PurposeTo evaluate vascular changes in patients with intermediate uveitis with or without retinal vasculitis using swept-source wide-field optical coherence tomography angiography (OCTA).MethodsThis is a prospective cross-sectional study. Consecutive patients with intermediate uveitis were evaluated using wide-field OCTA. Wide-field OCTA and en-face OCT images were analysed for the presence of capillary non-perfusion and reduced perfusion, disruption of ellipsoid zone, and abnormalities on en-face wide-field retinal thickness maps, respectively, and compared with fluorescein angiography (FA) findings in a subcohort.Results164 eyes of 88 patients with intermediate uveitis were included. Areas of capillary non-perfusion and reduced perfusion were more frequently observed in the choroidal OCTA slab (33.3% and 49.4%), choriocapillaris (CC; 31.4% and 48%) and deep capillary plexus (DCP; 9.6% and 34.6%) than in the superficial capillary plexus (SCP; 5% and 26.3%), respectively. Intermediate uveitis with vasculitis presented more frequently with non-perfusion and hypoperfusion in the DCP (p=0.003 and p=0.05, respectively) and SCP (p=0.007 and p=0.005, respectively) than intermediate uveitis without vasculitis. Peripheral capillary leakage on FA correlated with the presence of perivascular, macular and generalised thickening on en-face wide-field thickness maps (p=0.007). Ischaemia on FA was significantly associated with non-perfusion on wide-field OCTA in SCP and DCP (p=0.019 and p=0.027, respectively).ConclusionChanges in the choroid, CC and DCP are more frequently found than in the SCP on wide-field OCTA in intermediate uveitis. While wide-field OCTA is a reliable tool to detect capillary non-perfusion in intermediate uveitis, it was not helpful in determining disease activity.Trial registration numberNCT02811536.
Purpose We evaluated the repeatability of wide-field en face swept-source optical coherence tomography angiography (SS-OCTA) in healthy subjects. Methods Healthy subjects underwent two imaging sessions, on average 8 days apart, with a 100 kHz SS-OCTA instrument. The imaging protocol included a central 3 × 3 and 12 × 12 mm scans of the four quadrants resulting in more than a 70° wide-field OCTA of the posterior pole. Quantitative analysis was performed using the inbuilt Macular Density Algorithm Version v0.6.1 and AngioTool software. Consistency for the foveal avascular zone (FAZ), vessel density, and perfusion density of the superficial and deep capillary plexus slabs and the wide-field OCTA superficial slab, and the number of artefacts on the wide-field images were assessed. Results A total of 21 healthy volunteers (seven men and 14 women; mean age 32 years; range, 18–61; standard deviation, 10.28 years) were included in this analysis. Internal consistency was highest for FAZ area with an intraclass correlation (ICC) = 0.998 (95% confidence interval [CI], 0.997–0.999), a FAZ perimeter with an ICC = 0.995 (95% CI, 0.990–0.997), a FAZ circularity with an ICC= 0.976 (95% CI, 0.956–0.987), followed by the vessel density of the inner ring in the superficial slab with an ICC = 0.834 (95% CI, 0.691–0.911), and a vessel density of the inner ring in the deep slab with an ICC = 0.523 (95% CI, 0.113–0.744). The reproducibility of the average vessels length of the wide-field OCTA cropped images was strong (ICC = 0.801; 95% CI, 0.624–0.895), followed by the reproducibility of total number of junctions (ICC = 0.795; 95% CI, 0.613–0.892) and the vessels percentage area (ICC = 0.662; 95% CI, 0.361–0.821). Conclusions The level of reproducibility for assessing the microvascular anatomy in wide-field OCTA is strong and can be used to quantify microvascular changes over time. Refinements in analysis strategies and a consensus of which parameters are most useful for quantitative assessment of wide-field OCTA images would be useful in the future. Translational Relevance These findings bridge the gap between basic imaging research and clinical use for quantitative wide-field OCTA.
PurposeTo evaluate retinal and choroidal vascular changes in patients with intermediate uveitis with/without concomitant retinal vasculitis using wide field swept‐source optical coherence tomography angiography (OCTA).MethodsIn this study consecutive patients with intermediate uveitis ± vasculitis and healthy age‐matched controls were evaluated using central 3 × 3 mm OCTA scans and montage scans. Differences among the groups as well as the association between central changes assessed by 3 × 3 scans and wide field OCTA were evaluated.Results93 eyes of 58 patients with intermediate uveitis and 33 healthy age‐matched controls were included. The presence of a cystoid macular oedema (CME) was associated with capillary non‐and reduced perfusion of the superficial capillary plexus (SCP) (p = 0.03 and 0.02, respectively), and deep capillary plexus (DCP) (p = 0.02 and p ≤ 0.0001, respectively) of the 3 × 3 mm scans. The raw length, circularity and size of foveal avascular area (FAZ) significantly differed among the three groups. (p = 0.01, p = 0.045 and p = 0.004, respectively). Multivariable regression analysis revealed that the presence of epiretinal membranes (ERM) and CME rather than the disease entity contributed to the changes of FAZ size (R2 = 0.15, p = 0.0003) The mean vessel density (VD) of the SCP significantly differed among the three groups (intermediate uveitis with concomitant vasculitis: 16.8 ± 3.8 mm−1 vs intermediate uveitis only: 15.6 ± 4.4 mm−1 versus control: 18 ± 3.5 mm−1, p = 0.046). Multivariable regression analysis showed that the presence of CME rather than the disease entity impacted vessel density of SCP (R2 = 0.1, p = 0.016). There was no association between peripheral non‐ or reduced perfusion of the wide field OCTA slabs of the SCP and DCP and the VD of the 3 × 3 slabs.ConclusionAlthough patients with intermediate uveitis and vasculitis present with reduced central vessel density compared to healthy age‐matched controls, these changes are presumably contributed to the presence of CME.
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