Evaluation of retinal microvasculature in uveitic macular edema using Optical Coherence Tomography Angiography.

Abstract

 

Purpose

 

To evaluate the retinal microvasculature in eyes with uveitic macular edema using optical coherence tomography (OCT) angiography

 

Methods

 

OCT angiography images (AngioVue, Optovue) were acquired within a 3x3mm area in the central macula from patients with intermediate uveitis and divided into three groups: active, resolved, and no macular edema. The flow imaging was based on split-spectrum amplitude decorrelation angiography (SSADA), which assesses the vasculature in distinct layers of the retina. The layers assessed were the superficial retinal vascular plexus, deep retinal vascular plexus, avascular outer retina, and choriocapillaris

 

Results

 

25 eyes from 14 patients were included: 8 eyes had active macular edema, 5 resolved macular edema, and 12 no macular edema. Differences within the parafoveal vasculature were observed in eyes with active and resolved macular edema compared to uveitic eyes without macular edema. In eyes with active or resolved macular edema, there was a loss of the normal tapering of vessels feeding the macular area from the temporal vascular arcade. These vessels also appeared more irregular and tortuous compared to uveitic eyes without macular edema. Furthermore, a reduction of capillary density was observed in both superficial and deep retinal vascular plexus. Examination of the choriocapillaris in eyes with macular edema was precluded by the masking effect of the retinal cysts.

 

Conclusions

 

In this case series, we have observed changes in both superficial and deep vascular plexus layers in eyes with both active and resolved uveitic macular edema.<br /> OCT angiography can not only detect the presence of macular ischemia but may also be a useful tool for the management of patients with intermediate uveitis.  

 

Superficial and deep vascular plexus OCT angiography showing tortuous and irregular vessels with reduction in capillary density in eye with uveitic macular oedema

 

 

Superficial and deep vascular plexus OCT angiography in uveitic eye with healthy macula