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Objective Quantification of Posterior Segment Inflammation: Measuring Vitreous Cells and Haze Using Optical Coherence Tomography - 13/12/22

Doi : 10.1016/j.ajo.2022.08.025 
Federico Zicarelli a, Giovanni Ometto b, c, Giovanni Montesano b, c, Samuele Motta a, Luca De Simone d, Luca Cimino d, e, Giovanni Staurenghi a, Aniruddha Agarwal f, Francesco Pichi f, g, Alessandro Invernizzi a, h, ⁎
a Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy 
b Optometry and Visual Sciences, City, University of London, London, United Kingdom 
c NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom 
d Ocular Immunology Unit, Azienda USL-IRCCS of Reggio Emilia, Reggio Emilia, Italy 
e Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy 
f Eye Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates 
g Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA 
h The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia 

⁎Inquiries to Alessandro Invernizzi, Eye Clinic, Luigi Sacco Hospital, University of Milan, Via G.B. Grassi 74, 20157 Milan, Italy.Eye ClinicLuigi Sacco HospitalUniversity of MilanVia G.B. Grassi 74Milan20157Italy

Highlights

•
Posterior segment inflammation could be objectively graded by counting cells on optical coherence tomography scans.
•
Optical coherence tomography scans of the density of cells in the vitreous space significantly correlated with the inflammation clinical grading.
•
Optical coherence tomography scans of the density of cells in the vitreous space performed better than vitreous reflectivity analysis.
•
The density of cells in the vitreous space is a promising biomarker to objectively grade intraocular inflammation.

El texto completo de este artículo está disponible en PDF.

Resumen

Purpose

To objectively grade posterior segment inflammation by measuring vitreous cells and haze on optical coherence tomography (OCT) scans and to compare OCT-based results with clinical grading.

Design

Evaluation of a diagnostic test.

Methods

OCT scans of patients with uveitis were collected at 3 timepoints: with active (T0), clinically improving (T1), and resolved (T2) inflammation. At each visit, visual acuity and clinical grading of the vitreous haze (National Eye Institute [NEI] scale) were assessed. The density of vitreous cells was calculated on each OCT scan manually and automatically through a bespoke algorithm. Vitreous haze was indirectly measured on OCT scans by calculating the vitreous/retinal pigmented epithelium (VIT/RPE)-relative intensity manually and automatically. The variation of OCT-derived measurements over time was assessed. OCT-derived measurements were compared with clinical grading.

Results

A total of 222 scans from 74 eyes were analyzed. Both vitreous cell density and VIT/RPE-relative intensity significantly decreased over time. Cell density correlated with the clinical grading with a significant increase at each grade of the NEI scale. By contrast, the VIT/RPE-relative intensity was positively correlated with the clinical grade overall but there was no significant difference when comparing contiguous grades of the NEI scale. Infectious uveitis had a higher cell density. The intraclass correlation coefficient between manual and automatic assessment was 0.83 for cell density and 0.423 for the VIT/RPE-relative intensity.

Conclusions

Posterior segment inflammation could be objectively graded through OCT scans. Vitreous cell density was assessed manually and automatically with good agreement and correlated better with NEI clinical grading compared with VIT/RPE-relative intensity.

El texto completo de este artículo está disponible en PDF.

Esquema


 Supplemental Material available at AJO.com.
Meeting Presentation: The preliminary results of this work were presented in part at the American Academy of Ophthalmology 2021 Annual Meeting.


© 2022  Elsevier Inc. Reservados todos los derechos.
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Vol 245

P. 134-144 - janvier 2023 Regresar al número
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