Assessing Scleral Area Vessel Density of Patients with Anterior Scleritis using Optical Coherence Tomography Angiography
Neil Onghanseng, MD
Neil Onghanseng, Sarakshi Mahajan, Muhammad Sohail Halim, Muhammad Hassan, Maria S. Ormaechea, Günay Uludağ, Anh N. Tran, Jeong Hun Bae, Rubbia Afridi, Diana V. Do, Quan D. Nguyen, Yasir J. Sepah
Byers Eye Institute, Stanford University, Palo Alto, CA, United States
Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
Purpose: To measure and assess the scleral area vessel density in subjects with active anterior scleritis and compare to subjects without scleral inflammation.
Methods: Patients with a clinical diagnosis of anterior scleritis and healthy volunteers from a uveitis clinic at a tertiary care hospital were enrolled in the study. All the subjects initially underwent 9 cardinal gaze slit-lamp photography. A customized protocol published previously was utilized to obtain optical coherence tomography angiography (OCTA) of the scleral vessels in the temporal portion of the sclera using Optovue Angiovue (Optovue, Inc., California, USA). Scleral area vessel density was measured using Revue software. Grading of scleritis in the temporal scleral area and the area with highest degree of scleral inflammation were graded by 2 independent graders using a standardized scleritis grading scale. Adjudication was performed in cases of differences between the primary graders. The correlation was made between: 1) highest grade of scleritis or 2) grade of scleritis in the temporal scleral area with the scleral area vessel density using linear regression analysis.
Results: Sixty-one eyes (29: active scleritis and 32: No scleral inflammation) were included in the study. The mean age of the study population was 41 years. 69% of the subjects were female. Mean scleral area vessel density in eyes with active scleritis was 56.89 ± 1.20 %. Mean scleral area vessel density in eyes without scleral inflammation was 53.98 ± 0.79%. Mean difference in the scleral vessel density between active scleritis eyes and eyes without scleral inflammation was statistically significant (p=0.042). Regression analysis showed a statistically significant correlation between the grade of scleritis and scleral area vessel density (r=1.51; p=0.015). Similarly, there was a significant correlation between the grade of scleritis in the temporal scleral area and the scleral area vessel density (r=3.44; p=0.001).
Conclusions: The scleral area vessel density in eyes with active scleritis is significantly higher than in eyes without scleral inflammation. SAVD may be employed in objective assessment of scleral inflammation.