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Shilpa Kodati, Marib Akanda, Sapna Gangaputra, H Nida Sen; Qualitative and Automated Quantitative analysis of the Choriocapillaris on OCTA in Uveitis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2168.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the choriocapillaris (CC) in patients with uveitis using Optical Coherence Tomography Angiography (OCTA), including comparing CC flow voids on OCTA with areas of hypocyanescence on indocyanine angiography (ICGA), and deriving an automated quantitative method of determining total CC flow void area on OCTA.
In order to assess if the CC flow voids on OCTA correlate with (ICGA) we conducted a retrospective review of uveitis patients with CC involving flow voids and compared these flow deficits to hypocyanescent areas on ICGA. On patients with follow-up OCTA scans, automated quantitative analysis of the CC flow voids was performed using Image J software. Intervisit variability was minimized through standardization of images prior to analysis. After determination of a threshold intensity value, the total areas of CC flow void were calculated (in mm2) using Image J.
10 patients (15 eyes) were identified (mean age 36.5 years; 6 female and 4 male), which included 5 patients with Ampiginous choroiditis (AC), 2 with Serpiginous choroiditis (SC) and 3 with either infectious or non-infectious chorioretinitis (CR). 6/10 patients had either a new diagnosis or active disease. In 9/10 patients, the areas of CC flow voids correlated well with areas of hypocyanescence on ICGA. In the remaining 1 patient, small areas of flow deficits were visualized with OCTA but not apparent on ICGA. Automated quantitative analysis of total flow void area was performed on 7 eyes from 4 patients (2 AC, 1 SC, 1 CR) with 2 or more follow-up OCTA scans. Of these 4 patients, the 2 with active disease had a reduction (mean 79.1%; range 53.6%-95.3%) in total flow void area. Of the 2 patients with clinically inactive disease and clinically unchanged disease status on follow-up, the mean percentage difference in flow deficits between 2 consecutive visits was 15.6% (range 10.3-23.7%).
Given that CC flow voids detected on OCTA were comparable to areas of hypocyanescence on ICGA, our results suggest that OCTA can be an effective method to visualize the choriocapillaris in uveitis. Furthermore, automated quantitative analysis of CC flow deficits on OCTA can be useful and non-invasive method to help monitor disease activity as well as the response to therapy. Longitudinal studies to validate this correlation are underway.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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