June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
OCT-assessed vitreous inflammation in uveitis patients treated with intravitreal dexamethasone implants
Author Affiliations & Notes
  • Jan Henrik Terheyden
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Moritz Berger
    Medical Biometry, Informatics and Epidemiology, University of Bonn, Germany
  • Giovanni Ometto
    City University London, United Kingdom
  • Dominika Pohlmann
    Department of Ophthalmology, University Charité Berlin, Germany
  • Giovanni Montesano
    City University London, United Kingdom
  • Magdalena Langner
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Maximilian W.M. Wintergerst
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Tariq Aslam
    School of Health Science, University of Manchester, United Kingdom
    Division of Pharmacy and Optometry, Manchester Royal Eye Hospital, United Kingdom
  • Xiaoxuan Liu
    University of Birmingham, United Kingdom
    Queen Elizabeth Hospital Birmingham NHS Foundation Trust, United Kingdom
  • Frank G. Holz
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Pearse Andrew Keane
    Moorfields Eye Hospital NHS Foundation Trust, United Kingdom
  • David Paul Crabb
    City University London, United Kingdom
  • Uwe Pleyer
    Department of Ophthalmology, University Charité Berlin, Germany
  • Alastair K Denniston
    University of Birmingham, United Kingdom
    Queen Elizabeth Hospital Birmingham NHS Foundation Trust, United Kingdom
  • Robert Patrick Finger
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Footnotes
    Commercial Relationships   Jan Terheyden, Carl Zeiss Meditec (F), CenterVue (F), Heidelberg Engineering (F), Optos (F); Moritz Berger, None; Giovanni Ometto, None; Dominika Pohlmann, Allergan (R), Bayer (F); Giovanni Montesano, None; Magdalena Langner, Carl Zeiss Meditec (F), CenterVue (F), Heidelberg Engineering (F), Optos (F); Maximilian Wintergerst, CenterVue (F), D-Eye (F), DigiSight Technologies (F), Heidelberg Engineering (F), HEINE Optotechnik (F), HEINE Optotechnik (C), Optos (F), Zeiss Meditec (F); Tariq Aslam, None; Xiaoxuan Liu, None; Frank G. Holz, Acucela (C), Acucela (R), Allergan (R), Bayer (C), Bayer (R), Bioeq/Formycon (C), Boehringer-Ingelheim (C), CenterVue (F), Ellex (R), Geuder (C), Grayburg Vision (C), Heidelberg Engineering (C), Kanghong (C), LinBioscience (C), NightStarX (F), Novartis (C), Optos (F), Oxurion (C), Pixium Vision (C), Pixium Vision (R), Roche/Genentech (C), Roche/Genentech (R), Stealth BioTherapeutics (C), Stealth BioTherapeutics (R), Zeiss (R); Pearse Keane, Allergan (R), Bayer (S), Bayer (R), Carl Zeiss Meditec (R), DeepMind (C), Haag-Streit (R), Heidelberg Engineering (R), Novartis (S), Novartis (R), Optos (C), Topcon (R); David Crabb, Allergan (R), CenterVue (C), Roche (R), Santen (R); Uwe Pleyer, Abbvie (C), Abbvie (R), Allergan (R), Bayer (C), Bayer (R), Boehringer (C), Boehringer (R), Lilly (C), Lilly (R), Novartis (C), Novartis (R), Panoptes (C), Panoptes (R), Roche (R), Santen (R), Santen (C); Alastair Denniston, None; Robert Finger, Alimera (C), Bayer (C), CentreVue (F), Ellex (C), Novartis (C), Novartis (F), Ophtea (C), Roche/Genentech (C), Santhera (C), Zeiss (F)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3246. doi:
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      Jan Henrik Terheyden, Moritz Berger, Giovanni Ometto, Dominika Pohlmann, Giovanni Montesano, Magdalena Langner, Maximilian W.M. Wintergerst, Tariq Aslam, Xiaoxuan Liu, Frank G. Holz, Pearse Andrew Keane, David Paul Crabb, Uwe Pleyer, Alastair K Denniston, Robert Patrick Finger; OCT-assessed vitreous inflammation in uveitis patients treated with intravitreal dexamethasone implants. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3246.

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

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Abstract

Purpose : Vitreous haze is an established biomarker of intraocular inflammation in uveitis patients. However, its use for clinical trials is limited by inter-rater variability. A recently developed optical coherence tomography (OCT)-based algorithm quantifying vitreous inflammation (Montesano G et al., 2018) may overcome these limitations and was shown to be associated with clinical disease activity ratings. We used this algorithm to assess change in vitreous inflammation following intravitreal dexamethasone (DEX) implant over at least 12 months and compare it to clinical ratings.

Methods : Retrospective clinical and OCT data (Spectralis; Heidelberg Engineering Inc) were collated. The inflammation score (INS) was obtained using the available automated OCT-based algorithm. Data were compared in a pre-post analysis using a random effects model and correlation coefficients.

Results : Patients with cystoid macular edema in intermediate uveitis (n = 14), posterior uveitis (n = 60), panuveitis (n = 10) or anterior uveitis (n = 3) resulting in a total of n=87 eyes of 73 uveitis patients treated with intravitreal DEX implants were available for analysis. The INS changed from 0.134 at baseline to 0.070 at last follow up (p = 0.0158). Patients received an average of 2.3 ± 2.3 injections (range: 1 – 14 injections). The overall INS correlated significantly with the clinical ratings of anterior vitreous cells. In all patients, the INS at baseline did not correlate significantly with the INS at final follow-up (FU), number of injections, visual acuity at last FU or visual acuity change. However, in only intermediate and panuveitis patients, we found a considerable positive correlation between initial INS and number of injections (r = 0.40, 95% CI 0.01 – 0.69).

Conclusions : We found OCT-assessed vitreous inflammation to decrease following intravitreal dexamethasone implants. The inflammation score was associated with clinical parameters and predictive of the number of future injections. The OCT-based vitreous haze score is a potentially relevant biomarker for long-term follow-up in uveitis patients as well as for future clinical trials. Further research should assess its relationship with structural and functional parameters.

This is a 2020 ARVO Annual Meeting abstract.

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