Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema

Sreekanth Sreekantam; T MacDonald; Pearse Keane; Dawn Sim; Philip Murray; Alastair Denniston

doi:10.1136/bjophthalmol-2015-308008

Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema

Sreekanth Sreekantam, T MacDonald, Pearse Keane, Dawn Sim, Philip Murray, Alastair Denniston

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND/AIMS: 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.

METHODS: 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.

MAIN OUTCOME MEASURE: Difference in VIT/RPE-relative intensity before and after treatment.

RESULTS: 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).

CONCLUSIONS: 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.

Original language	English
Pages (from-to)	175-179
Journal	British Journal of Ophthalmology
Volume	101
Issue number	2
Early online date	5 May 2016
DOIs	https://doi.org/10.1136/bjophthalmol-2015-308008 https://doi.org/10.1136/bjophthalmol-2015-308008
Publication status	Published - 1 Feb 2017

Keywords

uveitis
cystoid macular oedema
optical coherence tomography
imaging
outcome measures

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Murray_Sreekantham Macdonald OCT in Uveitic CMO 191015 Final
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Sreekantam, S., MacDonald, T., Keane, P., Sim, D., Murray, P., & Denniston, A. (2017). Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema. British Journal of Ophthalmology, 101(2), 175-179. Advance online publication. https://doi.org/10.1136/bjophthalmol-2015-308008, https://doi.org/10.1136/bjophthalmol-2015-308008

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title = "Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema",

abstract = "BACKGROUND/AIMS: 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.METHODS: 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.MAIN OUTCOME MEASURE: Difference in VIT/RPE-relative intensity before and after treatment.RESULTS: 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).CONCLUSIONS: 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.",

keywords = "uveitis, cystoid macular oedema, optical coherence tomography, imaging, outcome measures",

author = "Sreekanth Sreekantam and T MacDonald and Pearse Keane and Dawn Sim and Philip Murray and Alastair Denniston",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",

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doi = "10.1136/bjophthalmol-2015-308008",

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Sreekantam, S, MacDonald, T, Keane, P, Sim, D, Murray, P & Denniston, A 2017, 'Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema', British Journal of Ophthalmology, vol. 101, no. 2, pp. 175-179. https://doi.org/10.1136/bjophthalmol-2015-308008, https://doi.org/10.1136/bjophthalmol-2015-308008

Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema. / Sreekantam, Sreekanth; MacDonald, T; Keane, Pearse et al.
In: British Journal of Ophthalmology, Vol. 101, No. 2, 01.02.2017, p. 175-179.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema

AU - Sreekantam, Sreekanth

AU - MacDonald, T

AU - Keane, Pearse

AU - Sim, Dawn

AU - Murray, Philip

AU - Denniston, Alastair

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2017/2/1

Y1 - 2017/2/1

N2 - BACKGROUND/AIMS: 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.METHODS: 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.MAIN OUTCOME MEASURE: Difference in VIT/RPE-relative intensity before and after treatment.RESULTS: 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).CONCLUSIONS: 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.

AB - BACKGROUND/AIMS: 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.METHODS: 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.MAIN OUTCOME MEASURE: Difference in VIT/RPE-relative intensity before and after treatment.RESULTS: 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).CONCLUSIONS: 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.

KW - uveitis

KW - cystoid macular oedema

KW - optical coherence tomography

KW - imaging

KW - outcome measures

U2 - 10.1136/bjophthalmol-2015-308008

DO - 10.1136/bjophthalmol-2015-308008

M3 - Article

C2 - 27150826

SN - 0007-1161

VL - 101

SP - 175

EP - 179

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

IS - 2

ER -

Sreekantam S, MacDonald T, Keane P, Sim D, Murray P , Denniston A. Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema. British Journal of Ophthalmology. 2017 Feb 1;101(2):175-179. Epub 2016 May 5. doi: 10.1136/bjophthalmol-2015-308008, 10.1136/bjophthalmol-2015-308008

Quantitative analysis of vitreous inflammation using optical coherence tomography in patients receiving sub-Tenon's triamcinolone acetonide for uveitic cystoid macular oedema

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