Abstract
Background / Objectives:
We aimed to investigate the potential of anterior segment OCT (AS-OCT) in differentiating anterior chamber (AC) pigment and inflammatory cells.
Subject / Methods:
Cross-sectional study of adults with uveitis. Exclusion criterion was corneal opacity sufficient to obscure slit lamp examination of anterior chamber. Reference testing comprised slit lamp based detection of pigment and Standardization of Uveitis Nomenclature (SUN) grading of intraocular inflammation. Index testing comprised CASIA2 swept-source AS-OCT acquisition, with semi-automated analysis to detect and measure hyper-reflective particles within the AC. Correlations between AS-OCT derived counts of different sized particles and clinical grades were explored using multilevel multivariable regression analyses.
Results:
62 eyes (31 patients) were included. There was a positive correlation between AS-OCT particle counts of >2 pixels (equivalent to >12microns), and SUN grading (adjusted coefficient, adjCoef 52.1, 95% CI 10.1-94.0, p=0.02), strengthened in eyes clinically absent of pigment (adjCoef 69.8, 17.4-122.1, p=0.01). Positive correlation was also noted between particle counts ≤2 pixels and presence of AC pigment clinically.
Conclusions:
Swept source (SS) AS-OCT holds potential utility in differentiating between pigment and cells within the AC, leading to improved management of individuals with or at risk of intraocular inflammation. SS AS-OCT derived biomarkers may also provide information on uveitis aetiology, supporting diagnosis of underlying conditions. Further work on a larger cohort, replication by other investigators and clinical teams, and clinical correlation with anterior chamber sampling, will enable future clinical validation.