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Torrey Guan, Arthi Venkat, Kimberly Baynes, Emily Fisher, Ashley Balascoe, Jennifer Welsh, Peter K Kaiser, Sunil K Srivastava, Sumit Sharma; Swept-source Optical Coherence Tomography Angiography Detection of Flow Abnormalities in Patients with Pulmonary Sarcoidosis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4571. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
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.
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