Optical coherence tomography biomarkers of posterior scleritis in different stages of the disease activity

By
Sameera Nayak
Niroj Kumar Sahoo
Udit Ajmani
P. Srinivas Rao
Raja Narayanan
Ritesh Narula
Rajeev R. Pappuru
July 10, 2026

Frontiers In Ophthalmology

Objective:

To analyze the optical coherence tomography (OCT) characteristics in different stages of posterior scleritis (PS) and explore possible correlations between OCT features and the different stages of PS.

Approach:

Study Design: Retrospective study on clinically diagnosed cases of PS with transparent media and good OCT images at an academic tertiary eye care center in India from April 2014 to March 2019.
Data Collection: Analysis of 25 predefined OCT biomarkers across acute, resolving, and resolved stages of PS.

Key Findings:

104 OCT plates from 31 patients were analyzed; 43 in acute, 28 in resolving, and 33 in resolved stages.
Acute PS showed 100% choroidal thickening, 97.7% RPE–choroidal bump, 90.7% ILM folds, and 86.0% NSD.
Resolving PS had 92.9% HRD in inner and subretinal space, and 89.3% in outer retina.
Resolved PS was characterized by 54.5% EZ reflectivity and 39.4% ERM.
Median central foveal thickness significantly declined from 737 µm in acute to 212 µm in resolved PS.
Acute PS was strongly associated with RPE–choroidal bump (odds ratio 527.7, 95% CI 54.8–5,079.4), ILM folds (OR 73.1, 95% CI 19.5–273.9), RPE thickening (OR 29.0, 95% CI 9.1–92.3), NSD (OR 14.8, 95% CI 5.0–44.0), cystoid macular edema (OR 8.3, 95% CI 3.4–20.5), and vitreous cells (OR 3.1, 95% CI 1.2–7.6).
Resolving PS showed associations with HRD involving the inner retina (OR 8.39, 95% CI 1.95–36.2), outer retina (OR 7.10, 95% CI 1.94–25.9), subretinal space (OR 7.43, 95% CI 1.72–32.2), and choroid (OR 4.50, 95% CI 1.20–16.8).
Resolved PS was associated with variable reflectivity of the EZ (OR 15.6, 95% CI 3.75–65.0) and ELM (OR 7.31, 95% CI 1.87–28.5), and posterior vitreous detachment (OR 2.80, 95% CI 1.29–6.11).