title: Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema.
abstract: To evaluate the vitreous signals obtained on spectral domain optical coherence tomography (SD-OCT) in patients with uveitic cystoid macular oedema (CMO) and compare these signals before and after sub-Tenon's triamcinolone acetonide injection.
  
  
  
  Retrospective study with standardised longitudinal imaging preintervention and postintervention. The study cohort comprises 22 patients (22 eyes) with uveitic CMO receiving a sub-Tenon's triamcinolone acetonide (STTA) injection. Post hoc analysis of SD-OCT images using custom software provided an 'absolute' measurement of vitreous signal intensity, which was expressed as a ratio to the retinal pigment epithelium intensity ('VIT/RPE-relative intensity') in arbitrary units.
  
  
  
  Difference in VIT/RPE-relative intensity before and after treatment.
  
  
  
  Treatment with STTA resulted in a significant reduction in VIT/RPE-relative intensity, which was associated with both a reduction in central retinal thickness (CRT) and improvement in visual acuity. Mean (SD) VIT/RPE-relative intensity pretreatment was 0.139 (0.074) versus 0.053 (0.028) post-treatment (p=3×10-5). Mean (SD) CRT was 581 μm (119 μm) pretreatment versus 333 μm (95 μm) post-treatment (p=2×10-8); the mean reduction in CRT was 248 (95% CI 189 to 306). The correlation coefficient between VIT/RPE-relative intensity and CRT was 0.534 (p=0.011) and between VIT/RPE-relative intensity and visual acuity was 0.702 (p=0.0001).
  
  
  
  This study provides evidence that the OCT-derived VIT/RPE-relative intensity may be useful as a quantitative and objective marker of disease activity and treatment response in uveitis complicated by CMO. This first longitudinal study of this novel OCT parameter is an encouraging step in the development of sensitive objective OCT-based endpoints for trials of efficacy in uveitis.
authors.affiliation: Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK.
authors.forename: Sreekanth
authors.initials: S
authors.lastname: Sreekantam
authors.affiliation: Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Trystan
authors.initials: T
authors.lastname: Macdonald
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: 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: Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK.|Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Philip I
authors.initials: PI
authors.lastname: Murray
authors.affiliation: Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.|Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Alastair K
authors.initials: AK
authors.lastname: Denniston
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000188:drug therapy; D056965:Injections, Intraocular; D008137:Longitudinal Studies; D008269:Macular Edema / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014605:Uveitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014792:Visual Acuity; D014822:Vitreous Body / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide
keywords: Diagnostic tests/Investigation; Imaging; Inflammation; Macula; Vitreous