In Vivo Laser Confocal Microscopy Using the HRT-Rostock Cornea Module: Diversity and Diagnostic Implications in Patients with Uveitis

Ocul Immunol Inflamm. 2018;26(6):900-909. doi: 10.1080/09273948.2017.1298818. Epub 2017 May 31.

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.

Keywords: Confocal microscopy; imaging analysis; keratic precipitates; uveitis.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cell Count
  • Child
  • Cornea / pathology*
  • Female
  • Humans
  • Male
  • Microscopy, Confocal / methods*
  • Middle Aged
  • Prospective Studies
  • Uveitis / pathology*
  • Young Adult