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Aim The aim of this study is to characterise the choroidal features of patients diagnosed with sarcoid-and tuberculosis (TB)-associated granulomatous uveitis using spectral domain optical coherence tomography (OCT). Methods Twenty-seven patients (27 eyes) diagnosed with sarcoid-(13 eyes) and TB (14 eyes)-related uveitis were included in this retrospective, cross-sectional study. Over a sixmonth period, patients diagnosed with sarcoid and TB granulomatous uveitis were scanned using enhanced depth imaging OCT. Clinical and demographical characteristics were recorded, including the method of diagnosis, disease activity, site of inflammation (anterior or posterior), treatments, and visual acuity (VA). Manual segmentation of the choroidal layers was performed using custom image analysis software. Results The main outcome measure was OCT-derived thickness measurements of the choroid and choroidal sublayers (Haller's large vessel and Sattler's medium vessel layers) at the macula region. The ratio of Haller's large vessel to Sattler's medium vessel layer was significantly different at the total macula circle in eyes diagnosed with TB uveitis (1.47 ( = 140.71/95.72 μm)) compared with sarcoid uveitis (1.07 ( = 137.70/128.69 μm)) (P = 0.001). A thinner choroid was observed in eyes with a VA ≥ 0.3 LogMAR (Snellen 6/12; 198.1 μm (interquartile range (IQR) = 147.0-253.4 μm) compared with those with VA o0.3 LogMAR (292.4 μm (IQR = 240.1-347.6 μm)) at the total macula circle (P = 0.004). At the foveal central subfield, the median choroidal thickness was 336.8 μm (IQR = 272.3-375.4 μm) in active compared with 239.3 μm (IQR = 195.3-330.9 μm) in quiescent disease (P = 0.04). Conclusion A disproportionately enlarged Sattler's layer may indicate a diagnosis of sarcoid-related uveitis, and choroidal thickening may be a feature of active granulomatous uveitis.

ystemic lupus erythematosus is a systemic autoimmune condition that can be associated with uveitis. The prevalence of SLE as a cause of uveitis varies in the literature. In 1990, Rosenbaum and Wernick 1 reported on the use of routine antinuclear antibody (ANA) testing for patients with uveitis. Their Bayesian analysis required a pretest probability of SLE in patients with uveitis. Rosenbaum and Wernick 1 estimated a prevalence of SLE as a cause of uveitis as 0.1%. This estimate was based on 1218 patients in 3 studies in the 1980s where SLE was neither found nor explicitly mentioned. Based on this prevalence, they estimated that with a positive ANA test result in a patient with uveitis, the chance of the patient having SLE was less than 1%. They recommended against the routine screening of patients with uveitis with ANA testing in the absence of other features suggestive of SLE. A higher pretest probability resulted in a higher posttest probability.Rodriguez et al 2 described the etiology of uveitis in 1237 patients attending the Massachusetts Eye and Ear Infirmary, reporting the prevalence of SLE as 4.8%. Substituting this value for pretest probability into the Bayesian analysis performed by Rosenbaum and Wernick 1 resulted in a 24% posttest probability of having SLE. Thus, the prevalence of SLE in uveitis determines the value of routine ANA testing.

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Smartphones have been used in anterior and posterior segment photography 1,2 and adaptors are available to enable the recording of surgical videos. The two-dimensional (2D) images can be of excellent quality but are lacking when compared to the stereoscopic three-dimensional (3D) view through the slit lamp or microscope eyepieces. A number of companies (eg Google/Samsung/ Zeiss) are using smartphones and head-mounted Virtual Reality (VR) headsets (eg Google Cardboard/Samsung Gear VR/Zeiss VR One) for the purpose of immersive 3D video gaming or movie viewing. These are effectively headmounted stereoscopes into which a smart phone is placed to display the image. Using two smartphones and a VR headset we have developed a way of viewing slit lamp and surgical videos in 3D. We connected two iPhone 4Ss to the slit lamp or operating microscope using 3D-printed eyepiece adaptors (Figure 1). Video of signs such Figure 1 Two phones attached to the slit lamp or microscope eyepieces record images from two perspectives to create a stereoscopic effect.