OCT Assisted Vitreous Evaluation (OCTAVE)
Research type
Research Study
Full title
Optical Coherence Tomography Assisted Vitreous Evaluation (OCTAVE)
IRAS ID
239985
Contact name
Alastair Denniston
Contact email
Sponsor organisation
University Hospitals Birmingham NHSFT
Duration of Study in the UK
3 years, 3 months, 0 days
Research summary
Research Summary
Uveitis (inflammation in the eye) is a major cause of blindness in the working-age population. Current measures of disease activity are based on subjective clinical estimates which are unreliable. This leads to under- and over-treatment of disease, patient harm and significant health-economic impact. Optical Coherence Tomography is a non-invasive imaging technique which is commonly used to diagnose conditions in the retina, such as diabetes and macular degeneration. We have shown in previous studies that OCT could also be used to measure disease activity in uveitis by measuring haziness in the vitreous gel. We demonstrated correlation with clinical vitreous haze, and subsequently have shown clinically meaningful changes with treatment. This next stage is about refining the parameters and settings for acquiring vitreous haze OCT images. The objectives of OCTAVE study will be: \n(1) exploring OCT settings which allow a larger volume of vitreous scanned \n(2) improving reproducibility and quality of scans\n(3) improving automation and usability\n(4) evaluating correlation between OCT vitreous haze measurement and other clinical indicators (i.e. visual acuity, inflammation seen on slit lamp)\n(5) evaluating technician feasibility and patient acceptability
Summary of Results
A major issue in uveitis (inflammation of the eye) is the lack of a good way to measure how much inflammation there is. This affects our ability to make treatment decisions in clinic and our ability to show whether or not new treatments work in clinical trials. Recently, we developed a new image analysis software to detect inflammation in the vitreous (the clear gel in the eye), using a scan called optical coherence tomography (OCT). This technique is promising because it is objective (whereas doctors examinations are subjective), fast, and automated.
Prior to this project, the technique had not been evaluated in a clinical study (the OCTAVE study) involving uveitis patients. The purpose of this project was to improve the software and gather more evidence, to show the technique is a valid way of measuring inflammation in the vitreous.
During this project, we improved our software so the image analysis technique was more accurate less affected by noisy signals. We did this by using the raw signal from the OCT machine instead of OCT images. We found the best settings for the OCT machine to give reliable results, whilst still being feasible to perform and acceptable to patients. We carried out the OCTAVE study which showed that the OCT measurement was higher when there was higher level of inflammation seen on clinical examination. However, we also found that the measurement was variable and sometimes gave unexpected measurements, suggesting further refinements may be required.REC name
London - South East Research Ethics Committee
REC reference
18/LO/1332
Date of REC Opinion
23 Jul 2018
REC opinion
Favourable Opinion