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前房炎症的客观量化分析:眼前段光学相干断层扫描细胞和房水闪辉测量分析

Invernizzi, A., Marchi, S., Aldigeri, R., et al.

期刊名称:Ophthalmology

卷期:2017年第124卷第11期

关键词:
房水 断层 炎症

摘要

摘要:目的:旨在客观的评价前房扫描光源(SS)光学相干断层扫描(OCT)检测前房(AC)炎症(包括闪辉和细胞)的能力。比较OCT源炎症指标与标准技术。设计:对诊断试验进行前瞻性评估。研究对象:前葡萄膜炎(活动性或非活动性)患者和对照。方法:参与者进行AC炎症评估,包括:临床细胞和眩光分级和激光闪光法(LFP)。根据临床分级将葡萄膜炎患者分为活动性或非活动性葡萄膜炎。每个参与者进行前房SS-OCT扫描。分析断层图像以计数AC细胞,并计算房水信号强度的绝对测量值。将绝对值与通过眼外扫描测量的信号进行比较,产生光密度比(房水空气相对强度[ARI]指数)。评估OCTAC炎症指标与LFP,临床分级,参与者类别(活动性或非活动性葡萄膜炎,对照),年龄,性别和中央角膜厚度(CCT)之间的相关性。主要观察指标: OCTARI指数和AC细胞数量以及标准临床技术(LFP,临床细胞分级)之间的关联。结果:共包括277只眼(70例活动性葡萄膜炎,97例无活动性葡萄膜炎,70例对照)。 无活动性葡萄膜炎和对照组之间的OCT前房细胞计数没有差异,但活动性葡萄膜炎与明显高于其他类别(均P <0.0001)。所有组别的LFP均不同(均P <0.0001)。活动性葡萄膜炎的ARI指数明显高于无活动葡萄膜炎和对照组(均P <0.0001)。 ARI指数的观察者间一致性(组内相关系数)为0.78 ARI指数与年龄呈正相关(P = 0.043),与CCT呈负相关(P = 0.006)。 ARI指数与活动性葡萄膜炎组中的LFP相关(P <0.0001),而与其他指标无关。 OCT显示的前房细胞在所有细胞临床分级中均升高(P <0.0001)。结论:前房SS-OCT可用于全面评估AC炎症,提供炎症细胞和炎性水肿的客观测量。

PURPOSE:To assess the ability of swept-source (SS) optical coherence tomography (OCT) of the anterior segment (AS) to measure anterior chamber (AC) inflammation (both flare and cells) objectively. To compare OCT-derived inflammatory indices with standard techniques.DESIGN:Prospective evaluation of a diagnostic test.PARTICIPANTS:Patients diagnosed with anterior uveitis (active or inactive) and controls.METHODS:Participants underwent an AC inflammation evaluation including: clinical cell and flare grading and laser flare photometry (LFP). Uveitis patients were divided into active or inactive uveitis status according to clinical grading. Anterior segment SS-OCT scans were obtained for each participant. Tomographic images were analyzed to count the AC cells, and to calculate to absolute measurements of aqueous signal intensity. The absolute values were compared with the signal measured by the scan outside the eye, generating an optical density ratio (aqueous-to-air relative intensity [ARI] index). Correlations between OCT-derived AC inflammatory indexes and LFP, clinical grading, participant category (active or inactive uveitis, control), age, gender, and central corneal thickness (CCT) were assessed.MAIN OUTCOME MEASURES:Correlation between OCT-derived AC inflammatory indexes (ARI index and AC cells on OCT) and standard clinical techniques (LFP, clinical cell grading).RESULTS:Two hundred thirty-seven eyes (70 active uveitis, 97 inactive uveitis, and 70 controls) were included. Anterior chamber cells count on OCT did not differ between inactive uveitis and controls, but was significantly higher in active uveitis compared to the other categories (both P < 0.0001). All groups had different LFP (all P < 0.0001). Active uveitis had significantly higher ARI index compared with inactive uveitis and controls (both P < 0.0001). Interobserver agreement (intraclass correlation coefficient) for ARI index was 0.78. The ARI index correlated positively with age (P= 0.043) and negatively with CCT (P= 0.006). The ARI index correlated with LFP in the active uveitis group (P < 0.0001), but not in the others. Anterior chamber cells on OCT increased among all cell clinical grades (P < 0.0001). The ARI index increased among all flare clinical grades (P < 0.005).CONCLUSIONS:Anterior segment SS-OCT could be used for a comprehensive assessment of AC inflammation, providing objective measurements of inflammatory cells and aqueous flare.


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