Correlation of “Panoramic” Optical Coherence Tomography Angiography With Indocyanine Green Angiography Characteristics of Serpiginous-Like Choroiditis

Nagpal, Manish; Mehrotra, Navneet; Juneja, Rakesh; Vishnoi, Avijit; Jain, Ashish

doi:10.3928/23258160-20181101-07

Cited by 9 publications

(3 citation statements)

References 14 publications

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“…The choriocapillaris flow appeared to progressively restore centrally from the lesion edges under treatment, correlating with FAF signal changes over time, which is an interesting and similar finding as in APMPPE and in idiopathic serpiginous chorioretinopathy [92]. These findings were confirmed in a larger prospective case series of 32 eyes using a panoramic OCTA device [93].…”

Section: About the Implementation Of Optical Coherence Tomography Angsupporting

confidence: 56%

Optical coherence tomography angiography (OCTA) as a new diagnostic tool in uveitis

Dingerkus

Munk

Brinkmann

et al. 2019

J Ophthal Inflamm Infect

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Background The broad spectrum of uveitis disorders requires a multimodal imaging approach in the daily practice of an ophthalmologist. As inflammatory conditions, they have in common an alteration in leukocyte migration. In this context, optical coherence tomography angiography (OCTA) might be of great value for diagnosing or following up patients with these disorders. To date, OCTA has rather been used as an additional tool besides the well-established diagnostic imaging tools, but its complementary diagnostic features become increasingly relevant, to follow disease activity and treatment response and for the understanding of pathomechanisms of various uveitis types. This review summarizes the possible applications of OCTA and its advantages and disadvantages as opposed to dye-based angiographies in uveitic diseases. Main body Hitherto gold standards in the diagnostic workup of posterior or intermediate uveitis have been angiography on a dye-based method, which is fluorescein or indocyanine green. It gives information about the status of the blood-retinal barrier and the retinal and choroidal vasculature by visualizing diffuse leakage as a state of inflammation or complications as an ischemia or choroidal neovascularization. As noninvasive methods, fundus autofluorescence depicts the status of metabolic activity of the retinal pigment epithelium and OCT or enhanced depth imaging OCT, respectively, as a depth-resolving imaging method can supply additional information. OCTA as a non-invasive, depth-resolution imaging tool of retinal and choroidal vessels adds detailed qualitative and quantitative information of the status of retinal and choroidal vessels and bridges the gap between the mentioned conventional diagnostic tools used in uveitis. It is important, though, to be aware of its limitations, such as its susceptibility to motion artifacts, limited comparability among different devices, and restricted contribution of information regarding the grade of disease activity. Conclusion OCTA as a non-invasive, depth-resolution imaging tool can give qualitative and quantitative information about the status of retinal and choroidal vessels, but also has certain limitations. Employing OCTA as a complementary rather than exclusive tool, it can give important additional information about the macro- and microvasculature under inflammatory circumstances. Thereby, it also contributes to the understanding of the pathophysiology of various uveitis entities.

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Section: About the Implementation Of Optical Coherence Tomography Angsupporting

confidence: 56%

Optical coherence tomography angiography (OCTA) as a new diagnostic tool in uveitis

Dingerkus

Munk

Brinkmann

et al. 2019

J Ophthal Inflamm Infect

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“…15 Wide-field and panoramic imaging techniques using OCTA and ICGA also demonstrate large extramacular areas of choriocapillaris ischemia in TB SLC. 21 Apart from TB SLC, conditions such as acute posterior multifocal placoid pigment epitheliopathy also demonstrate choriocapillaris flow reduction corresponding to dye-based angiographies in active disease. [22][23][24] It is relevant to understand why there might be areas of choriocapillaris flow deficit in active TB SLC.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Follow-Up of Tubercular Serpiginous-Like Choroiditis Using Optical Coherence Tomography Angiography

Agarwal

Aggarwal

Mandadi

et al. 2020

Retina

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Purpose: To analyze and describe serial follow-up of choriocapillaris alterations in tubercular serpiginouslike choroiditis (SLC) using optical coherence tomography angiography (OCTA) and to compare it with multimodal imaging.Methods: In this prospective cohort study, patients with active tubercular SLC underwent OCTA using Optovue RTVue XR Avanti and other imaging techniques including enhanced-depth imaging OCT (EDI-OCT) (Heidelberg Spectralis; Heidelberg Engineering, Heidelberg, Germany), fundus autofluorescence, fluorescein angiography, and indocyanine green angiography. Serial imaging was performed for a total follow-up of 3 months. Choriocapillaris alterations at the site of lesions were analyzed on OCTA imaging, and their mean lesion areas were calculated.Results: Twenty-six eyes (26 patients; 20 males; mean age: 32.68 ± 10.56 years) were included. Fourteen eyes had active multifocal lesions (n = 39), whereas 12 eyes had active placoid lesions (n = 12). At baseline, OCTA showed hyporeflective flow deficit lesions corresponding to the hypofluorescent lesions on indocyanine green angiography in all eyes. In the multifocal type of SLC, the mean lesion area decreased in all eyes compared with baseline, and lesions with a lesion area less than 0.1 mm 2 on OCTA showed near-complete resolution with minimal choriocapillaris atrophy. In comparison, all eyes with a placoid type of SLC showed no significant reduction in the lesion area and showed extensive choriocapillaris atrophy.Conclusion: Optical coherence tomography angiography has the unique ability to demonstrate pathological flow impairment at the level of choriocapillaris in active tubercular SLC. Serial OCTA analysis reveals that large tubercular SLC lesions result in choriocapillaris atrophy as the lesions heal, whereas smaller multifocal lesions show resolution of choriocapillaris hypoperfusion with minimal atrophy.

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“…The authors observed a good correlation between the two imaging tools in detection of active lesions (Figure 8). Similarly, Nagpal et al 59 have utilized panoramic OCTA in evaluating eyes with TB SLC, and observed flow deficit areas which correlated with hypofluorescent areas on ICGA. During the healing stage, the authors observed residual unmasked choriocapillaris that corresponded to reduced hypofluorescence on ICGA.…”

Section: Flow Deficit Areas In Choroiditismentioning

confidence: 93%

Imaging in Tubercular Choroiditis: Current Concepts

Agarwal

Invernizzi

Markan

et al. 2020

Ocular Immunology and Inflammation

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Purpose: Ocular tuberculosis has protean clinical manifestations. Because of its varied clinical presentation, multimodal imaging is essential to characterize the disease activity, presence of inflammation, determining therapeutic response, and detection of complications. Methods: Narrative reviewResults: In this review, various imaging modalities employed in the management of ocular tuberculosis including fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) have been reviewed. Not only do these imaging tools complement each other in providing a comprehensive assessment of the pathology, they also help in gaining valuable insights regarding the evolution of the disease.Conclusions: Fundus imaging plays a vital role in the diagnosis and management of patients with posterior uveitis due to tuberculosis. Fundus imaging may have a useful role in defining clinical endpoints for ocular tuberculosis in the future.

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Correlation of “Panoramic” Optical Coherence Tomography Angiography With Indocyanine Green Angiography Characteristics of Serpiginous-Like Choroiditis

Cited by 9 publications

References 14 publications

Optical coherence tomography angiography (OCTA) as a new diagnostic tool in uveitis

Optical coherence tomography angiography (OCTA) as a new diagnostic tool in uveitis

Longitudinal Follow-Up of Tubercular Serpiginous-Like Choroiditis Using Optical Coherence Tomography Angiography

Imaging in Tubercular Choroiditis: Current Concepts

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