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Marie-Helene Errera, Solene Coisy, Christine Fardeau, Jose-Alain Sahel, Sofiene Kallel, Mark Westcott, Bahram Bodaghi, Michel Paques; Prospective follow-up study of the course of retinal vasculitis by adaptive optics imaging.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1654.
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To document retinal vasculitis using flood illumination adaptive optics (AO) 1/ throughout natural course of the disease or 2/ before and after the course of treatment.
Prospective case series. Six subjects with retinal vasculitis identified by clinical examination and fluorescein angiography. Diagnoses included: ocular syphilis (n=2), ocular sarcoidosis (n=1), Birdshot choroidopathy (n=1), idiopathic retinitis, vasculitis, aneurysm and neuroretinitis (IRVAN) syndrome (n=1), idiopathic vasculitis (n=1). The testings performed were: standard ophthalmological examination, color fundus photographs, fluorescein angiography, and AO infrared flood-imaging (rtx1 camera, ImagineEye, Orsay, France). The main outcome measure was the identification by AO imaging of perivascular opacification suggestive of retinal vasculitis.
By AO imaging, well demarcated linear areas of opacification on both sides of veins, 20-100µm wide, up to several millimeters long, were found, often surrounding focal venous narrowing. These could be detected even in areas showing no changes by fluorescein angiography. Follow-up examinations over 3 to 6 months documented changes of infiltrates and of venous narrowing, in accordance with the level of clinical inflammation. A striking feature was the variation of the topography of inflammatory venous narrowing. In the IRVAN case, perivascular infiltrates were noted along both arteries and veins, which remained stable over 6 months.
AO may be of interest for monitoring non invasively perivascular inflammation in eyes with uveitis. It may also be useful for assessing the presence of vasculitis in systemic non ocular diseases, given its high sensitivity. Several biomarkers such as venous narrowing or width of perivascular inflammation may be of interest for the follow-up of patients.
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