Projects – Ocular Infections

COTS

International Ocular inflammation society, International Uveitis study group and Foster Ocular Immunology Society have joined hands together with Collaborative ocular tuberculosis study (COTS) group to address this conundrum related to ocular tuberculosis and their joint efforts are supported by physicians and basic science scientists with special interest in field of tuberculosis..

Infectious Uveitis

The infectious uveitides encompasses a wide array of potential pathogens with heterogeneous presentations. In an increasingly global ophthalmic world with new emerging infections, this area of ophthalmology demands the attention of all clinicians, any one of whom may encounter patients with puzzling presentations related to infectious causes.

The Infectious Uveitis Treatment Algorithm Network (TITAN) strives to establish evidence and experience based guidelines for the management of all patients with intraocular infectious diseases. TITIAN employs the Delphi method originally conceived in the 1950s by Olaf Helmer and Norman Dalkey of the Rand Corporation to achieve group consensus on the treatment algorithm for the infectious uveitides through iterations of online questionnaires and scientific discussion via teleconference.

COIN

COIN (Comprehensive Ocular Imaging Network) is a platform for automating the analysis of ocular images including OCT Scans and fundus images.

Choroidal Vascularity Index

Vitreous Haze Index

The vitreous humor is a gelatinous body occupying the posterior segment, diffusely adherent to the retina. It acts as a metabolic repository for surrounding structures, with studies demonstrating close relationships between retinal changes and alterations in the vitreous’ biochemistry. Structurally, with a viscosity of two to four times that of water, the vitreous is composed of abundant cross-linked collagen fibers, hyaluronic acid, and glycosaminoglycans, helping to preserve the eye’s shape. But more importantly, the vitreous is a transparent media that enables light passage, playing an irreplaceable role in maintaining optimum visual acuity. The clarity of vitreous is related to disease activity, and corresponds to one’s vision.

Therefore, intraocular diseases that compromise the vitreous’ integrity can lead to media opacity, resulting in significant visual deficits. Uveitis is a group of diseases characterized by intraocular inflammation, with a myriad of bizarre causes ranging from infective to autoimmune. With the exception of anterior uveitis, inflammatory infiltrates and proteinaceous exudates build- up within the vitreous regardless of the etiology. On examination, the diseased vitreous assumes a ‘hazy’ appearance, which can be qualitatively classified as various grades of ‘vitreous haze’.

Our group has developed a new biomarker named ‘Vitreous haze index‘ (VHI), which quantifies vitreous haze by measuring signal strength with respect to retinal pigment epithelium. VHI is currently computed by vitreous analysis software (VITAN), allowing both manual and automated computation. VHI has become a widely accepted research tool amongst uveitis specialist in UK and USA and also been reviewed with pharma and FDA as possible end point measurement for intraocular inflammatory diseases. VHI has the potential as a practical tool for monitoring, diagnosing and prognosticating intraocular inflammatory disease, with significant implications on clinicians’ therapeutic decision making.