From the Ocular Inflammatory Disease Center, UCLA Stein Eye Institute (E.T., J.L.C., O.L., S.S.M.F., G.N.H.), Los Angeles; Department of Ophthalmology (E.T., J.L.C., O.L., H.R., E.B., S.S.M.F., S.R.S., G.N.H.).
From the Ocular Inflammatory Disease Center, UCLA Stein Eye Institute (E.T., J.L.C., O.L., S.S.M.F., G.N.H.), Los Angeles; Department of Ophthalmology (E.T., J.L.C., O.L., H.R., E.B., S.S.M.F., S.R.S., G.N.H.).
Am J Ophthalmol. 2022 Sep;241:254-261. doi: 10.1016/j.ajo.2022.05.012. Epub 2022 May 21.
To evaluate the feasibility of anterior segment optical coherence tomography (AS-OCT) for measuring anterior chamber (AC) cells in children with uveitis and to compare different AS-OCT acquisition modes.
Validity and reliability analysis.
We enrolled children younger than 18 years who had uveitis involving the anterior segment and children without eye disease as controls. All underwent clinical grading of AC cells. AC images of each eye were obtained using the Optovue Avanti RTVue XR AS-OCT. Two acquisition modes were used: a single cross-sectional line scan and an 8-line radial scan in an asterisk pattern. Two independent, masked graders counted cells manually on AS-OCT images. Rater agreement was assessed using intraclass correlation (ICC).
Included were 30 children (59 eyes) with uveitis (median age 13.0 years, range 3-17 years) and 20 control children (40 eyes, median age 10.5 years, range 4-17 years). The number of eyes assigned each clinical grade of cells were as follows: none, 32 (54%); 0.5+, 12 (20.3%); 1+, 5 (8.5%); 2+, 8 (13.6%); 3+, 2 (3.4%). ICC of graders for line and radial scan protocols were 0.87 and 0.90. There was no significant difference between acquisition modes for pooled grader results (95% CI for difference: -0.04 to 0.14). ICC of cell counts between line and radial scan protocols was 0.85 (95% CI: 0.69-0.90). No control eyes had cells on AS-OCT images.
Quantification of AC cell in children with uveitis is feasible with AS-OCT and has excellent reliability between different graders and acquisition modes.
评估眼前段光学相干断层扫描(AS-OCT)测量葡萄膜炎患儿前房细胞的可行性,并比较不同的 AS-OCT 采集模式。
有效性和可靠性分析。
我们纳入了年龄小于 18 岁的前葡萄膜炎患儿和无眼部疾病的儿童作为对照组。所有患者均进行前房细胞临床分级。使用 Optovue Avanti RTVue XR AS-OCT 对每只眼的前房图像进行采集。使用两种采集模式:单次横断面线扫描和星状图案的 8 线径向扫描。两名独立的、盲法评估者在 AS-OCT 图像上手动计数细胞。采用组内相关系数(ICC)评估评估者间的一致性。
纳入 30 例(59 只眼)葡萄膜炎患儿(中位年龄 13.0 岁,范围 3-17 岁)和 20 例对照组儿童(40 只眼,中位年龄 10.5 岁,范围 4-17 岁)。各临床分级细胞数的眼数如下:无细胞 32 只(54%);0.5+细胞 12 只(20.3%);1+细胞 5 只(8.5%);2+细胞 8 只(13.6%);3+细胞 2 只(3.4%)。线扫描和径向扫描协议的分级者 ICC 为 0.87 和 0.90。两种采集模式的汇总分级者结果之间无显著差异(差值 95%CI:-0.04 至 0.14)。线扫描和径向扫描协议的细胞计数 ICC 为 0.85(95%CI:0.69-0.90)。对照组的眼均未在前房 OCT 图像上出现细胞。
AS-OCT 可定量测量葡萄膜炎患儿的前房细胞,且不同分级者和采集模式间具有极好的可靠性。