April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Peripheral vasculitis, ischemia and vascular leakage in uveitis as evaluated by ultra widefield fluorescein angiography
Author Affiliations & Notes
  • Colin J Chu
    UCL Institute of Ophthalmology, London, United Kingdom
    Moorfields Eye Hospital, London, United Kingdom
  • Dawn A Sim
    UCL Institute of Ophthalmology, London, United Kingdom
    NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
  • Michael Karampelas
    Moorfields Eye Hospital, London, United Kingdom
  • Ester Carreno
    Moorfields Eye Hospital, London, United Kingdom
  • Pearse Andrew Keane
    NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
  • Catherine A Egan
    Moorfields Eye Hospital, London, United Kingdom
  • Adnan Tufail
    NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
  • Richard W J Lee
    NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
  • Mark C Westcott
    Moorfields Eye Hospital, London, United Kingdom
  • Carlos E Pavesio
    Moorfields Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships Colin Chu, None; Dawn Sim, None; Michael Karampelas, None; Ester Carreno, None; Pearse Keane, None; Catherine Egan, None; Adnan Tufail, None; Richard Lee, None; Mark Westcott, None; Carlos Pavesio, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5290. doi:https://doi.org/
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      Colin J Chu, Dawn A Sim, Michael Karampelas, Ester Carreno, Pearse Andrew Keane, Catherine A Egan, Adnan Tufail, Richard W J Lee, Mark C Westcott, Carlos E Pavesio; Peripheral vasculitis, ischemia and vascular leakage in uveitis as evaluated by ultra widefield fluorescein angiography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5290. doi: https://doi.org/.

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

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Abstract

Purpose: To investigate the prevalence and relationships of peripheral vasculitis, ischemia, and vascular leakage in uveitis using ultra widefield fluorescein angiography (uwFA).

Methods: Consecutive uwFA images were collected from patients with uveitis over a 12-month period. The extent of peripheral vasculitis, capillary non perfusion and leakage were quantified. Parameters quantified included (1) vasculitis- the length of vascular segment affected, (2) capillary non perfusion- foveal avascular zone (FAZ) area, peripheral ischemic index, and (3) peripheral vascular index from (i) “diffuse leakage” i.e. from existing retinal arteries, veins and capillaries, or (ii) leakage from neovascularisation. Optical coherence tomography scans at the foveal centre subfield were used to derive central macular thickness (CMT).

Results: 82 eyes from 82 patients were included. 38 (46.3%) had a diagnosis of idiopathic uveitis, 26 (31.7%) tuberculosis, 7 (8.5%) sarcoidosis, and the remaining 11 (13.4%) from other causes. 29/82 (35.4%) of patients had peripheral ischemia, 38/82 (46.3%) peripheral leakage, and 24/82 (29.3%) peripheral vasculitis. In all patients, the extent of peripheral ischemia was correlated to CMT (r=0.37, p=0.006) and the peripheral vasculitis index (r=0.45, p=0.0001). An association was also observed between the peripheral vasculitis index and CMT (r=0.30, p=0.03). No relationships were observed between peripheral ischemia and leakage. Stepwise multiple regression analysis revealed that a poor visual acuity was independently associated with peripheral ischemia and FAZ size (R2-adjusted=0.41, p=0.0001) but not with CMT, peripheral leakage or vasculitis.

Conclusions: The relationships between peripheral vascular pathology and visual function in uveitis are not well understood. We present the largest reported cohort of patients with uveitis, imaged using uwFA and describe novel methods for characterization of peripheral vascular pathology, in an attempt to identify visually significant parameters, not possible with conventional fluorescein angiography.

Keywords: 550 imaging/image analysis: clinical • 746 uveitis-clinical/animal model • 464 clinical (human) or epidemiologic studies: risk factor assessment  
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