June 2015
Volume 56, Issue 7
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ARVO Annual Meeting Abstract  |   June 2015
Assessment of Macular Circulation in Patients With Retinal Vasculitis using OCT Angiography
Author Affiliations & Notes
  • Rasanamar Sandhu
    Casey Eye Institute, Oregon Health Sciences University, Portland, OR
  • Yali Jia
    Casey Eye Institute, Oregon Health Sciences University, Portland, OR
  • Liang Liu
    Casey Eye Institute, Oregon Health Sciences University, Portland, OR
  • Neal V Palejwala
    Casey Eye Institute, Oregon Health Sciences University, Portland, OR
  • Eric B Suhler
    Casey Eye Institute, Oregon Health Sciences University, Portland, OR
  • Thomas S Hwang
    Casey Eye Institute, Oregon Health Sciences University, Portland, OR
  • David Huang
    Casey Eye Institute, Oregon Health Sciences University, Portland, OR
  • Phoebe Lin
    Casey Eye Institute, Oregon Health Sciences University, Portland, OR
  • Footnotes
    Commercial Relationships Rasanamar Sandhu, None; Yali Jia, Optovue, Inc. (F), Optovue, Inc. (P); Liang Liu, None; Neal Palejwala, None; Eric Suhler, None; Thomas Hwang, None; David Huang, Carl Zeiss Meditec, Inc (P), Optovue, Inc. (F), Optovue, Inc. (I), Optovue, Inc. (P); Phoebe Lin, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 3359. doi:
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      Rasanamar Sandhu, Yali Jia, Liang Liu, Neal V Palejwala, Eric B Suhler, Thomas S Hwang, David Huang, Phoebe Lin; Assessment of Macular Circulation in Patients With Retinal Vasculitis using OCT Angiography. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3359.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

A feature of OCT angiography is its ability to provide quantitative estimate of retinal blood flow by calculating vessel density. This study examines macular blood flow using OCT angiography in eyes with angiographically active retinal vasculitis compared to normal eyes.

 
Methods
 

Adult patient with retinal vasculitis were imaged with fluorescein angiography (FA) and OCT angiography with 70 kHz OCT, using the split-spectrum amplitude decorrelation angiography algorithm (SSADA). A 3 x 3 mm angiogram centered at the fovea was obtained by projecting the flow signal internal to the RPE in the en face orientation. Parafoveal vessel density was defined as percentage of pixels with detectable flow signal in a 1mm-wide ring surrounding the fovea (Fig. 1A). The choriocapillaris vessel density was calculated as a percentage of pixels with detectable flow signal within 10 microns external to the RPE in the 3x3mm area.

 
Results
 

5 patients (7 eyes) with angiographically active retinal vasculitis were included in the study. Their diagnoses included lupus retinal vasculitis with choroiditis, Bechet’s disease, TINU with retinal vasculits, sarcoidosis, and idiopathic retinal vasculitis. 11 normal eyes were drawn from a prevously compiled database. The average vessel density in normal eyes, in a 1mm wide parafoveal ring (Figure 1A), was 87.1% (95% CI 83.9-90.2). In eyes with retinal vasculitis, the average parafoveal vessel density (see Figure 1B for example) was significantly lower, at 79.8% (95% CI 76.3-83.4, p=0.006). We also imaged choroidal blood flow in the patient with lupus vasculitis and choroiditis. Her choriocapillaris vessel densities were 83.3% and 83.6% in the right and left eyes, respectively, compared to 96.3% (95%CI 94.0%-98.5%) in normal eyes (n=7).

 
Conclusions
 

Patients with retinal vasculitis have significantly lower parafoveal vessel density compared to normal eyes, as measured by OCT angiography. Lower parafoveal vessel density was noted even in patients who had only peripheral vasculitis on FA. This technique shows promise as a possible biomarker for determining disease activity, and gauging treatment response in patients with retinal vasculitis.  

 
Fig1A: OCT angiography of a normal eye. The circles demarcate the 1mm-wide parafoveal ring where vascular density was measured.
 
Fig1A: OCT angiography of a normal eye. The circles demarcate the 1mm-wide parafoveal ring where vascular density was measured.
 
 
Fig1B: OCT angiography of a patient with lupus retinal vasculitis, displaying lower parafoveal vascular density.
 
Fig1B: OCT angiography of a patient with lupus retinal vasculitis, displaying lower parafoveal vascular density.

 
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