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Non-invasive method of monitoring retinal vasculitis in patients with birdshot chorioretinopathy using optical coherence tomography
  1. Jared E Knickelbein,
  2. William Tucker,
  3. Shilpa Kodati,
  4. Marib Akanda,
  5. H Nida Sen
  1. National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA
  1. Correspondence to Dr H Nida Sen, Laboratory of Immunology National Eye Institute, NIH 10 Center Dr, 10/10 109 Bethesda, MD 20892, USA; senh{at}


Background/aims To investigate the utility of using montaged optical coherence tomography (OCT) thickness maps to monitor perivascular thickness as a marker of vasculitic activity in patients with large-vessel retinal vasculitis.

Methods This is a retrospective cohort study of 22 eyes of 11 patients with a history of retinal vasculitis associated with birdshot chorioretinopathy (BCR). Patients had serial spectral domain 6×6 mm cube OCT scans centred on the fovea, optic nerve and proximal branches of the superior and inferior retinal vessels. OCT thickness change maps for each respective region were analysed. Changes in perivascular thickness were confirmed by assessing vasculitic activity on fluorescein angiography (FA), when clinically indicated.

Results In three patients, montaged OCT scans were acquired at diagnosis and serially through initial treatment. In all three patients, montaged OCT demonstrated reduced perivascular thickening with oral prednisone treatment, which was confirmed by FA showing reduced vascular leakage in both eyes. Eight patients had serial montaged OCT scans after diagnosis and initial treatment of BCR. Four of these patients showed fluctuations in perivascular thickness during flares and treatment that were confirmed by either increased or decreased vascular leakage on FA. The other four patients remained quiet on their immunosuppressive treatment regimens, and no changes in perivascular thickness were detected.

Conclusions Evaluating large-vessel perivascular thickness on OCT scans may be a useful method for non-invasively monitoring posterior pole large-vessel retinal vasculitis.

  • birdshot chorioretinopathy
  • fluorescein angiography
  • optical coherence tomography
  • retinal vasculitis

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  • JEK and WT contributed equally.

  • Contributors JEK, WT and HNS designed the study. JEK and WT collected the data. JEK, WT, SK, MA and HNS analysed the data. JEK drafted the manuscript, and all authors critically reviewed and approved the manuscript.

  • Funding This work was supported by the National Eye Institute Intramural Research Program, National Institutes of Health.

  • Competing interests None declared.

  • Ethics approval National Eye Institute, National Institutes of Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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