Abstract
Purpose:
The aim of this clinical case series is to describe the choroid with swept-source OCT (SS-OCT) technology in patients with ocular inflammation and to determine possible signs of infra-clinical reactivation.
Methods:
The charts of consecutive patients with intraocular inflammatory disorders, managed between may and june 2013 at Pitie-Salpetriere Hospital, have been reviewed. A choroidal map with SS-OCT, using 12-mm horizontal vertical scans through the macula was performed in all cases.
Results:
We included 20 patients with an average age of 55 years (40-84) and a M/F ratio of 0.82. Most of cases were posterior with 7 birdshot retinochoroidopathies (BRC), 3 Behçet's diseases (BD), 2 multifocal choroiditis (MFC), 1 Vogt-Koyanagi-Harada (VKH) disease, 1 acute syphilitic posterior placoid chorioretinitis, 2 ARN syndromes. Four anterior cases were also analyzed. The average choroidal thicknesss (CT) in active and inactive BRC was 280 µm and 247 µm, respectively with a maximum CT decrease of 30 µm immediately after therapeutic initiation. The lowest CT value of 194 µm was found in an advanced atrophic form of BRC associated with a discrete dashed line square. The average retinal thickness (RT) was decreased to 210 µm. CT and RT in 3 BD were decreased to 292 µm and 180 µm. Their low visual acuity was caused by a loss of IS/OS line. CT of the 2 ARN syndromes was decreased to 270 and 210 µm. The maximum CT difference between healthy and affected eyes was 110 µm. In 2 MFC, one patient had an increased CT of 307µm and one patient had a thin CT of 111µm with a minor dashed line square. In the VKH patient CT was unchanged in both eyes. There was a significant asymmetry in the patient with syphilitic placoid chorioretinitis, with a choroidal thickness of 334 µm in the affected eye vs 387 µm in the contralateral eye. CT was increased in a case of sarcoidosic intermediate uveitis while it was normal in cases of anterior uveitis.
Conclusions:
Choroidal mapping shows increased CT compared to the controlateral unaffected eye and the same eye after anti-inflammatory treatment as a sign of activity in most cases of this series (BRC, BD or CMF). These cases may have a poor prognosis with further choroidal atrophy. A comparative prospective study of choroidal thickness before and after treatment may complete these preliminary findings.
Keywords: 452 choroid •
550 imaging/image analysis: clinical •
746 uveitis-clinical/animal model