Advanced UltraTech approach for distinguishing granulomatous from non-granulomatous corneal endothelial exudates in autoimmune rheumatic anterior uveitis.

Journal of biological methods Pub Date : 2024-11-07 eCollection Date: 2024-01-01 DOI:10.14440/jbm.2024.0049
Roberta Foti, Marco Zeppieri, Rosario Foti, Ylenia Dal Bosco, Davide Scollo, Elisa Visalli, Salvatore Ficili, Giorgio Amato, Valentina Cifalinò, Riccardo Foti, Alessandro Avitabile, Ludovica Cannizzaro, Caterina Gagliano
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Abstract

Background: Anterior uveitis is a common manifestation in individuals with rheumatic conditions such as spondylarthritis, Behçet's syndrome, juvenile idiopathic arthritis, and sarcoidosis. Clinical differentiation between granulomatous and non-granulomatous corneal endothelial exudates is crucial to subsequent diagnosis and treatment. Anterior segment optical coherence tomography (AS-OCT) can ensure an accurate differential diagnosis and appropriate follow-up after local and systemic therapy.

Objective: This study aimed to distinguish between granulomatous and non-granulomatous endothelial exudates in patients with anterior uveitis using AS-OCT.

Methods: This longitudinal observational study involved 30 patients diagnosed with or suspected of having rheumatic autoimmune disease presenting with anterior uveitis. The study was conducted at the combined Rheumatology and Ophthalmology Clinic, San Marco Hospital, Catania, Italy. All patients underwent slit-lamp examination, which revealed or suspected corneal endothelial exudates. A comprehensive rheumatological and ophthalmological evaluation was also performed. Subsequently, the patients were subjected to AS-OCT using the Optovue Solix device.

Results: Granulomatous corneal exudates were identified in 30% of the subjects, with counts ranging from 5 to 20 and sizes varying between 50 and 150 μm. Detailed 3D scans further exhibited the morphology of these exudates. A follow-up of patients after steroid therapy (both topical and systemic) and immunosuppressive treatment demonstrated a progressive reduction in the exudates, ultimately leading to their complete resolution.

Conclusion: Use of ophthalmological equipment that allows for simple, rapid, and non-invasive investigations in combination with a multidisciplinary approach, enables appropriate diagnosis and monitoring of therapeutic efficacy in patients with inflammatory ocular conditions presenting with corneal endothelial exudates.

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自体免疫性风湿性前葡萄膜炎中肉芽肿性与非肉芽肿性角膜内皮渗出物的先进超声技术鉴别。
背景:前葡萄膜炎是风湿病患者的常见表现,如脊柱炎、behet综合征、幼年特发性关节炎和结节病。肉芽肿性和非肉芽肿性角膜内皮渗出物的临床鉴别对后续的诊断和治疗至关重要。前段光学相干断层扫描(AS-OCT)可以确保在局部和全身治疗后准确的鉴别诊断和适当的随访。目的:本研究旨在利用AS-OCT区分前葡萄膜炎患者的肉芽肿性和非肉芽肿性内皮渗出物。方法:这项纵向观察性研究纳入了30例诊断为或疑似患有风湿性自身免疫性疾病并伴有前葡萄膜炎的患者。这项研究是在意大利卡塔尼亚圣马可医院风湿病和眼科联合诊所进行的。所有患者均行裂隙灯检查,发现或怀疑有角膜内皮渗出。还进行了风湿病学和眼科综合评估。随后,患者使用Optovue Solix设备进行AS-OCT检查。结果:在30%的受试者中发现肉芽肿性角膜渗出物,数量在5到20之间,大小在50到150 μm之间。详细的3D扫描进一步显示了这些渗出物的形态。对接受类固醇治疗(局部和全身)和免疫抑制治疗的患者的随访显示,渗出物逐渐减少,最终导致其完全消除。结论:使用眼科设备,结合多学科方法进行简单、快速和无创的检查,可以对以角膜内皮渗出物为表现的眼部炎症患者进行适当的诊断和监测治疗效果。
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