate the utility of pseudoguttata as a reliable and clinically relevant marker of AU. We believe that this represents a significant advancement in terms of uveitis assessment and evaluation of treatment efficacy. Furthermore, we propose that pseudoguttata merit consideration as a SUN criterion.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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