Optical coherence tomography diagnostic signs in posterior uveitis

Pichi, Francesco; Invernizzi, Alessandro; Tucker, William R; Munk, Marion R.

doi:10.1016/j.preteyeres.2019.100797

Cited by 44 publications

(38 citation statements)

References 223 publications

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“…Cells in the vitreous result from inflammation, hemorrhage or a neoplastic process. [3,5,6] Strikingly, in two participants OCT scans prior to their COVID-19 illness showed no evidence of inflammation in the vitreous, while their scans after COVID-19 showed hyperreflective foci, strongly suggesting that even ambulatory COVID-19 may lead to inflammatory cells persisting in the eye up to 1 month after recovery. Persons who felt that their recovery was incomplete had more cells, which likely suggests residual inflammation elsewhere.…”

Section: Discussionmentioning

confidence: 96%

Subclinical ocular inflammation in persons recovered from ambulatory COVID-19

Bakhoum

Ritter

Garg

et al. 2020

Preprint

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Coronavirus disease 2019 (COVID-19) is characterized by striking variability in clinical severity, and a hyperinflammatory response in the lung is associated with high mortality. Little is known about the extent and duration of inflammation in persons recovering from COVID-19. Here, we used spectral domain optical coherence tomography (SD-OCT) to detect the presence of inflammatory cells in the vitreous cavity, an immune-privileged microenvironment, in persons recovered from COVID- 19. Our results provide quasi-histologic evidence that neuroinflammation is present in persons who recovered from COVID-19, only one of whom required hospitalization. Our results also suggest that persons who feel that their recovery is incomplete have evidence of subclinical eye inflammation, which may be a marker of residual inflammation elsewhere as well.

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Section: Discussionmentioning

confidence: 96%

Subclinical ocular inflammation in persons recovered from ambulatory COVID-19

Bakhoum

Ritter

Garg

et al. 2020

Preprint

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“…During the acute phase, multiple hyperreflective dots are seen in the vitreous cavity. Other findings include posterior hyaloid thickening and subsequent separation and migration of inflammatory cells into the vitreous and spherical deposits that appear along the retinal vessels [24,27]. During the active disease stages, the choroid is also characterized by focal thickening and loss of the physiologic architecture and becomes homogenously hyporeflective.…”

Section: Discussionmentioning

confidence: 99%

“…During the active disease stages, the choroid is also characterized by focal thickening and loss of the physiologic architecture and becomes homogenously hyporeflective. The technology allows differentiation of the toxoplasmic foci of necrotizing retinitis from those with a viral etiology that are characterized by a normal-appearing choroid [ 27 ]. In the current study, choroidal thickening during the active phase was seen in 80% of patients, and evolution to choroidal thinning was seen in all patients after resolution of the disease.…”

Section: Discussionmentioning

confidence: 99%

New findings useful for clinical practice using swept-source optical coherence tomography angiography in the follow-up of active ocular toxoplasmosis

et al. 2020

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Background: Ocular toxoplasmosis is one of the most common causes of intraocular inflammation and posterior uveitis in immunocompetent patients. This paper aims to investigate swept-source optical coherence tomography angiography (SS-OCTA) findings in eyes with active toxoplasmic retinochoroiditis. Methods: This case series was conducted from November 2017 through October 2019 in two Brazilian centers. 15 eyes of 15 patients with active toxoplasmic retinochoroiditis were included, and were imaged at baseline and after at least 4 weeks of follow-up. All patients underwent ophthalmic examinations and multimodal imaging including SS-OCT and SS-OCTA before and after treatment of ocular toxoplasmosis. The differential diagnoses included toxoplasmosis, syphilis, and human immunodeficiency virus, which were eliminated through serologic and clinical evaluations. Results: All 15 patients presented with positive anti-Toxoplasma gondii immunoglobulin G titers and three also presented with positive anti-T. gondii immunoglobulin M titers. The mean age at examination was 32.4 years ± 12.7 years (range 15-59 years). Sixty percent of the patients were female. In all eyes, the inner retinal layers were abnormally hyperreflective with full-thickness disorganization of the retinal reflective layers at the site of the active toxoplasmic retinochoroiditis. At baseline, 80% of eyes had focal choroidal thickening beneath the retinitis area, and all eyes had a choroidal hyporeflective signal. Before treatment, SS-OCTA showed no OCTA decorrelation signal next to the lesion site in all eyes, and flow signal improvement was noticed after treatment. Three eyes presented with intraretinal vascular abnormalities during follow-up. SS-OCTA showed retinal neovascularization in one patient and a presumed subclinical choroidal neovascular membrane in another patient. Conclusions: SS-OCT and SS-OCTA are useful for assessing unexpected structural and vascular retinal and choroidal changes in active and post-treatment toxoplasmic retinochoroiditis and these findings are useful for clinical practice.

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“…27 Although FA has been used traditionally to identify and monitor CNV in eyes with uveitis, OCTangiography (OCTA) appears to be more reliable as eyes with uveitis tend to show both leakage and staining of involved areas even in the absence of CNV. 1,2,[28][29][30][31][32][33][34][35][36][37] Most patients with iCNV respond well to a series of intravitreal anti-VEGF injections, commonly in conjunction with regional or short-term systemic corticosteroids. Longer-term systemic immunosuppression has been employed successfully in eyes with frequent recurrences.…”

mentioning

confidence: 99%