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Choroidal assessment in idiopathic panuveitis using optical coherence tomography

  • Inflammatory Disorders
  • Published:
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Abstract

Background

Idiopathic panuveitis is a diagnosis of exclusion that lacks distinguishing features on fluorescein and indocyanine green angiography. Choroidal hypoperfusion or ischaemia has been implicated in panuveitis of different aetiologies. In this study, we use enhanced depth imaging optical coherence tomography (OCT) to examine the choroid and its vasculature in patients with this disease.

Methods

In this retrospective, cross-sectional study, OCT-derived measurements of retinal and choroidal thickness were obtained after manual segmentation using custom software. Choroidal measurements were further subdivided into Haller’s large vessel layer (HLVL) and Sattler’s medium vessel layer (SMVL), and correlated with clinical parameters.

Results

Twenty-one eyes from 21 patients were included. A reduction in hypo-reflective spaces, corresponding to vascular lumens, was observed in HLVL. The mean thickness of both the choroid (233.7 ± 73.3 μm), and HLVL (167.8 ± 53.7 μm), was less than that previously reported for normal eyes. Choroidal thickness expressed as a ratio to retina thickness showed significant correlation to visual acuity (r = 0.58, p = 0.006). This correlation was maintained in the ratio between HLVL and retinal thickness (r = 0.56, p = 0.009), but not in SMVL to retinal thickness (r = 0.352, p = 0.12).

Conclusions

This study reports novel OCT-derived parameters in patients with idiopathic panuveitis. We noted loss of hyporeflectivity in HLVL, and thinning of both HLVL and the choroid as a whole. The observed correlation between visual acuity and the ratio of choroidal to retinal thickness is a strong enhanced depth imaging (EDI)-OCT derived candidate for prospective validation in future studies.

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Abbreviations

RPE:

Retinal pigment epithelium

OCT:

Optical coherence tomography

EDI:

Enhanced depth imaging

FA:

Fluorescein angiography

ICGA:

Indocyanine green angiography

BCVA:

Best corrected visual acuity

logMAR:

Logarithm of the minimum angle of resolution

CMO:

Cystoid macular oedema

ERM:

Epiretinal membrane

HLVL:

Haller’s large vessel layer

SMVL:

Sattler’s medium vessel layer

VKH:

Vogt Koyanagi Harada

MEWDS:

Multiple evanescent white dot syndrome

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Disclosure

Dr Sim receives funding from Fight For Sight UK, Grant 1987.

Drs. Keane, Patel, Sim, Lee, Tufail and Pavesio receive financial support from the Department of Health’s NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology. The views expressed in the publication are those of the authors and not necessarily those of the Department of Health.

Dr Zarranz-Ventura is a grant recipient of the Spanish Retina & Vitreous Society (Sociedad Española de Retina y Vítreo, SERV).

The authors have full control of all primary data and they agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review the data if requested.

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Authors and Affiliations

  1. NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK

    Michael Karampelas, Dawn A. Sim, Pearse A. Keane, Javier Zarranz-Ventura, Praveen J. Patel, Adnan Tufail, Mark Westcott, Richard Lee & Carlos E. Pavesio

  2. Institute of Ophthalmology, University College London, London, UK

    Dawn A. Sim, Pearse A. Keane, Praveen J. Patel, Adnan Tufail, Richard Lee & Carlos E. Pavesio

  3. Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain

    Javier Zarranz-Ventura

  4. School of Clinical Sciences, University of Bristol, Bristol, UK

    Richard Lee

  5. University Hospitals Bristol NHS Foundation Trust, Bristol, UK

    Richard Lee

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  1. Michael Karampelas
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  2. Dawn A. Sim
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Correspondence to Michael Karampelas.

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Karampelas, M., Sim, D.A., Keane, P.A. et al. Choroidal assessment in idiopathic panuveitis using optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 251, 2029–2036 (2013). https://doi.org/10.1007/s00417-013-2330-7

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  • DOI: https://doi.org/10.1007/s00417-013-2330-7

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