Swept-source optical coherence tomography objective composite activity score for uveitis

Victor Llorenç, Alba R. Serrano, Marina Mesquida, Phoebe Lin, Cristina Esquinas, Maite Sainz-de-la-Maza, Christina Metea, Anna Bosch, Maria Calvo, Ariel Balter, Yukiko Nakamura, Blanca Molins, Carmen Alba, Eric Suhler, Alfredo Adán

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To develop an objective intraocular inflammation composite score. Methods: Cross-sectional study. Non-invasive image acquisition and processing were conducted from April 2017 to April 2019. Inflammation-grade stratified eyes from patients with active, inactive uveitis and healthy controls were recruited. After clinical assessment, four anterior and posterior segment image acquisition protocols per eye, using swept-source optical coherence tomography (SS-OCT), were performed at inclusion. Eight imaging biomarkers in three domains: anterior, intermediate and posterior were studied. They were ranked and selected by discriminatory power and correlation with clinical scores. A final SS-OCT-derived composite uveitis activity score (SS-UAS) was developed through multiple linear regression. Results: We studied 224 eyes with uveitis (165 active and 59 inactive) from 165 patients (mean age 46.6 SD 15.5 years; 55.3% women) and 38 eyes from 19 healthy controls (mean age 43.6 SD 17.1; 47% women). The selected SS-OCT-derived biomarkers to build the final score were anterior chamber hyper-reflective dots (anterior), high-definition relative vitreous intensity (intermediate) and the averaged thickened retinal index (posterior). Swept-source (SS)-UAS was highly discriminant between active and inactive, and between active and healthy eyes (means 2.06 SD 1.86, 0.93 SD 0.44, and 0.96 SD 0.38, respectively, both p -, Mann–Whitney U). Construct validity (Cronbach's alpha = 0.7), internal consistency, criterion validity and reliability (concordance correlation coefficient intra-rater = 0.99, 95% CI: 0.98–0.99; inter-rater = 0.98, 95% CI: 0.96–0.99) were favourable. Conclusions: Global intraocular inflammation can potentially be staged and scored objectively, continuously, consistently and in a valid manner through the combined processing of SS-OCT scans.

Original languageEnglish (US)
Pages (from-to)756-764
Number of pages9
JournalActa ophthalmologica
Volume99
Issue number7
DOIs
StateAccepted/In press - 2021

Keywords

  • grading
  • imaging
  • intraocular inflammation
  • optical coherence tomography
  • score
  • staging
  • swept-source
  • thickness map
  • uveitis

ASJC Scopus subject areas

  • Ophthalmology

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