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Wataru Matsumiya, Sentaro Kusuhara, Atsuko Katsuyama, Akihito Uji, Makoto Nakamura; Evaluation of vitreoretinal cellular infiltration in uveitis on optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2018;59(9):269. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate vitreoretinal cellular infiltration in uveitis on spectral domain optical coherence tomography (SD-OCT) and to develop a new OCT-based grading system of severity of inflammation in uveitis.
In this retrospective study, 40 eyes from 26 patients with uveitis in posterior segment and 23 eyes with no apparent abnormalities from 23 persons as sex- and age-matched controls were enrolled. All subjects in this study were received detailed ophthalmic examinations including SD-OCT (Spectralis; Heidelberg Engineering, Heidelberg, Germany).The SD-OCT cross-sectional images through fovea in all subjects were graded as follows: grade 0, no presence of cell-like hyper-reflective particle (CLHP); grade 1, several CLHPs (≦10 particles) on the retinal surface; grade 2, a small number of CLHPs (≦5 particles) in the vitreous and several CLHPs on the retinal surface.; grade 3, increased CLHPs in the vitreous; grade 4, a large number of CLHPs in the whole vitreous space. Reference images in the OCT-based grading were shown in figure.The primary outcome measures were sensitivity and specificity of the ability of the grading system to differentiate uveitis. The secondary outcome measure was a correlation of the OCT-based grading with vitreous haze classification according to the SUN Working Group criteria. Inter-observer agreement was also evaluated.
The presence of vitreous CLHPs in SD-OCT was detected in 27 eyes (67.5%) in uveitis group, and detected in 2 eyes (8.7%) in control group. The sensitivity and specificity were 67.5% and 91.3%, respectively. The presence of inflammation using the OCT-based grading (≧grade 0.5) was detected in 34 eyes (85%) in uveitis group, and no one in control group, and the sensitivity and specificity were 85% and 100%, respectively. This OCT-based grading in uveitis was significantly correlated with the vitreous haze classification (R=0.403, p<0.01). The inter observer agreement of the presence or absence of inflammation using the OCT-based grading was excellent (κ= 0.84) and the inter observer agreement of the OCT-based grading score was moderate (κ= 0.5).
This newly developed OCT-based grading in vitreoretinal cellular infiltration can provide a good sensitivity and specificity to differentiate uveitis in posterior segment and control subjects, and may be applicable in evaluating severity of vitreous haze.
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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