Lyndell L Lim1,2, Jing Xie2, Chyn C Chua2, Tiffany Wong1, Lani T Hoang1, Matthias D Becker3,4, Eric B Suhler1,5, James T Rosenbaum1,6, Friederike Mackensen1,3. 1. a Ophthalmology , Oregon Health & Science University , Portland , Oregon , USA. 2. b Centre for Eye Research Australia , University of Melbourne , Melbourne , Australia. 3. c Ophthalmology , Interdisciplinary Uveitis Center , Heidelberg , Germany. 4. d Department of Ophthalmology , Triemli Hospital , Zurich , Switzerland. 5. e Portland Veteran's Affairs Medical Center , Portland , Oregon , USA. 6. f Legacy Devers Eye Institute , Portland , Oregon , USA.
Abstract
PURPOSE: Keratic precipitates (KP) are a common feature of uveitis. We prospectively examined KP with the Heidelberg Retinal Tomograph II confocal laser scanning microscope and Rostock Corneal Module (HRT-RCM) to explore their diagnostic implications. METHODS: Prospective, observational, multicenter study. HRT-RCM images were classified by two masked observers. RESULTS: 120 scans on 120 eyes from 110 subjects were included. The majority (N = 93) had non-infectious uveitis. Sixty eyes had active disease at scanning. Eight KP morphologies were defined. Agreement between the two masked graders was high (Kappa value across all categories = 0.81). Cluster and nodular KP were associated with active infectious uveitis (p < 0.01): patients with cluster KP (odds ratio [OR] = 3.03, 95% confidence interval [CI]: 1.43, 6.45) and nodular KP (OR = 3.89, 95% CI: 1.42, 10.65) were more likely to have infectious uveitis than those without. CONCLUSIONS: Laser confocal microscopy of KP may have a role in determining between infectious and non-infectious uveitis.
PURPOSE: Keratic precipitates (KP) are a common feature of uveitis. We prospectively examined KP with the Heidelberg Retinal Tomograph II confocal laser scanning microscope and Rostock Corneal Module (HRT-RCM) to explore their diagnostic implications. METHODS: Prospective, observational, multicenter study. HRT-RCM images were classified by two masked observers. RESULTS: 120 scans on 120 eyes from 110 subjects were included. The majority (N = 93) had non-infectious uveitis. Sixty eyes had active disease at scanning. Eight KP morphologies were defined. Agreement between the two masked graders was high (Kappa value across all categories = 0.81). Cluster and nodular KP were associated with active infectious uveitis (p < 0.01): patients with cluster KP (odds ratio [OR] = 3.03, 95% confidence interval [CI]: 1.43, 6.45) and nodular KP (OR = 3.89, 95% CI: 1.42, 10.65) were more likely to have infectious uveitis than those without. CONCLUSIONS: Laser confocal microscopy of KP may have a role in determining between infectious and non-infectious uveitis.
Authors: Hinnerk Schulz-Hildebrandt; Mario Pieper; Charlotte Stehmar; Martin Ahrens; Christian Idel; Barbara Wollenberg; Peter König; Gereon Hüttmann Journal: Biomed Opt Express Date: 2018-01-16 Impact factor: 3.732