Correlation Between SUN Scale Grades and AS-OCT Cell Counts in Pediatric Uveitis: A Retrospective Central 7-Frame...

This study evaluated the correlation between the Standardization of Uveitis Nomenclature (SUN) scale and anterior chamber cell counts measured by anterior segment optical coherence tomography (AS-OCT) in pediatric uveitis. We hypothesized that analyzing the central 7 frames of AS-OCT scans would improve measurement consistency and accuracy, as this region may provide greater anatomical relevance than peripheral frames, while also simplifying image acquisition in children.

One hundred and thirteen clinical episodes from pediatric uveitis patients aged ≤16 years, over 28 months, were retrospectively analyzed. All patients underwent AS-OCT imaging on the same day as clinical review. Only scans with ≥9 frames were included. SUN Scale grades were: 0 (n=49), 0.5+ (n=22), 1+ (n=17), 2+ (n=15), and 3+ (n=10). Mean anterior chamber cell counts were calculated from the central 7 frames. Spearman's rank correlation assessed the relationship between SUN grades and AS-OCT counts; analyses were performed in R.

There was a strong positive correlation between SUN Scale grades and mean AS-OCT cell counts (ρ = 0.933, 95% CI 0.89-0.96, p < 0.001). Restricting analysis to the central seven frames improved measurement reproducibility and reduced exclusions due to patient movement or scan misalignment. Intra-grader repeatability of manual cell counts was excellent (ICC = 0.968, 95% CI 0.93-0.99), confirming high measurement reliability.

AS-OCT, particularly when focusing on the central 7 frames, provides a consistent and reproducible method for quantifying anterior chamber inflammation in pediatric uveitis. This approach offers enhanced accuracy and operational feasibility, supporting its integration into clinical practice to improve monitoring and management in children.