Anterior Segment Optical Coherence Tomography in Endophthalmitis

Area of Science:

• Ophthalmology
• Medical Imaging

Background:

• Endophthalmitis is a severe intraocular inflammation requiring prompt diagnosis.
• Anterior Segment Optical Coherence Tomography (AS-OCT) is a non-invasive imaging modality for the anterior segment of the eye.

Purpose of the Study:

• To describe the anterior chamber (AC) changes in eyes with endophthalmitis using AS-OCT.
• To evaluate the utility of AS-OCT in visualizing inflammatory markers like hypopyon and fibrin.

Main Methods:

• A retrospective single-center cohort study reviewed electronic patient records, slit lamp photography, and anterior segment infrared imaging.
• Swept-source AS-OCT scans of 14 eyes with endophthalmitis (postoperative and endogenous) were correlated with clinical findings.

Main Results:

• AS-OCT detected hypopyon in all 13 cases and fibrin formations in 10 cases.
• Hypopyon appeared as a hyperreflective level at the AC base with corneal endothelial prolongation.
• Fibrin presented as hyperreflective filaments in various patterns (single-stranded, stork-nest-like, cloth-like, mixed).

Conclusions:

• AS-OCT imaging effectively visualizes inflammatory activity in the anterior chamber during endophthalmitis.
• The study provides morphological characterization of fibrin formation using AS-OCT.
• AS-OCT findings are valuable even with reduced corneal transparency.