Superficial and deep retinal foveal avascular zone OCTA findings of non-infectious anterior and posterior uveitis

Waizel, Maria della Volpe; Todorova, Margarita G.; Terrada, C.; Lehoang, P.; Massamba, Nathalie; Bodaghi, Bahram

doi:10.1007/s00417-018-4057-y

Cited by 29 publications

(17 citation statements)

References 17 publications

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“…Interestingly, lower V-SO 2 values have also been mentioned in autosomal recessive mode of inheritance in inherited macular dystrophies and more specifically those with STGD phenotype (Bojinova et al 2017). Thus, primarily vascular damages seem to be a characteristic feature for STGD rather than RP which did not present with significant enlargement neither of the superficial, nor the deep foveal avascular zones when excluding patients with macular oedema in order to avoid a strong bias in OCTA analyses (Waizel et al 2018b).…”

Section: Discussionmentioning

confidence: 94%

Microvascular and metabolic alterations in retinitis pigmentosa and Stargardt disease

Waizel

Scholl

Todorova

2021

Acta Ophthalmologica

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Purpose: The aim of our study was to evaluate retinal microvascular changes recorded with optical coherence tomography angiography (OCTA) and the metabolic function measured with retinal oximetry (RO) in patients with retinitis pigmentosa (RP) and Stargardt disease (STGD). Methods: In this prospective, noninterventional study, OCTA and RO were performed on 107 eyes (56 subjects): 53 eyes diagnosed with RP without the presence of macular oedema (no-ME-RP), 26 eyes with STGD, and 28 control eyes. Main outcome measures were the mean superficial (FAZ-S; mm 2 ) and deep foveal avascular zone (FAZ-D; mm 2 ) measured with OCTA as well as the mean arterial (A-SO 2 ; %), venular (V-SO 2 ; %) oxygen saturation, their difference (A-V SO 2 ; %) and the corresponding mean diameters of the peripapillary retinal arterioles (D-A; lm) and venules (D-V; lm) determined with RO. Results: Stargardt disease (STGD) patients differed from controls and no-ME-RP by an enlarged FAZ-S and reduced A-SO 2 and V-SO 2 (p ≤ 0.013). No-ME-RP eyes presented with attenuated vessels (p < 0.001) and increased A-SO 2 and V-SO 2 (p ≤ 0.012) compared to controls and STGD. The FAZ-D showed significant interactions with A-SO 2 (p = 0.003) in no-ME-RP while the FAZ-S correlated with visual acuity in no-ME-RP (p = 0.007) and STGD (p = 0.034). Conclusion: Retinitis pigmentosa (RP) and Stargardt disease (STGD) patients suffer from microvascular and metabolic alterations, however, showing a different pattern. A combined microvascular-metabolic model may therefore allow to more precisely characterize RP and STGD as well as presumably other inherited retinal diseases.

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Section: Discussionmentioning

confidence: 94%

Microvascular and metabolic alterations in retinitis pigmentosa and Stargardt disease

Waizel

Scholl

Todorova

2021

Acta Ophthalmologica

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“…In addition, retinal atrophy can occur as a common consequence of retinal capillary dropout. While retinal capillary dropout is a common sequel of retinal vasculitis, it can also occur in cases without obvious presence of retinal vasculitis, for example, in intermediate uveitis [38, 129, 140]. In addition, quantification of the microcirculation in the peripapillary area by OCT-A may be a useful indicator for capillary insufficiency and impairment of ocular blood flow as a long-term complication from inflammation [141].…”

Section: Methodsmentioning

confidence: 99%

Structural Endpoints and Outcome Measures in Uveitis

et al. 2021

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Most uveitis entities are rare diseases but, taken together, are responsible for 5–10% of worldwide visual impairment which largely affects persons of working age. As with many rare diseases, there is a lack of high-level evidence regarding its clinical management, partly due to a dearth of reliable and objective quantitative endpoints for clinical trials. This review provides an overview of available structural outcome measures for uveitis disease activity and damage in an anatomical order from the anterior to the posterior segment of the eye. While there is a multitude of available structural outcome measures, not all might qualify as endpoints for clinical uveitis trials, and thorough testing of applicability is warranted. Furthermore, a consensus on endpoint definition, standardization, and “core outcomes” is required. As stipulated by regulatory agencies, endpoints should be precisely defined, clinically important, internally consistent, reliable, responsive to treatment, and relevant for the respective subtype of uveitis. Out of all modalities used for assessment of the reviewed structural outcome measures, optical coherence tomography, color fundus photography, fundus autofluorescence, and fluorescein/indocyanine green angiography represent current “core modalities” for reliable and objective quantification of uveitis outcome measures, based on their practical availability and the evidence provided so far.

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“…A prospective observational OCTA study including 74 eyes separated into five groups (posterior uveitis with or without ME, anterior uveitis with or without ME, and healthy controls) showed that, when compared to healthy controls, eyes with non-infectious posterior uveitis with or without ME had a significantly larger deep foveolar avascular zone, and eyes with anterior uveitis and ME had a significantly larger deep and superficial foveolar avascular zone [58]. A possible explanation for these findings might be a peripheral displacement of retinal capillaries as a result of the formation of cystoid spaces or cysts, preferentially leading to non-perfusion areas [58].…”

Section: About the Implementation Of Optical Coherence Tomography Angmentioning

confidence: 99%

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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Superficial and deep retinal foveal avascular zone OCTA findings of non-infectious anterior and posterior uveitis

Abstract: The deep retinal foveal avascular zone seems to be enlarged in eyes presenting with non-infectious posterior uveitis, both in the presence or absence of macular edema.

Cited by 29 publications

References 17 publications

Microvascular and metabolic alterations in retinitis pigmentosa and Stargardt disease

Microvascular and metabolic alterations in retinitis pigmentosa and Stargardt disease

Structural Endpoints and Outcome Measures in Uveitis

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

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