Original ArticleA Novel Method to Detect and Monitor Retinal Vasculitis Using Swept-Source OCT Angiography
Section snippets
Methods
This retrospective case series was performed in accordance with the Declaration of Helsinki and the Health Insurance Portability and Accountability Act of 1996, and was approved by the Institutional Review Board of the University of Miami Miller School of Medicine. No study-specific informed consent or authorization was required because it was a retrospective review of images obtained during routine clinical care. However, all patients had signed a consent to undergo SS-OCTA based on the
Results
From August 2016 to November 2019, 21 patients with a prior diagnosis of retinal vasculitis underwent SS-OCTA imaging at Bascom Palmer Eye Institute and same-day FA. Seventeen patients had retinal vascular leakage or staining in the posterior pole on FA and were considered to have active retinal vasculitis. Of these 17 patients, there were 8 with BSCR, 2 with pars planitis, 1 with intraocular lymphoma, and 1 with syphilis. The 5 remaining patients were diagnosed with an undifferentiated
Discussion
OCTA is a desirable imaging modality because it is quick and noninvasive. The high-resolution en face OCTA of retinal blood flow co-registers with a retinal thickness map and multiple corresponding structural OCT B-scans.13 Many studies have reported the utility of OCTA in age-related macular degeneration and diabetic retinopathy.15,16,23 To date, there has been a limited clinical role for OCTA in uveitis because of its inability to directly show real-time retinal vascular leakage and
Conclusions
Our descriptive study presents a method to demonstrate retinal vasculitis on OCTA. However, for more unbiased evaluation, a quantitative study is required to grade the retinal vasculitis on FA and compare it with the perivascular retinal thickness on OCTA in a blinded fashion. This provides more quantitative data such as sensitivity and specificity of OCTA compared with FA for detection and monitoring of retinal vasculitis.
References (25)
- et al.
Retinal periphlebitis and retinitis in multiple sclerosis. I. Pathologic characteristics
Ophthalmology
(1984) - et al.
Pathology of pars planitis
Am J Ophthalmol
(1978) - et al.
Fluorescein angiography complication survey
Ophthalmology
(1986) - et al.
Optical coherence tomography angiography: a comprehensive review of current methods and clinical application
Prog Retin Eye Res
(2017) - et al.
Quantifying retinal microvascular changes in Uveitis using spectral-domain optical coherence tomography angiography
Am J Ophthalmol
(2016) - et al.
Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration
Ophthalmology
(2014) - et al.
Widefield OCT angiography of idiopathic retinal vasculitis, aneurysms, and neuroretinitis
Ophthalmol Retina
(2017) - et al.
Distribution of diabetic neovascularization on ultra- widefield fluorescein angiography and on simulated widefield OCT angiography
Am J Ophthalmol
(2019) - et al.
Retinal vasculitis
Int Ophthalmol Clin
(2005) - et al.
Referral patterns of uveitis in a tertiary eye care center
Arch Ophthalmol
(1996)
Retinal vasculitis
Curr Opin Rheumatol
Sarcoidosis with optic nerve and retinal involvement
Arch Ophthalmol
Cited by (0)
Research supported by grants from the National Eye Institute (R01EY024158, R01EY028753), Carl Zeiss Meditec, Inc., the Salah Foundation, an unrestricted grant from the Research to Prevent Blindness, Inc., and the National Eye Institute Center Core Grant (P30EY014801) to the Department of Ophthalmology, University of Miami Miller School of Medicine. The funding organizations had no role in the design or conduct of this research.
Disclosure(s): All authors have completed and submitted the ICMJE disclosures form.
The author(s) have made the following disclosure(s): J.L.D.: Rresearch grant funding -- Biogen, EyePharma, Johns Hopkins University; Consultant – Kodiak, 4D Molecular Therapeutics. G.G.: Research support -- Carl Zeiss Meditec, Inc. G.G. and the University of Miami co-own a patent that is licensed to Carl Zeiss Meditec, Inc. P.J.R.: Research support -- Carl Zeiss Meditec, Inc, Stealth BioTherapeutics; Consultant -- Apellis, Biogen, Boehringer-Ingelheim, Carl Zeiss Meditec, Chengdu Kanghong Biotech, EyePoint, Ocunexus Therapeutics, Ocudyne, Unity Biotechnology; Equity interest -- Apellis, Valitor, Verana Health, Ocudyne. T.A.B.: Research funding from Klorfine Foundation; consulatant -- Adverum Biotechnologies, Allergan, B+L/Valeant Pharmaceuticals, Beaver Visitec, Clearside Biomedical, Inc., Eyepoint Pharmaceuticals, Genentech, Novartis, RegenexBio; member of the Data Safety Monitoring Committee at Applied Genetic Technologies Corp., and Novartis.
HUMAN SUBJECTS: Human subjects were included in this study. The human ethics committees at the University of Miami Miller School of Medicine approved the study. All research adhered to the tenets of the Declaration of Helsinki. No study-specific informed consent or authorization was required because it was a retrospective review of images obtained during routine clinical care. However, all patients had signed a consent to undergo SS-OCTA based on the institute protocol for SS-OCTA imaging.
No animal subjects were included in this study.
Author Contributions:
Conception and design: Noori, Shi, Yang, Gregori, Albini, Rosenfeld, Davis
Data collection: Noori, Shi, Yang, Gregori, Albini, Rosenfeld, Davis
Analysis and interpretation: Noori, Shi, Yang, Gregori, Albini, Rosenfeld, Davis
Obtained funding: N/A
Overall responsibility: Noori, Shi, Yang, Gregori, Albini, Rosenfeld, Davis