POL Scientific / JBM / Volume 11 / Issue 4 / DOI: 10.14440/jbm.2024.0049
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RESEARCH ARTICLE

Advanced UltraTech approach for distinguishing granulomatous from non-granulomatous corneal endothelial exudates in autoimmune rheumatic anterior uveitis

Roberta Foti1 ,  Marco Zeppieri2* ,  Rosario Foti1 ,  Ylenia Dal Bosco1 ,  Davide Scollo3 ,  Elisa Visalli1 ,  Salvatore Ficili3 ,  Giorgio Amato1 ,  Valentina Cifalinò3 ,  Riccardo Foti4 ,  Alessandro Avitabile5 ,  Ludovica Cannizzaro5 ,  Caterina Gagliano6,7
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1 Division of Rheumatology, Policlinico-San Marco Academic Hospital (AOU), 95123 Catania, Italy
2 Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
3 Eye Clinic, Catania University, San Marco Hospital, 95121 Catania, Italy
4 Department of Surgical Sciences, Plastic and Reconstructive Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
5 Faculty of Medicine, University of Catania, 95123 Catania, Italy
6 Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy
7 Mediterranean Foundation “G.B. Morgagni”, 95125 Catania, Italy
JBM 2024 , 11(4), e99010034; https://doi.org/10.14440/jbm.2024.0049
Submitted: 31 July 2024 | Revised: 19 September 2024 | Accepted: 23 September 2024 | Published: 7 November 2024
© 2024 by the Journal of Biological Methods published by POL Scientific. Licensee POL Scientific, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: Anterior uveitis is a common manifestation in individuals with rheumatic conditions such as spondylarthritis, Behçet’s syndrome, juvenile idiopathic arthritis, and sarcoidosis. Clinical differentiation between granulomatous and non-granulomatous corneal endothelial exudates is crucial to subsequent diagnosis and treatment. Anterior segment optical coherence tomography (AS-OCT) can ensure an accurate differential diagnosis and appropriate follow-up after local and systemic therapy. Objective: This study aimed to distinguish between granulomatous and non-granulomatous endothelial exudates in patients with anterior uveitis using AS-OCT. Methods: This longitudinal observational study involved 30 patients diagnosed with or suspected of having rheumatic autoimmune disease presenting with anterior uveitis. The study was conducted at the combined Rheumatology and Ophthalmology Clinic, San Marco Hospital, Catania, Italy. All patients underwent slit-lamp examination, which revealed or suspected corneal endothelial exudates. A comprehensive rheumatological and ophthalmological evaluation was also performed. Subsequently, the patients were subjected to AS-OCT using the Optovue Solix device. Results: Granulomatous corneal exudates were identified in 30% of the subjects, with counts ranging from 5 to 20 and sizes varying between 50 and 150 μm. Detailed 3D scans further exhibited the morphology of these exudates. A follow-up of patients after steroid therapy (both topical and systemic) and immunosuppressive treatment demonstrated a progressive reduction in the exudates, ultimately leading to their complete resolution. Conclusion: Use of ophthalmological equipment that allows for simple, rapid, and non-invasive investigations in combination with a multidisciplinary approach, enables appropriate diagnosis and monitoring of therapeutic efficacy in patients with inflammatory ocular conditions presenting with corneal endothelial exudates.

Keywords
Corneal endothelial exudates
Anterior uveitis
Autoimmune diseases
Spondylarthritis
Behçet’s syndrome
Anterior segment optical coherence tomography
Funding
None.
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Conflict of interest
The authors declare no conflicts of interest.
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Journal of Biological Methods, Electronic ISSN: 2326-9901 Print ISSN: TBA, Published by POL Scientific
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