Sutra Plern, Pothikamjorn Thananop, Lopez Sarah, Takhar Jaskirat, Chongchareon Mathinee, Keenan Jeremy, Gonzales John A
Francis I. Proctor Foundation, University of California, San Francisco, USA.
Department of Ophthalmology, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Graefes Arch Clin Exp Ophthalmol. 2025 Mar 17. doi: 10.1007/s00417-025-06788-8.
To determine the scleral thickness of inactive scleritis characterized by a violaceous hue (violaceous sclera) using anterior segment optical coherence tomography (AS-OCT).
Retrospective observational case series of patients with inactive unilateral anterior scleritis featuring a violaceous hue. Mean scleral thickness was measured by AS-OCT in violaceous areas and compared with the same region in the contralateral unaffected eye. Measurements were performed by two masked graders.
Nine patients with median age of 52 ± 12.8 years were assessed. Eight patients were female. Rheumatoid arthritis and history of treated latent tuberculosis (33.3%) were the most common causes of anterior scleritis. Mean scleral thickness was 582.93 ± 124.03 µm and 648.59 ± 103.61 µm for violaceous sclera and the corresponding unaffected areas of the contralateral eye, respectively (mean difference = -65.65 µm, 95% CI: -143.73 to 12.42, p = 0.0885). The mean image contrast percentage of scleral hyperreflectivity as assessed by image conversion in an area of violaceous hue was 65.07 µm ± 6.49 µm compared to 42.70 µm ± 5.46 µm of unaffected areas (mean difference = 22.37 µm, 95% CI: 14.72 µm to 30.03 µm, p = 0.0001).
Using AS-OCT, the thicknesses of violaceous sclerae were not significantly thinner than the contralateral unaffected areas, despite a mean difference of approximately 65 microns. The increased scleral hyperreflectivity observed in the violaceous sclera may suggest collagen remodeling in these areas. Such remodeling could play a role in the sclera reflecting violaceous hues while still preventing direct visualization of the underlying choroid.
使用眼前节光学相干断层扫描（AS-OCT）测定以紫蓝色调为特征的非活动性巩膜炎（紫蓝色巩膜）的巩膜厚度。
对具有紫蓝色调的非活动性单侧前巩膜炎患者进行回顾性观察病例系列研究。通过AS-OCT测量紫蓝色区域的平均巩膜厚度，并与对侧未受影响眼的相同区域进行比较。测量由两名盲法分级者进行。
评估了9例中位年龄为52±12.8岁的患者。8例为女性。类风湿性关节炎和既往治疗过的潜伏性结核病病史（33.3%）是前巩膜炎最常见的病因。紫蓝色巩膜和对侧眼相应未受影响区域的平均巩膜厚度分别为582.93±124.03μm和648.59±103.61μm（平均差异=-65.65μm，95%CI：-143.73至12.42，p=0.0885）。通过图像转换评估，紫蓝色调区域巩膜高反射率的平均图像对比度百分比为65.07μm±6.49μm，而未受影响区域为42.70μm±5.46μm（平均差异=22.37μm，95%CI：14.72μm至,30.03μm，p=0.0001）。
使用AS-OCT，尽管平均差异约为65微米，但紫蓝色巩膜的厚度并不显著薄于对侧未受影响区域。在紫蓝色巩膜中观察到的巩膜高反射率增加可能表明这些区域存在胶原重塑。这种重塑可能在巩膜呈现紫蓝色调的同时仍阻止直接观察到下方脉络膜方面发挥作用。
