Rose-Nussbaumer Jennifer, Li Yan, Lin Phoebe, Suhler Eric, Asquith Mark, Rosenbaum James T, Huang David
Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States.
Invest Ophthalmol Vis Sci. 2015 Feb 3;56(3):1430-6. doi: 10.1167/iovs.14-15118.
The differential diagnosis of a patient presenting with anterior uveitis is broad and can present a diagnostic challenge. In this study, we evaluate the characteristic findings of inflammatory cells on optical coherence tomography (OCT) both in vitro and in vivo.
Blood from two healthy volunteers was prepared using standardized methods for cell sorting with a flow cytometer (FASCAria). Neutrophils, lymphocytes, monocytes, and red blood cells were placed in suspension and scanned with a 26-kHz Fourier-domain OCT system (RTVue) with 5-μm axial resolution. Custom software algorithms were used to identify cells based on their reflectance distribution. These algorithms were then applied to OCT images obtained from uveitis patients with active anterior chamber inflammation.
On OCT images the cells appeared as hyperreflective spots. In vitro, cell reflectance was statistically significantly different between all of the cell types (neutrophils, monocytes, lymphocytes, and red blood cells, P < 0.001, Mann-Whitney test). In vivo, the relationship between underlying disease and cell type imaged on OCT was highly statistically significant, with human leukocyte antigen (HLA)-B27-associated uveitis patients having a predominantly polymorphonuclear pattern on OCT and sarcoidosis and inflammatory bowel disease patients having a predominantly mononuclear pattern on OCT (P < 0.001, Fisher's exact test).
These in vitro and in vivo data demonstrate the potential of OCT to evaluate cells in the anterior chamber of patients noninvasively. Optical coherence tomography may be a useful adjunct to guide the diagnosis and treatment of ocular inflammatory conditions.
前葡萄膜炎患者的鉴别诊断范围广泛，可能带来诊断挑战。在本研究中，我们评估了体外和体内光学相干断层扫描（OCT）上炎症细胞的特征性表现。
使用流式细胞仪（FASCAria）的标准化细胞分选方法制备两名健康志愿者的血液。将中性粒细胞、淋巴细胞、单核细胞和红细胞制成悬液，并用轴向分辨率为5μm的26kHz傅里叶域OCT系统（RTVue）进行扫描。使用定制软件算法根据细胞的反射率分布识别细胞。然后将这些算法应用于从伴有前房活动性炎症的葡萄膜炎患者获得的OCT图像。
在OCT图像上，细胞表现为高反射点。在体外，所有细胞类型（中性粒细胞、单核细胞、淋巴细胞和红细胞）之间的细胞反射率在统计学上有显著差异（P<0.001，曼-惠特尼检验）。在体内，潜在疾病与OCT上成像的细胞类型之间的关系在统计学上具有高度显著性，人类白细胞抗原（HLA）-B27相关性葡萄膜炎患者在OCT上主要表现为多形核模式，结节病和炎症性肠病患者在OCT上主要表现为单核模式（P<0.001，费舍尔精确检验）。
这些体外和体内数据证明了OCT在无创评估患者前房细胞方面的潜力。光学相干断层扫描可能是指导眼部炎症性疾病诊断和治疗的有用辅助手段。
