Abstract
Purpose :
Sarcoidosis can present with sub-clinical choroidal pathology visible on indocyanine green angiography, the gold standard for choroidal imaging. Swept-source optical coherence tomography angiography (SS-OCTA) has deeper penetration into the choroid which allows for detailed images of the choroidal vasculature without the use of injectable dyes. This study hypothesizes that SS-OCTA can serve as a screening tool for choroidal pathology in patients with pulmonary sarcoidosis without other signs of ocular inflammation.
Methods :
Patients with pulmonary sarcoidosis diagnosed clinically either by characteristic chest CT findings or transbronchial biopsy were imaged prospectively using SS-OCTA (Zeiss PLEX Elite 9000, Zeiss, Inc., Dublin,CA). SS-OCTA images were examined for the presence of choroidal flow abnormalities in the choriocapillaris and choroidal en-face images in correspondence to structural B-scan signal abnormalities. Imaging findings were then compared to clinical eye exam records.
Results :
78 eyes of 39 patients with pulmonary sarcoidosis were evaluated. Of the 78 eyes, 33 (42.3%) demonstrated flow abnormalities on the en-face choriocapillaris or choroidal scan that corresponded to signal voids on structural B-scan. The appearance of choroidal lesions were classified as either clustered or scattered; 2 of the 33 eyes with flow abnormalities were characterized as having clustered lesion formation. Amongst the samples that had choroidal lesions, the mean number of flow abnormalities was 3.97 (1-15) per eye. 25 of the 33 eyes (75.8%) with choroidal pathology identified on SS-OCTA did not have evidence of uveitis or choroidal abnormalities on eye examination.
Conclusions :
SS-OCTA captures subclinical choroidal pathology in patients with diagnosed pulmonary sarcoidosis and may therefore demonstrate utility as a screening tool for uveitis in sarcoid patients. Additionally flow changes seen on SS-OCTA may provide a non-invasive marker of activity in those with systemic sarcoidosis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.