Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional Study

Abstract Introduction The use of optical coherence tomography (OCT) as a potential tool for the measurement of vitreous inflammation has been previously described as a more objective and reproducible method when compared to historically known subjective scales. In this study, our objective is to eva...

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Main Authors: William Rojas-Carabali, Jinghan Lin, Paola Saboya-Galindo, Eunice Jin Hui Goh, Joewee Boon, Carlos Cifuentes-González, Rupesh Agrawal
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-06-01
Series:Ophthalmology and Therapy
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Online Access:https://doi.org/10.1007/s40123-025-01182-3
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author William Rojas-Carabali
Jinghan Lin
Paola Saboya-Galindo
Eunice Jin Hui Goh
Joewee Boon
Carlos Cifuentes-González
Rupesh Agrawal
author_facet William Rojas-Carabali
Jinghan Lin
Paola Saboya-Galindo
Eunice Jin Hui Goh
Joewee Boon
Carlos Cifuentes-González
Rupesh Agrawal
author_sort William Rojas-Carabali
collection DOAJ
description Abstract Introduction The use of optical coherence tomography (OCT) as a potential tool for the measurement of vitreous inflammation has been previously described as a more objective and reproducible method when compared to historically known subjective scales. In this study, our objective is to evaluate OCT’s ability to characterize vitreous hyperreflective dots (VHDs) across eyes with varying conditions, including healthy controls, vitreous degenerations, intraocular inflammation, and others. Methods We utilized a purpose built semiautomated software comprising an image binarization tool to segment OCT scans of 61 eyes, comprising 15 eyes with vitreous degenerations, 20 uveitic eyes, 17 healthy controls, and 9 with other eye conditions. The vitreous dot index (VDI) was computed by determining the number of dots (VDI-N) and the dot area (VDI-A). VHDs were identified as the hyperreflective shadows observed in OCT images within segmented areas of the vitreous, stratified as zones I, II, and III. We compared the difference between groups using analysis of variance (ANOVA). Intergrader reliability was evaluated by comparing results obtained by two trained independent graders, employing intraclass correlation coefficient (ICC) analysis. Results When the medians of VDI-N and VDI-A were compared in healthy controls, patients with uveitis, patients with vitreous degeneration, and others, patients with vitreous degeneration had the highest VDI-N median (2.61 ± 2.76 mm3 p < 0.001) followed by healthy controls (0.48 ± 0.87 mm3 p < 0.001) in zone l. As for VDI-A in the same zone, healthy controls had the greatest median (0.71 ± 0.96, p < 0.001) among the different groups. In zone II, uveitis and the healthy control group had similar medians for VDI-N (0.03 ± 0.36 and 0.03 ± 0.29, p < 0.001 respectably) and VDI-A was greater in the vitreous degeneration group (0.40 ± 0.50 p < 0.001). Zone III had lower VDI-N and VDI-A; patients with uveitis and patients with vitreous degeneration had equal VDI-N (0.00 ± 0.03 p < 0.001) and patients with uveitis had the higher VDI-A among the rest of the groups (0.00 ± 0.65 p < 0.001). For the total vitreous (TV), the highest VDI-N was found in patients with vitreous degeneration (2.92 ± 2.85 p < 0.001) while the highest VDI-A was in the uveitis group patients (0.66 ± 1.31) p < 0.001. The average vitreous dot density index and the average vitreous dot reflectivity index (VDRI) in the TV were greater in patients with vitreous degeneration (2.15 × 10−5 ± 1.52 × 10−5) and patients with uveitis (0.13 ± 0.08), respectively. When comparing VDI markers using a Kruskal–Wallis nonparametric one-way ANOVA test, we found that only the average vitreous dot reflectivity index in zone I and VDI-A in TV were statistically significant. However, only the reflectivity index was significant when comparing patients with vitreous degeneration and healthy controls in a pairwise analysis. Conclusion While vitreous inflammation scales must evolve toward more objective metrics, our findings suggest that VHDs on OCT can act as confounders, as they may represent normal vitreous cells or even the presence of vitreous degeneration. The reflectivity index appears to have better reproducibility than simple count; however, when searching for a more objective parameter for measuring vitreous inflammation, vitreous degeneration must be considered.
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spelling doaj-art-fb0e0c125ca44d0e962b4ab885013ce62025-08-20T03:42:44ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282025-06-011481827184110.1007/s40123-025-01182-3Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional StudyWilliam Rojas-Carabali0Jinghan Lin1Paola Saboya-Galindo2Eunice Jin Hui Goh3Joewee Boon4Carlos Cifuentes-González5Rupesh Agrawal6Programme for Ocular Inflammation and Infection Translational Research, Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng HospitalLee Kong Chian School of Medicine, Nanyang Technological UniversityNeuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT). Escuela de Medicina y Ciencias de La Salud, Universidad del RosarioNational Healthcare Group Eye Institute, Tan Tock Seng HospitalNational Healthcare Group Eye Institute, Tan Tock Seng HospitalProgramme for Ocular Inflammation and Infection Translational Research, Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng HospitalProgramme for Ocular Inflammation and Infection Translational Research, Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng HospitalAbstract Introduction The use of optical coherence tomography (OCT) as a potential tool for the measurement of vitreous inflammation has been previously described as a more objective and reproducible method when compared to historically known subjective scales. In this study, our objective is to evaluate OCT’s ability to characterize vitreous hyperreflective dots (VHDs) across eyes with varying conditions, including healthy controls, vitreous degenerations, intraocular inflammation, and others. Methods We utilized a purpose built semiautomated software comprising an image binarization tool to segment OCT scans of 61 eyes, comprising 15 eyes with vitreous degenerations, 20 uveitic eyes, 17 healthy controls, and 9 with other eye conditions. The vitreous dot index (VDI) was computed by determining the number of dots (VDI-N) and the dot area (VDI-A). VHDs were identified as the hyperreflective shadows observed in OCT images within segmented areas of the vitreous, stratified as zones I, II, and III. We compared the difference between groups using analysis of variance (ANOVA). Intergrader reliability was evaluated by comparing results obtained by two trained independent graders, employing intraclass correlation coefficient (ICC) analysis. Results When the medians of VDI-N and VDI-A were compared in healthy controls, patients with uveitis, patients with vitreous degeneration, and others, patients with vitreous degeneration had the highest VDI-N median (2.61 ± 2.76 mm3 p < 0.001) followed by healthy controls (0.48 ± 0.87 mm3 p < 0.001) in zone l. As for VDI-A in the same zone, healthy controls had the greatest median (0.71 ± 0.96, p < 0.001) among the different groups. In zone II, uveitis and the healthy control group had similar medians for VDI-N (0.03 ± 0.36 and 0.03 ± 0.29, p < 0.001 respectably) and VDI-A was greater in the vitreous degeneration group (0.40 ± 0.50 p < 0.001). Zone III had lower VDI-N and VDI-A; patients with uveitis and patients with vitreous degeneration had equal VDI-N (0.00 ± 0.03 p < 0.001) and patients with uveitis had the higher VDI-A among the rest of the groups (0.00 ± 0.65 p < 0.001). For the total vitreous (TV), the highest VDI-N was found in patients with vitreous degeneration (2.92 ± 2.85 p < 0.001) while the highest VDI-A was in the uveitis group patients (0.66 ± 1.31) p < 0.001. The average vitreous dot density index and the average vitreous dot reflectivity index (VDRI) in the TV were greater in patients with vitreous degeneration (2.15 × 10−5 ± 1.52 × 10−5) and patients with uveitis (0.13 ± 0.08), respectively. When comparing VDI markers using a Kruskal–Wallis nonparametric one-way ANOVA test, we found that only the average vitreous dot reflectivity index in zone I and VDI-A in TV were statistically significant. However, only the reflectivity index was significant when comparing patients with vitreous degeneration and healthy controls in a pairwise analysis. Conclusion While vitreous inflammation scales must evolve toward more objective metrics, our findings suggest that VHDs on OCT can act as confounders, as they may represent normal vitreous cells or even the presence of vitreous degeneration. The reflectivity index appears to have better reproducibility than simple count; however, when searching for a more objective parameter for measuring vitreous inflammation, vitreous degeneration must be considered.https://doi.org/10.1007/s40123-025-01182-3UveitisInflammatory markersTreatment responseConfoundersVitreous cells
spellingShingle William Rojas-Carabali
Jinghan Lin
Paola Saboya-Galindo
Eunice Jin Hui Goh
Joewee Boon
Carlos Cifuentes-González
Rupesh Agrawal
Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional Study
Ophthalmology and Therapy
Uveitis
Inflammatory markers
Treatment response
Confounders
Vitreous cells
title Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional Study
title_full Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional Study
title_fullStr Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional Study
title_full_unstemmed Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional Study
title_short Advanced Characterization of Vitreous Hyperreflective Dots via OCT-Derived Metrics: A Cross-Sectional Study
title_sort advanced characterization of vitreous hyperreflective dots via oct derived metrics a cross sectional study
topic Uveitis
Inflammatory markers
Treatment response
Confounders
Vitreous cells
url https://doi.org/10.1007/s40123-025-01182-3
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