Analysis of ocular inflammation in anterior chamber-involving uveitis using swept-source anterior segment OCT

Purpose To evaluate the utility of swept-source (SS) optical coherence tomography (OCT) to objectively analyze the degree of anterior chamber (AC) inflammation. Methods Thirty-eight eyes of 32 patients with uveitis and 20 control eyes were enrolled. SS OCT B-scans were obtained, and the number of cells in the B-scans was counted using two methods: (1) manual grading by Point Picker plug-in of Image J () and (2) automated grading by the Image J Particle Analysis algorithm (). The automated and manual AC cell counts were correlated with the Standardization of Uveitis Nomenclature score. Results The average numbers of AC inflammatory cells counted by the automated method were 8 +/- 4.0, 18 +/- 3.0, 42 +/- 14.0, 81 +/- 32.0, 117 +/- 57.0, and 275 +/- 67.0 cells/mm(2) for grades 0, 0.5 + , 1 + , 2 + , 3 + , and 4 + , respectively. For the same clinical categories, the average manual cell counts were 6 +/- 4.0, 18 +/- 3.0, 34 +/- 14.0, 72 +/- 32.0, 92 +/- 43.0, and 168 +/- 65.0 cells/mm(2), respectively. Zero cells were detected in the AC of healthy eyes. The automated and manual methods were highly correlated (R = 0.98, p < 0.001) and showed good correlation with the clinical grading (R = 0.88, p < 0.001). A mean AC particle size of 117.4 +/- 108.8 mu m was obtained by the automated method. Conclusions Quantification of the AC cells imaged by SS AS-OCT shows good correlation with categorical clinical severity assessments in uveitis eyes. This approach may provide a more objective method for monitoring uveitis and response to uveitis therapy.