title: Aqueous cell differentiation in anterior uveitis using Fourier-domain optical coherence tomography.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States.
authors: Jennifer
authors: J
authors: Rose-Nussbaumer
authors: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States.
authors: Yan
authors: Y
authors: Li
authors: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States.
authors: Phoebe
authors: P
authors: Lin
authors: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States.
authors: Eric
authors: E
authors: Suhler
authors: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States.
authors: Mark
authors: M
authors: Asquith
authors: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States.
authors: James T
authors: JT
authors: Rosenbaum
authors: Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States.
authors: David
authors: D
authors: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001082:Aqueous Humor / Q000166:cytology*; D004912:Erythrocytes / Q000502:physiology; D005260:Female; D005434:Flow Cytometry; D005583:Fourier Analysis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D066298:In Vitro Techniques; D008214:Lymphocytes / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000502:physiology; D009504:Neutrophils / Q000502:physiology; D012984:Software; D041623:Tomography, Optical Coherence; D014606:Uveitis, Anterior / Q000175:diagnosis* / Q000503:physiopathology*; D055815:Young Adult
keywords: Fourier-domain optical coherence tomography; anterior uveitis; image analysis; mononuclear leukocytes; polymorphonuclear leukocytes
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