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Judy L Chen, Edmund Tsui, Nicholas J Jackson, Michael Marchand-Gareau, Tara Gallant, Michele Lim, Gary N Holland; High-Frequency Ultrasound Biomicroscopy Imaging of the Ciliary Body in Patients with Intraocular Inflammation. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1438.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether hypotony in patients with histories of intraocular inflammation is associated with anatomic changes in the ciliary body (CB) on high-frequency ultrasound biomicroscopy (UBM).
In this pilot study, we performed a retrospective chart review of patients with histories of intraocular inflammation, seen by 3 uveitis providers (2016-20), who underwent UBM, performed with the VuMAX HD (SonomedEscalon) using immersion technique (an exception was a child intolerant of the immersion shell, who underwent direct contact technique). Using ImageJ (National Institutes of Health), we measured CB thickness, and ciliary process (CP) length, thickness, density, and area for available high-quality scans of each quadrant. Patients were categorized into 2 groups based on UBM indication: hypotony (IOP≤5mmHg) or other. Linear regression with clustered robust standard errors at the patient-eye level were used to assess group differences in CB measurements.
A total of 159 scans (35 eyes, 28 patients) were included. Each patient underwent a median of 4 scans (range 3–12). Mean age at time of UBM was 48.1±24.5 years (range 10–78 years), and 20 patients (71.4%) were female. Seventeen patients (60.7%) underwent UBM for hypotony and 11 (39.3%) for evaluation of intraocular lens position or preoperative planning. Categories of disease were: anterior (n=19, 67.9%), intermediate (n=2, 7.1%), posterior (n=2, 7.1%), and pan- (n=4, 14.3%) uveitis, and chronic post-operative endophthalmitis (n=1, 3.6%). Median disease duration at time of UBM was 2.7 years (range 14 days–23.0 years); the hypotony group had longer median duration of disease (5.0 vs. 1.3 years). Mean CB thickness was increased in the hypotony group versus the non-hypotony group (0.660±0.041 vs. 0.559±0.024 mm, p=.038). Means of all CP measures were decreased in the hypotony group versus the non-hypotony group, including length (0.502±0.066 vs. 0.738±0.039 mm, p=.004), thickness (0.254±0.031 vs. 0.370±0.014 mm, p=.001), density (2.9±0.3 vs. 3.8±0.1 processes/2 mm, p=.011), and area (0.920±0.12 vs. 1.44±0.08 mm2, p=.001).
Hypotony as a late complication of intraocular inflammation appears to be related to anatomic changes in the ciliary body, which may result in decreased aqueous humor production. This hypothesis should be tested in a longitudinal study of uveitis patients who do and do not develop hypotony.
This is a 2021 ARVO Annual Meeting abstract.
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