Anterior Segment Optical Coherence Tomography in Endophthalmitis

Anterior Segment Optical Coherence Tomography (AS-OCT) can assess anterior chamber's (AC) changes. This study aims to describe AC changes in eyes with endophthalmitis using AS-OCT.

Electronic patient records, slit lamp photography and anterior segment infrared imaging were reviewed in this retrospective single-center cohort study and correlated to swept-source AS-OCT scans of eyes with endophthalmitis.

Fourteen eyes of 14 patients with postoperative (n = 6 after cataract surgery; n = 6 after anti-VGEF-injection) and endogenous (n = 2) endophthalmitis were included. The visual acuity was light perception (n = 3), hand movement (n = 7) and ≥1.30 LogMar (n = 4). On slit lamp examination, hypopyon (n = 13) and fibrin (n = 5) were seen. AS-OCT detected hypopyon (n = 13) and fibrin formations (n = 10); hypopyon appeared as a hyperreflective level at the bottom of the AC and showed a hyperreflective lamellar prolongation on the corneal endothelium. Fibrin had the shape of hyperreflective filaments and presented in four patterns: single-stranded, stork-nest-like, cloth-like, or with a mixed phenotype.

AS-OCT imaging may visualize inflammatory activity of the AC in endophthalmitis and enable a morphological characterization of fibrin formation. Characteristic findings are also seen in cases with reduced corneal transparency.