Abstract
Purpose :
We investigated the clinical significance of preretinal and vitreous cells on optical coherence tomography (OCT) in posterior uveitis. We hypothesized the shape and location of these cells at presentation in these patients may aid in an early diagnosis of infectious versus non-infectious uveitis.
Methods :
This was a retrospective chart review of 209 patients with intermediate, posterior, or panuveitis at UT Southwestern Medical Center (Dallas, Texas). Uveitis patients were put into infectious and non-infectious categories. Infectious uveitis included endophthalmitis, tuberculous chorioretinitis, syphilitic uveitis, toxoplasmosis chorioretinitis, acute retinal necrosis, and ocular toxocara. Anterior uveitis cases or non-inflammatory vitreous opacities were excluded. Personal identifiable information was redacted. IRB approval was obtained. Two blinded retina specialists graded for cell location, shape, and the presence of ERMs or CMEs on central rasters of OCT scans (Heidelberg Spectralis, Germany). An adjudicator reviewed discrepancies. A chi squared test was done, determining the statistical significance of OCT findings in infectious versus non-infectious uveitis.
Results :
Out of 209 cases, 152 (73%) were included in the study. Of these, 121 (79%) eyes were initially diagnosed with non-infectious uveitis and 31 (20%) with infectious uveitis. Four (3%) non-infectious cases were initially diagnosed as infectious. Two (6%) infectious cases were initially diagnosed and managed as non-infectious with anti-inflammatory agents. Infectious uveitis (vs. non-infectious uveitis) was associated with an increased prevalence of the following OCT findings: fine vitreous cells (54% vs. 38%, p=0.015), cells in the preretinal space (24% vs. 22%, p=0.004), and cells lined along the posterior edge of the hyaloid (16% vs. 11%, p=0.004). There was no significant difference in OCT features between infectious and non-infectious uveitis: presence of epiretinal membrane (20% vs. 23%, p=0.74) and cystoid membrane edema (16% vs. 24%, p=0.24).
Conclusions :
We conclude that the presenting OCT features, including vitreous shape and location, may help distinguish infectious from non-infectious posterior uveitis in some cases. Further studies are indicated to confirm these findings and determine whether utilizing these imaging techniques would result in an earlier diagnosis of infectious uveitis in clinical practice.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.