PurposeTo compute choroidal vascularity index (CVI) using an image binarization tool on enhanced depth imaging (EDI)-optical coherence tomography (OCT) scans as a non-invasive optical tool to monitor progression in panuveitis and to investigate the utility of volumetric data from EDI-OCT scans using custom image analysis software.Materials and MethodsIn this retrospective cohort study, segmented EDI-OCT scans of both eyes in 19 patients with panuveitis were taken at baseline and at 3-month follow-up and were compared with EDI-OCT scans of normal eyes. Subfoveal choroidal area was segmented into luminal (LA) and stromal interstitial area (SA). Choroidal vascularity index (CVI) was defined as the proportion of LA to the total circumscribed subfoveal choroidal area (TCA).ResultsThe mean choroidal thickness was 265.5±100.1μm at baseline and 278.4±102.6μm at 3 months follow up (p = 0.06). There was no statistically significant difference in TCA between study and control eyes (p = 0.08). CVI in the control group was 66.9±1.5% at baseline and 66.4±1.5% at follow up. CVI was 74.1±4.7% at baseline and 69.4±4.8% at 3 months follow up for uveitic eyes (p<0.001). The % change in CVI was 6.2 ±3.8 (4.3 to 8.0) for uveitic eyes, which was significantly higher from % change in CVI for control eyes (0.7±1.1, 0.2 to 1.3, p<0.001).ConclusionThe study reports composite OCT-derived parameters and CVI as a possible novel tool in monitoring progression in panuveitis. CVI may be further validated in larger studies as a novel optical tool to quantify choroidal vascular status.

Purpose To obtain measurements of vitreous signal intensity from optical coherence tomography (OCT) image sets in patients with uveitis, with the aim of developing an objective, quantitative marker of inflammatory activity in patients with this disease. Design Retrospective, observational case-control series. Participants Thirty patients (30 eyes), with vitreous haze secondary to intermediate, posterior, or panuveitis; twelve patients (12 eyes) with uveitis but without evidence of vitreous haze; and 18 patients (18 eyes) without intraocular inflammation or vitreoretinal disease. Methods Clinical and demographic characteristics were recorded, including visual acuity (VA), diagnosis, and anatomic type of uveitis. In each eye, the anterior chamber (AC) was graded for cellular activity and flare according to standardized protocols. The presence and severity of vitreous haze was classified according to the National Eye Institute system. Spectral domain OCT images were analyzed using custom software. This software provided an “absolute” measurement of vitreous signal intensity, which was then compared to that of the retinal pigment epithelium (RPE), generating an optical density ratio with arbitrary units (“VIT/RPE-Relative Intensity”). Main Outcome Measures Correlation between clinical vitreous haze scores and OCT-derived measurements of vitreous signal intensity. Results VIT/RPE-Relative Intensity was significantly higher in uveitic eyes with known vitreous haze (0.150) than in uveitic eyes without haze or in healthy controls (0.0767, p=0.0001). VIT/RPE-Relative intensity showed a significant, positive correlation with clinical vitreous haze scores (r=0.566, p=0.0001). Other ocular characteristics significantly associated with VIT/RPE-Relative Intensity included VA (r=0.573, p=0.0001), AC cells (r=0.613, p=0.0001), AC flare (r=0.385, p=0.003). Measurement of VIT/RPE-Relative Intensity showed a good degree of inter-grader reproducibility (95% limits of agreement: −0.019 to 0.016). Conclusions These results provide preliminary evidence that OCT-derived measurements of vitreous signal intensity may be useful as an outcome measure in patients with uveitis. If validated in future studies, such measures may serve as an objective, quantitative disease activity endpoint, with the potential to improve the “signal:noise” ratio of clinical trials in this area, thus enabling smaller studies for the same power. The incorporation of automated vitreous analysis in commercial OCT systems may, in turn, greatly facilitate monitoring and retreatment of patients with uveitis in clinical practice.