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Maite Sainz De La Maza, Mireia Hereu, Monica Hernandez, Marina Mesquida, Victor Llorenç, Alfredo Adan Civera, Javier Zarranz-Ventura; Swept-source optical coherence tomography with multiple B-scan averaging in the management of anterior scleral inflammation. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1095.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the scleral changes observed in patients with active and inactive anterior scleritis with a swept-source optical coherence tomography device (SS-OCT, DRI Triton, Topcon, Japan).
Single centre consecutive case series of unilateral anterior scleritis. SS-OCT images were acquired in patients with active scleritis and followed up until remission with sequential scans. Healthy fellow eye was used as a control. Images were quantitatively assessed using the caliper incorporated in the device software. Analysis included measurement of thickness of total sclera, conjunctival epithelium, conjunctival stroma/episclera, and scleral stroma in the mid point between the sclerocorneal limbus and the rectus muscle insertion rim (Tillaux spiral) in active and inactive scleritis. Thickness measurements were also compared between diffuse and nodular scleritis for each layer.
Thirty five active scleritis eyes were included in the study. Of them, 75% had diffuse scleritis, 14% nodular scleritis, and 14% necrotizing scleritis. Mean total scleral thickness was significantly higher during active phase compared to remission phase (887.9±216.0 mm vs 676±98.50 mm, p<0.001). Conjunctival epithelium and scleral stroma were not significantly thicker in eyes with active scleritis than in eyes with inactive scleritis (55.8±27 mm vs 50.3±13 mm, p=0.56 and 360.4±113.2 mm vs 323±96 mm, p=0.23, respectively). Conjunctival stroma/episclera was significantly thicker in eyes with active scleritis than in eyes with inactive scleritis (440.7±154 mm vs 277±61.2 mm, p<0.001). No significant differences were observed between the inactive phase and the normal fellow eye. Only conjunctival stroma/episcleral thickness was significantly higher in nodular scleritis than in diffuse scleritis.
SS-OCT DRI Triton can be employed to obtain direct images of the anterior sclera, allowing adequate identification of conjunctival epithelium, conjunctival stroma/episclera, and scleral stroma layers that may be useful in the assessment of the inflammatory status in scleritis. Eyes with active scleritis have inflammation within the conjunctival stroma/episclera layer more actively than within the scleral stroma layer. Nodular scleritis have thicker conjunctival stroma/episclera layer than diffuse scleritis. These findings may have therapeutic implications.
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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