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Alejandra Maiz, Minhaj Nur Alam, Priyanka Doctor, Ann-Marie Lobo, Yannek Leiderman, Jennifer I Lim, Xincheng Yao, Pooja Bhat; Quantitative Analysis of OCT Angiography findings in Birdshot Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4204.
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Purpose: Birdshot chorioretinopathy (BSCR) is an inflammatory white dot syndrome, affecting the retina and choroid, with a chronic, insidious course. OCT angiography (OCTA) is a non-invasive imaging modality that provides details of the retinal capillary plexuses in 3-dimensions. The purpose of this study was to quantify changes in retinal vascular microstructure of patients with BSCR compared with controls and evaluate changes with respect to disease duration.
Methods: 16 eyes of 8 patients with BSCR were compared with 13 eyes of 7 age-matched controls, using 3 x 3 mm obtained from OCTA. The vascular density (VD), avascular region (AvR) and gray zone (GZ) within superficial vascular plexus (SVP) and deep vascular plexus (DVP) were analyzed as was the blood vessel tortuosity and foveal avascular zone (FAZ) area within SVP. Correlation of these parameters with disease duration was performed.
Results: There were 6 female and 2 male BSCR patients with an average age of 61.3 yrs and average disease duration of 7.6 + 5.02 years. All patients were treated with systemic immunosuppressive drugs and 2 had active disease. The average VD, AvR, and GZ area in the SVP of patients was 54.8 + 2.6, 20.3 + 3.5 and 24.8 + 0.9 and in controls was 63.6 + 1.8, 15.1 + 1.4 and 21.1 + 0.7. Differences within the VD and AvR area were significant (p<0.05). The average VD, AvR and GZ area within the DVP of patients was 53.4 + 4.3, 18.1 + 5.5 and 28.4 + 4.5 while in controls was 64.3 + 1.2, 12.5 + 0.7 and 23.1 + 0.4. Differences within the VD and AvR in the central zone of DVP were significant (p=0.005; p<0.001). Statistically significant (p<0.0001) difference was found in the average vessel tortuosity in the SVP within patients (9.4 + 1.56) and controls (7.34 + 0.78). Difference in the FAZ area within patients (0.26 + 0.01) and controls (0.19 + 0.05) was significant (p<0.0001). Co-relation analysis with disease duration revealed decreased VD and increase in tortuosity with increased duration of the disease.
Conclusion: Our results reveal significant decrease in the VD and AvR in SVP as well as DVP in patients with BSCR. Vascular tortuosity and FAZ area were increased compared with controls. VD decreased whereas tortuosity increased with longer duration of the disease. These parameters may serve as biomarkers of low-grade continuing activity in the absence of clinical signs and guide treatment decisions.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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