Ocular Spot Fluorometer Equipped With a Lock-In Amplifier for Measurement of Aqueous Flare

Abstract

PurposeTo evaluate a custom-made ocular fluorometer for detection of intensity of light scatter (ILS) from the anterior chamber (A/C) as an objective measure of aqueous flare.MethodsThe fluorometer, equipped with a lock-in amplifier, was employed in the scatter mode to detect ILS from A/C. Measurements were performed with two illumination slit widths of 0.5 and 0.25 mm. The axial resolution at these slit widths were 80 and 200 μm, respectively. Healthy and pseudophakic eyes, with grade 0 Standardization of Uveitis Nomenclature (SUN) score, were employed as control subjects. ILS was also recorded in a cohort of patients who had undergone phacoemulsification and showed grades 1+ or 2+ on postoperative days 1 and 4.ResultsThe inter- and intraobserver variabilities in the measurement of ILS were not significant. In cataract patients, ILS was significantly higher on postoperative day 1 relative to healthy eyes. By day 4, ILS decreased significantly and was only marginally different from ILS in quiet pseudophakic eyes or healthy eyes. Eyes with higher SUN scores showed proportionately increased ILS. The receiver-operator characteristic analysis indicated no advantage in using the smaller slit width in discriminating ILS at different SUN scores although it provided higher axial resolution.ConclusionsThe lock-in–based spot fluorometer is reliable for measurement of ILS with high precision and accuracy.The measured ILS correlates linearly with SUN scores and can be used to provide a higher granularity for recording aqueous flare.Translational RelevanceThe instrument can be used in the clinical management of uveitis and drug development toward uveitis.

The cold eye irrigation BSS solution used during phacoemulsification reduces post-surgery patients discomfort preventing the inflammation

“…26 Based on SUN, the standardization of uveitis nomenclature, [27][28][29] the aqueous flare was graded as follows: in the absence of any notable flare 0, for faint flare 1+, for moderate flare (iris and lens details are clear) 2+, for marked flare (iris and lens details are hazy) 3+, and for intense flare (fibrin in the aqueous humor) 4+. 30…”