title: Automated Analysis of Vitreous Inflammation Using Spectral-Domain Optical Coherence Tomography.
abstract: OBJECTIVE
  To develop an automated method for quantifying vitreous signal intensity on optical coherence tomography (OCT), with particular application for use in the assessment of vitreous inflammation.
  
  
  METHODS
  This retrospective, observational case-control series comprised 30 patients (30 eyes), with vitreous haze secondary to intermediate, posterior, or panuveitis; 12 patients (12 eyes) with uveitis without evidence of vitreous haze; and 18 patients (18 eyes) without intraocular inflammation or vitreoretinal disease. The presence and severity of vitreous haze was classified according to the National Eye Institute system; other inflammatory indices and clinical parameters were also documented. Spectral-domain OCT images were analyzed using custom VITreous ANalysis software (termed 'VITAN'), which is fully automated and avoids the need for manual segmentation.
  
  
  RESULTS
  VITAN performed accurate segmentation in all scans. Automated measurements of the vitreous:retinal pigment epithelium (RPE) signal ratio showed a moderate correlation with clinical vitreous haze scores (r= 0.585,P< 0.001), comparable to that reported using manual segmentation in our previous study (r= 0.566,P= 0.0001). The novel parameter of vitreous:RPE textural ratio showed a marginally stronger correlation (r= 0.604,P< 0.001) with clinical vitreous haze scores than the Vitreous:RPE signal ratio.
  
  
  CONCLUSIONS
  The custom OCT image analysis software (VITAN) allows rapid and automated measurement of vitreous parameters, that is comparable to our previously reported vitreous:RPE index, and correlates with clinically measured disease activity. Such OCT-based indices may provide the much needed objective markers of vitreous activity, which may be used in both clinical assessment, and as outcome measures in clinical trials for intermediate, posterior, and panuveitis.
  
  
  CONCLUSIONS
  We describe a rapid automated method for quantifying vitreous signal intensity on optical coherence tomography (OCT) and show that this correlates with clinical assessment of vitreous inflammation. Such OCT-based indices may provide the much needed objective markers of vitreous activity, which may be used both in routine clinical assessment, and as outcome measures in clinical trials for intermediate, posterior, and panuveitis.
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Pearse A
authors.initials: PA
authors.lastname: Keane
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Balaskas
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Dawn A
authors.initials: DA
authors.lastname: Sim
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Kiran
authors.initials: K
authors.lastname: Aman
authors.affiliation: Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK ; Centre for Translational Inflammation Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK ; Birmingham & Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK.
authors.forename: Alastair K
authors.initials: AK
authors.lastname: Denniston
authors.affiliation: Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK ; Faculty of Medical and Human Sciences, University of Manchester, UK ; School of Built Environment, Herriot-Watt University, UK.
authors.forename: Tariq
authors.initials: T
authors.lastname: Aslam
authors.affiliation: NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.lastname: And For The Equator Study Group
keywords: optical coherence tomography; uveitis automated segmentation; vitreous inflammation