Purchase this article with an account.
Sumit Sharma, Richard Gans, Kimberly Baynes, Emily Fisher, Peter K Kaiser, Arthi Venkat, Careen Lowder, Sunil K Srivastava; Automated Analysis of Anterior Chamber Inflammation by Spectral-Domain Optical Coherence Tomography in Cataract Surgery Patients. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1301. doi: https://doi.org/.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
This study was designed to determine the feasibility of optical coherence tomography (OCT) to objectively image and quantify the degree of AC inflammation in patients undergoing cataract surgery.
IRB approved, observational, prospective, case series of patients undergoing cataract surgery with a single surgeon (RG) at the Cleveland Clinic Cole Eye Institute without uveitis. Both eyes were included if the patient was undergoing surgery in both eyes. All patients underwent slit lamp examination with inflammation graded using the SUN grading system and compared to SD-OCT images taken on the Optovue Avanti. Images were analyzed using an automated, proprietary algorithm to count the number of cells based on the number of hyperreflective spots measured that are above a certain threshold reflectance value. Images were taken preoperatively, on postoperative day 0 or 1 (POD0/POD1), postoperative week 1 (POW1) and postoperative month 1 (POM1).
153 eyes of 117 patients were includedwith a mean age of 69.3 years (range 44-91 years), 91 (59%) were females. On automated analysis the average cell density prior to surgery was 0.58 cells/mm3 (n=153), on POD0 the cell density was 35.5 cells/mm3 (n=113), on POD1 the average cell density was 19.4 cells/mm3 (n=41), at POW1 the average cell density was 3.2 cells/mm3 (n=131), at POM1 the average cell density was 0.99 cells/mm3 (n=122). The Pearson correlation coefficients comparing clinical grade by the cataract surgeon vs automated cell counts were: POD0 r=0.02 (p=0.79), POD1 r=-0.10 (p=0.52), POW1 r=-0.02 (p=0.89), and POM1 r=0.001 (p=0.99). Pearson correlation coefficients for masked uveitis specialist vs automated cell counts were: POD0 r=0.46 (p=0.0001), POD1 r=-0.34 (p=0.07), POW1 r=-0.38 (p=0.0004), and POM1 r=0.73 (p<0.00001).
Anterior segment OCT (AS-OCT) can be used to grade the degree of AC inflammation in cataract surgery patients and shows that cell counts decrease with time after cataract surgery. Clinical grading by the cataract surgeon did not correlate with the fluid density fluid density calculated from AS-OCT scans; however, it did correlate to the clinical grade by masked uveitis specialists at all time points except POD1. AS-OCT can accurately detect the level of inflammation after cataract surgery and accurately track the degree of improvement over time.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
This PDF is available to Subscribers Only