TY - JOUR
T1 - OCT-Based Evaluation of Vitreous Haze in the First-Line Antimetabolites as Steroid-Sparing Treatment Uveitis Trial
AU - Alhelaly, Mai
AU - Soylu, Ceren
AU - Oncel, Deniz
AU - Corradetti, Giulia
AU - Chen, Keren
AU - Jackson, Nicholas J.
AU - Rathinam, Sivakumar R.
AU - Gonzales, John A.
AU - Thundikandy, Radhika
AU - Kanakath, Anuradha Vadakke
AU - Murugan, S. Bala
AU - Vedhanayaki, Rajesh
AU - Lim, Lyndell L.
AU - Suhler, Eric B.
AU - Al-Dhibi, Hassan A.
AU - Doan, Thuy
AU - Sadda, Srinivas R.
AU - Madow, Brian
AU - Coyne, Alison B.
AU - Acharya, Nisha R.
AU - Tsui, Edmund
N1 - Publisher Copyright:
© 2026 American Academy of Ophthalmology. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/
PY - 2026/4
Y1 - 2026/4
N2 - Purpose: To evaluate OCT vitreous signal intensity (OCT-VI) as a biomarker of vitreous haze (VH) in a longitudinal, prospective, and standardized manner in the First-Line Antimetabolites as Steroid-Sparing Treatment (FAST) Uveitis Trial. Design: Secondary analysis of a block-randomized, observer-masked, multicenter clinical trial. Subjects: Two hundred sixty-seven eyes from 147 patients with uveitis enrolled in the FAST Trial were evaluated in this analysis at baseline (BL), month 6 (M6), and month 12 (M12). Methods: For each patient, Heidelberg Spectralis OCT volume scans (Heidelberg Engineering) were imported into the Doheny Reading Center 3D-OCTOR software and underwent a semi-automated segmentation. For each OCT volume, 5 B-scans were used to calculate the OCT-VI as a ratio of the vitreous space to the entire image. Main Outcome Measures: OCT vitreous signal intensity at BL, M6, and M12 visits and the association with the National Eye Institute VH scale, anterior chamber (AC) cell grade, posterior synechiae (PS), lens status, visual acuity (VA), and central macular thickness (CMT). Results: At BL, the median relative vitreous intensity was 0.43 (interquartile range, [0.33-0.54]) and reduced to 0.39 (0.27-0.53) at M6 and 0.39 (0.26-0.54) at M12. A mixed-effects linear regression model showed that OCT-VI and VH clinical grades were statistically significantly correlated (P < 0.001) when controlled for age, sex, time points, and eye. A statistically significant decrease of OCT-VI was observed over time with treatment (P < 0.001). A 2-step grade decrease in VH was associated with a -0.07 (standard deviation 0.19) change in OCT-VI. A mixed-effects linear regression model demonstrated a statistically significant association between OCT-VI and VA (b = 0.170, P = 0.020). A higher OCT-VI was associated with increasing grades of AC cell (P < 0.001) and presence of cataract (P < 0.001). There was no significant association (P > 0.05) of OCT-VI with PS or CMT. Conclusions: In the FAST Uveitis Trial, OCT-VI was significantly correlated with the VH clinical grades and demonstrated significant longitudinal changes. OCT vitreous signal intensity may serve as a potential objective biomarker of VH. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
AB - Purpose: To evaluate OCT vitreous signal intensity (OCT-VI) as a biomarker of vitreous haze (VH) in a longitudinal, prospective, and standardized manner in the First-Line Antimetabolites as Steroid-Sparing Treatment (FAST) Uveitis Trial. Design: Secondary analysis of a block-randomized, observer-masked, multicenter clinical trial. Subjects: Two hundred sixty-seven eyes from 147 patients with uveitis enrolled in the FAST Trial were evaluated in this analysis at baseline (BL), month 6 (M6), and month 12 (M12). Methods: For each patient, Heidelberg Spectralis OCT volume scans (Heidelberg Engineering) were imported into the Doheny Reading Center 3D-OCTOR software and underwent a semi-automated segmentation. For each OCT volume, 5 B-scans were used to calculate the OCT-VI as a ratio of the vitreous space to the entire image. Main Outcome Measures: OCT vitreous signal intensity at BL, M6, and M12 visits and the association with the National Eye Institute VH scale, anterior chamber (AC) cell grade, posterior synechiae (PS), lens status, visual acuity (VA), and central macular thickness (CMT). Results: At BL, the median relative vitreous intensity was 0.43 (interquartile range, [0.33-0.54]) and reduced to 0.39 (0.27-0.53) at M6 and 0.39 (0.26-0.54) at M12. A mixed-effects linear regression model showed that OCT-VI and VH clinical grades were statistically significantly correlated (P < 0.001) when controlled for age, sex, time points, and eye. A statistically significant decrease of OCT-VI was observed over time with treatment (P < 0.001). A 2-step grade decrease in VH was associated with a -0.07 (standard deviation 0.19) change in OCT-VI. A mixed-effects linear regression model demonstrated a statistically significant association between OCT-VI and VA (b = 0.170, P = 0.020). A higher OCT-VI was associated with increasing grades of AC cell (P < 0.001) and presence of cataract (P < 0.001). There was no significant association (P > 0.05) of OCT-VI with PS or CMT. Conclusions: In the FAST Uveitis Trial, OCT-VI was significantly correlated with the VH clinical grades and demonstrated significant longitudinal changes. OCT vitreous signal intensity may serve as a potential objective biomarker of VH. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
KW - FAST
KW - OCT-based vitreous signal intensity
KW - Standardization of uveitis nomenclature
KW - Uveitis
KW - Vitreous haze
UR - https://www.scopus.com/pages/publications/105035305405
U2 - 10.1016/j.xops.2026.101106
DO - 10.1016/j.xops.2026.101106
M3 - Article
AN - SCOPUS:105035305405
SN - 2666-9145
VL - 6
JO - Ophthalmology Science
JF - Ophthalmology Science
IS - 4
M1 - 101106
ER -