Abstract
PURPOSE: Anterior segment optical coherence tomography (AS-OCT) is an emerging diagnostic and monitoring tool for anterior uveitis. We investigated AS-OCT findings in the eyes of a large, diverse population of children free of uveitis to establish its potential to "rule out" accurately those without disease.
METHODS: In this cross-sectional observational study, image acquisition was performed with swept source AS-OCT (Heidelberg Anterion), using a protocol of 13 B-scans per volume, from 217 children (434 eyes) aged 5 to 15 years, with analysis of acquired images (identification of apparent inflammatory cells, or "cell events") by multiple graders. Outcomes of interest were median and maximum cell event count (MEDCC, MAXCC) per B-scan from each eye and the total cell event count (TCC) per volume scan.
RESULTS: At least one cell event was detected in volume scans of 76% of eyes (329/434) and 87% of children (189/217). The maximum number (MAXCC) per scan ranged from 0 to 6 (median, 2). There was a strong positive association between increasing age (years) and the number of cell events detected within a volume scan following adjustment for gender and iris color (adjusted regression coefficient for TCC 0.5; P < 0.0001; 95% confidence interval, 0.4-0.7).
CONCLUSIONS: Our findings demonstrate that apparent inflammatory cells are detectable on AS-OCT in the apparently healthy eyes of children and furthermore suggest early life developmental changes in blood-iris barrier stability that merit further exploration. We provide the foundation for the normative data set necessary for establishing the clinical utility of AS-OCT for surveillance of children with inflammatory eye diseases.
| Original language | English |
|---|---|
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | Investigative Ophthalmology and Visual Science |
| Volume | 65 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 1 Jan 2024 |
Bibliographical note
Funding Information:Supported by an NIHR Clinician Scientist grant (grant number CS-2018-18-ST2-005; ALS) and Fight for Sight Project grant 5212/5213, the NIHR BRC based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (JSR), and an NIHR Senior Investigator award (JSR). All research at UCL Great Ormond Street Institute of Child Health is made possible by the NIHR Great Ormond Street Hospital Biomedical Research Centre. The funding organizations had no role in the design or conduct of this research. This article presents independent research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.
Funding Information:
The authors thank Sophie Abel and the staff and students of Chace Community School, Enfield, England, and Merryhills Primary School, Enfield, England; Heidelberg for loan of the study instrument; and Tim Cole and Elizabeth Woodstock for their support with image acquisition. Heidelberg played no other role in the design or conduct of this research. The authors thank Alex Fraser, Ajeeta Patel, and Enda McGonigle for their support with image analysis. Supported by an NIHR Clinician Scientist grant (grant number CS-2018-18-ST2-005; ALS) and Fight for Sight Project grant 5212/5213, the NIHR BRC based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (JSR), and an NIHR Senior Investigator award (JSR). All research at UCL Great Ormond Street Institute of Child Health is made possible by the NIHR Great Ormond Street Hospital Biomedical Research Centre. The funding organizations had no role in the design or conduct of this research. This article presents independent research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.
Publisher Copyright:
Copyright 2024 The Authors.
Keywords
- Humans
- Child
- Cross-Sectional Studies
- Uveitis/diagnosis
- Uveitis, Anterior/diagnosis
- Iris
- Tomography, Optical Coherence/methods