An en face swept source optical coherence tomography study of the vitreous in eyes with anterior uveitis

Abstract

Purpose To analyse vitreous anatomy patients with anterior uveitis (AU) using swept source optical coherence tomography (SS‐OCT). Methods Patients with newly diagnosed AU and healthy participants were scanned using 16‐mm SS‐OCT B‐scans and 12 × 12 mm cube centred at the fovea. Linear SS‐OCT scans were evaluated to identify the premacular bursa (PB) above the macula and the Cloquet’s canal above the optic disc. A dynamic evaluation of the 12 × 12 mm cube enabled en face measurement of the vertical and horizontal diameters of the PB and the presence/absence of communication between the PB and Cloquet’s canal. Results One hundred and thirty‐five subjects were included in the study. Forty‐five patients were healthy (mean age 33.47 years). En face measurements of the horizontal and vertical PB mean diameters were 5.2 mm and 4.7 mm. In 90 subjects with AU (mean age 30.10 years), the mean horizontal and vertical diameter of the PB were significantly larger (p < 0.01). Thirty‐seven eyes with AU presented with cystoid macular oedema (CME). The mean diameters of the PB in this subgroup were significantly larger (p < 0.01). In 75% of the entire cohort (51% of eyes in the control group, 87% of eyes with AU and 100% of eyes with AU and CME), a channel connecting the PB and Cloquet’s canal could be identified. Conclusions SS‐OCT identification of a connecting channel between the PB and the Cloquet’s canal suggests that inflammatory cytokines may drain from the anterior chamber through this system of channels, thus increasing the risk of CME.

Vitreoretinal Interface Cells Correlate In Vivo With Uveitis Activity and Decrease With Anti-Inflammatory Treatment

“…Within our research group, we have adopted a methodology involving concurrent OCTA and en face OCT imaging of the same retinal region (as pioneered by Castanos et al 7 ) and have incorporated sequential scans of the identical area using tracking mechanisms to enhance image clarity and to cross-sectionally visualize VRICs in uveitis and make comparisons with healthy controls. 9,10 Furthermore, it is important to note that the term "macrophage-like cells" remains a speculative designation. Thus far, only studies conducted ex vivo or in animal models have provided insights into the dynamic behavior over time of microglia, monocyte-derived macrophages, and hyalocytes under various physiological conditions, elucidating alterations in cell morphology and motility in response to injury.…”

“…Normative VRIC data for comparison were obtained from our previous cross-sectional study in which we scanned 22 healthy eyes recruited from 11 patients (mean age, 30.1 ± 9.31 years; 63.6% females) attending the general ophthalmology clinic at Cleveland Clinic Abu Dhabi. 10…”

“…8 The application of en face OCT has facilitated a novel understanding of the dynamics of these vitreoretinal interface cells (VRICs) in uveitis, revealing the potential of this technology as a biomarker for disease activity and response to therapy. 9,10 This study aims to leverage en face OCT to quantitatively assess VRICs in the context of uveitis, investigating their role in the pathophysiology of the disease and the potential implications for therapeutic intervention. By elucidating the contributions of microglia and other VRICs to uveitis, we aspire to enhance the diagnostic and therapeutic landscape for this and related retinal conditions.…”

Artificial Intelligence-Assisted Processing of Anterior Segment OCT Images in the Diagnosis of Vitreoretinal Lymphoma

“…The correlation between the variables was studied using the Pearson correlation coefficient (r) for radiomic models built with five different sets of grey-level sampling (16,32,64,128, and 256 levels).…”

“…Thanks to the improvement in imaging technology, swept-source anterior segment OCT (AS-OCT) has been proven useful to identify cells and indirectly quantify flare in the anterior chamber of patients with uveitis [15,16]. Likewise, the posterior segment OCT image has such high resolution that it correlates with the clinical grading of vitreous haze [17][18][19][20].…”