Purpose To evaluate vascular changes in patients with intermediate uveitis with or without retinal vasculitis using swept-source wide-field optical coherence tomography angiography (OCTA).
Methods This 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.
Results 164 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).
Conclusion Changes 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 number NCT02811536.
- intermediate uveitis
- retinal vasculitis
- optical coherence tomography angiography (OCTA)
- fluorescein angiography
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Contributors MT: analysis of data, evaluation of data, writing the manuscript. TC: collecting data, critical review of the paper. MSZ: collecting data, evaluation of data, critical review of the paper. WH: statistical analysis, critical review of the paper. SW: financial support, collecting data, critical review of the paper. MRM: study design, analysis and evaluation of data, statistical analysis, critical review of the paper.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer MT: none. TC: consultant: AbbVie. WH: none. MRM: consultant: Novartis, Zeiss, GenSight Biologics and LumiThera; lecturer fees and travel support: Bayer. SW: consultant: Novartis, Zeiss, Heidelberg and Bayer. MSZ: consultant: Novartis, Heidelberg and Bayer; stocks: Novartis.
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval The study was approved by the University Clinic Bern IRB and followed the tenets of the Declaration of Helsinki.
Provenance and peer review Not commissioned; externally peer reviewed.
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