July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Automated Analysis of Anterior Chamber Inflammation by Spectral-Domain Optical Coherence Tomography in Cataract Surgery Patients
Author Affiliations & Notes
  • Sumit Sharma
    Cleveland Clinic - Cole Eye Institute, Cleveland, Ohio, United States
  • Richard Gans
    Cleveland Clinic - Cole Eye Institute, Cleveland, Ohio, United States
  • Kimberly Baynes
    Cleveland Clinic - Cole Eye Institute, Cleveland, Ohio, United States
  • Emily Fisher
    Cleveland Clinic - Cole Eye Institute, Cleveland, Ohio, United States
  • Peter K Kaiser
    Cleveland Clinic - Cole Eye Institute, Cleveland, Ohio, United States
  • Arthi Venkat
    Cleveland Clinic - Cole Eye Institute, Cleveland, Ohio, United States
  • Careen Lowder
    Cleveland Clinic - Cole Eye Institute, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cleveland Clinic - Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Sumit Sharma, Eyepoint (C); Richard Gans, None; Kimberly Baynes, None; Emily Fisher, None; Peter Kaiser, Optovue (C), Zeiss (C); Arthi Venkat, None; Careen Lowder, None; Sunil Srivastava, Allergan (F), Bausch and Lomb (C), Bausch and Lomb (F), Clearside (C), Eyepoint (C), Gilead (C), Optos (C), Regeneron (C), Regeneron (F), Sanofi (C), Santen (C), Santen (F), Zeiss (C)
  • Footnotes
    Support  Research to Prevent Blindness Institutional Grant
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1301. doi:https://doi.org/
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      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/.

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

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Abstract

Purpose : 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.

Methods : 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).

Results : 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).

Conclusions : 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.

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