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Mean scleral thickness was measured by AS-OCT in violaceous areas and compared with the same region in the contralateral unaffected eye. Measurements were performed by two masked graders.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Nine patients with median age of 52\u2009\u00b1\u200912.8\u00a0years were assessed. Eight patients were female. Rheumatoid arthritis and history of treated latent tuberculosis (33.3%) were the most common causes of anterior scleritis. Mean scleral thickness was 582.93\u2009\u00b1\u2009124.03\u00a0\u00b5m and 648.59\u2009\u00b1\u2009103.61\u00a0\u00b5m for violaceous sclera and the corresponding unaffected areas of the contralateral eye, respectively (mean difference\u2009=\u2009-65.65\u00a0\u00b5m, 95% CI: -143.73 to 12.42, <jats:italic>p<\/jats:italic>\u2009=\u20090.0885). The mean image contrast percentage of scleral hyperreflectivity as assessed by image conversion in an area of violaceous hue was 65.07\u00a0\u00b5m\u2009\u00b1\u20096.49\u00a0\u00b5m compared to 42.70\u00a0\u00b5m\u2009\u00b1\u20095.46\u00a0\u00b5m of unaffected areas (mean difference\u2009=\u200922.37\u00a0\u00b5m, 95% CI: 14.72\u00a0\u00b5m to 30.03\u00a0\u00b5m, <jats:italic>p<\/jats:italic>\u2009=\u20090.0001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Using AS-OCT, the thicknesses of violaceous sclerae were not significantly thinner than the contralateral unaffected areas, despite a mean difference of approximately 65 microns. The increased scleral hyperreflectivity observed in the violaceous sclera may suggest collagen remodeling in these areas. Such remodeling could play a role in the sclera reflecting violaceous hues while still preventing direct visualization of the underlying choroid.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00417-025-06788-8","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T01:40:44Z","timestamp":1742175644000},"page":"1997-2004","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Insights into scleral violaceous hue in anterior scleritis: anterior segment optical coherence tomography evaluation"],"prefix":"10.1007","volume":"263","author":[{"given":"Plern","family":"Sutra","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0072-8221","authenticated-orcid":false,"given":"Thananop","family":"Pothikamjorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Lopez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaskirat","family":"Takhar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathinee","family":"Chongchareon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Keenan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0558-9793","authenticated-orcid":false,"given":"John A.","family":"Gonzales","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"6788_CR1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.preteyeres.2013.02.004","volume":"35","author":"D Wakefield","year":"2013","unstructured":"Wakefield D, Di Girolamo N, Thurau S, Wildner G, McCluskey P (2013) Scleritis: Immunopathogenesis and molecular basis for therapy. 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