Purchase this article with an account.
Peter M Kaiser, Sumit Sharma, Kimberly Baynes, Emily Fisher, Arthi Venkat, Careen Lowder, Sunil K Srivastava; Automated Analysis of Anterior Chamber Inflammation by Spectral-Domain Optical Coherence Tomography in Pediatric Uveitis Patients. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1900. doi: https://doi.org/.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine the feasibility of Spectral Domain Optical Coherence Tomography (SD-OCT) to objectively image and quantify anterior chamber inflammation in pediatric uveitis patients.
This is an IRB approved, observational, prospective, consecutive case series of pediatric uveitis patients (age < 18 years). All patients underwrent slitlamp examination with inflammation graded using the SUN grading system. Anterior chamber SD-OCT imaging was performed on the Optoview RTVue- Avanti XR. Images were then analyzed using an automated algorithm to count the number of cells based on the number of hyperreflective spots measured that are above a certain threshold reflectance value.
176 eyes of 93 patients were included in the analysis. The mean age was 10.8 years (range 4-17 years). There were 55 (59%) females. On clinical exam, 74 (42%) eyes had grade 0 AC cells on SLE, 44 (25%) had grade 0.5+ (rare, trace), 22 (13%) had grade 1+, 18 (10%) had grade 2+, 14 (8%) had grade 3+, and 4 (2%) had grade 4+. The average fluid density (cells/mm3) was 7.63 for grade 0, 7.42 for grade 0.5+, 9.87 for grade 1+, 15.25 for grade 2+, 22.85 for grade 3+, and 31.02 for grade 4+. The Pearson correlation coefficient was r = 0.292 (P < 0.001) comparing fluid density with the clinical grade.
Anterior segment OCT (AS-OCT) can be used to image and grade the degree of AC inflammation in pediatric uveitis patients. Clinical grading significantly correlates with the number of cells imaged on AS-OCT scans. Interestingly, experienced clinicians may be missing cells in grade 0 and grade 1/2+ pediatric patients as the OCT showed cells when none or rare cells were seen by the clinician. Alternatively, pigmented cells could confuse the OCT but be graded correctly as no inflammation by experienced clinicians. Additional testing will help improve the algorithm and determine its applicability to pediatric uveitis management.
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