July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Three dimensional analysis of SS-OCTA choroidal flow voids and correlation with indocyanine green angiography in patients with birdshot chorioretinopathy
Author Affiliations & Notes
  • Kathryn Pepple
    University of Washington, Seattle, Washington, United States
  • Zhongdi Chu
    University of Washington, Seattle, Washington, United States
  • Jessica Weinstein
    University of Washington, Seattle, Washington, United States
  • Russell Van Gelder
    University of Washington, Seattle, Washington, United States
  • Ruikang K Wang
    University of Washington, Seattle, Washington, United States
  • Footnotes
    Commercial Relationships   Kathryn Pepple, None; Zhongdi Chu, None; Jessica Weinstein, None; Russell Van Gelder, None; Ruikang Wang, Carl Zeiss Meditech (P), Carl Zeiss Meditech (C)
  • Footnotes
    Support  NEIK08EY0123998, Research to Prevent Blindness
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1531. doi:
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      Kathryn Pepple, Zhongdi Chu, Jessica Weinstein, Russell Van Gelder, Ruikang K Wang; Three dimensional analysis of SS-OCTA choroidal flow voids and correlation with indocyanine green angiography in patients with birdshot chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1531.

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

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Abstract

Purpose : To compare swept-source optical coherence tomography angiography (SS-OCTA) and indocyanine green angiography (ICGA) for detection of choriocapillaris and choroid lesions in acute and chronic Birdshot chorioretinopathy (BSCR).

Methods : SS-OCTA images were acquired using the PlexEliteTM 9000. Montage scans were achieved by scanning 16 6x6 cubes or 5 12x12 cubes. Both 6x6 and 12x12 scans contained 500 A-lines x 500 B-scan locations with 2 repeated B-scans at each fixed location. Choriocapillaris (CC), choroid (Ch), Sattler’s layer (SL), and Haller’s layer (HL) segmentation was defined in relationship to the retinal pigment epithelium (RPE) best fit. After segmentation, sum projection method was utilized for both flow and structure slabs to generate en face images. compared to OptosICGA images. Images obtained both before and after initiation of immune modulation therapy were compared. SS-OCTA and ICGA were performed before and after initiation of corticosteroid therapy. Lesions identified as focal spots of hypocyanescence in late ICGA frames were correlated to flow voids in one or more choroidal layers by en face analysis.

Results : 4 eyes of 2 patients with BSCR were imaged, one with acute onset disease, one with chronic disease. These images were compared to age matched normal controls. In the acute disease patient, choroidal lesions identified by ICGA correlated with flow voids in the deep choroid (Haller’s layer), and flow voids were not identified in choriocapillaris. After treatment with corticosteroids, the ICGA lesions resolved and SS-OCTA flow voids decreased in number and area. In the patient with chronic BSCR, choroidal lesions identified by ICGA correlated with flow voids impacting all layers of the choroid including CC, SL, and HL. These lesions did not change over time.

Conclusions : SS-OCTA identifies the same BSCR lesions as ICGA, the gold standard, and provides the additional depth information of the location of the flow void within the choroid. SS-OCTA represents a promising and non-invasive option for identification and monitoring of choroidal disease activity in patients with BSCR.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

En face imaging of a patient with chronic BSCR.

En face imaging of a patient with chronic BSCR.

 

Three dimensional analysis of acute BSCR pre- and post-treatment.

Three dimensional analysis of acute BSCR pre- and post-treatment.

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