Anterior chamber cell grading by optical coherence tomography

Invest Ophthalmol Vis Sci. 2013 Jan 9;54(1):258-65. doi: 10.1167/iovs.12-10477.


Purpose: To quantify cells in the ocular anterior chamber (AC) by optical coherence tomography (OCT).

Methods: A time-domain anterior segment OCT system was used to image latex microsphere suspensions in vitro and the AC of uveitis and normal subjects in vivo. The OCT scan pattern, consisting of 2- and 4-mm-diameter concentric circular scans, was divided into central, superior, and inferior regions. A computer algorithm was developed to automatically identify particles in OCT images. A uveitis specialist used slit-lamp biomicroscopy to grade the AC cells on a scale of 0 to 4+.

Results: Latex microspheres and ac cells were visualized as reflective spots in oct images. OCT latex microsphere concentration measurements were highly correlated to known particle concentrations (r = 1.000) and had an efficiency of 0.72. in 30 nongranulomatous and 12 granulomatous eyes, the OCT cell counts correlated well with slit-lamp grades in all three regions (Spearman's rho coefficient: >0.63). The average OCT cell count was 3.7 cells/grade in nongranulomatous eyes and 2.0 cells/grade in granulomatous eyes. OCT revealed significant amounts of inferior AC cells in 5 of 16 quiescent uveitis eyes (mean ± SD: 19.9 ± 7.4 cells). OCT captured rare cells in normal eyes (1.1 ± 1.1 cells centrally).

Conclusions: OCT provided quantitative information on AC inflammatory cells. The OCT cell counts correlated well with clinical grading, and particles in the inferior AC that were missed by slit-lamp examination were detected by OCT. OCT could be a valuable tool for the diagnosis and management of anterior uveitis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Anterior Chamber / cytology*
  • Case-Control Studies
  • Cell Count
  • Cross-Sectional Studies
  • Granuloma / pathology
  • Humans
  • Microspheres
  • Prospective Studies
  • Tomography, Optical Coherence*
  • Uveitis, Anterior / pathology