Relationship of Retinal Vascular Leakage and Higher Order Optical Coherence Tomography Segmentation Analysis with Visual Acuity in Uveitis Patients

Abstract

Purpose : Automated and semi-automated imaging based quantifications of inflammation can offer highly reliable and reproducible measures of ocular inflammation. In this study we evaluate the correlations of higher order optical coherence tomography (OCT) analysis and retinal vascular leakage with visual acuity (VA) in a prospective study.

Methods : This is an IRB approved prospective study of active uveitis patients receiving standard care of treatment. Wide field fluorescein angiography (FA) and OCT imaging is performed at baseline and multiple follow-up time-points. Retinal leakage index scores were calculated utilizing an automated algorithm. Leakage index scores included: 3 disc diameter (3DD) and 6 disc diameter (6DD) macula centered areas and total retinal (TR) area leakage. OCT measurements included central ellipsoid zone to RPE (EZ-RPE) volume, central subfield thickness (CST) and total retinal fluid index (TRFI) – a measure of intraretinal and subretinal fluid divided by total retinal volume. Spearman’s correlation was utilized to correlate changes in these scores with logMAR VA.

Results : A total of 42 patients were included in the analysis. At baseline, increases in TRFI (r=0.40; p=0.00034), TR leakage (r=0.48; p=1.2E-05), 3DD leakage (r=0.62; p=3.4E-09) and 6DD leakage (r=0.44; p=7.6E-05) were significantly associated with reduced VA. 3DD leakage positively correlated with increased TRFI (r=0.36; p=0.0026) and CST (r=0.28; p=0.025). 6DD leakage positively correlated with increased TRFI (r=0.29; p=0.018) and CST (r=0.43; p=0.00035). TR leakage positively correlated with increased TRFI (r=0.33; p=0.0063) and CST (r=0.50; p=1.7E-05).

When including all follow-up time-points, poorer VA correlated with an increase in TRFI (r=0.40; p=8.6E-13), TR leakage (r=0.26; p=3.1E-05), 3DD leakage (r=0.44; p=7.9E-13) and 6DD leakage (r=0.29; p=3.0E-06). VA negatively correlated with EZ-RPE central subfield volume (r=-0.15; r=0.011) and EZ-RPE volume (r=-0.12; p=0.045).

Conclusions : At baseline and follow-up, reduced VA correlated with increased TRFI, retinal thickness, 3DD and 6DD leakage and TR leakage as measured using automated and semi-automated quantification software. TRFI correlated with retinal leakage indices. Parameters of inflammation quantified using an automated algorithm correlate with VA and can be a useful adjunct in following uveitis patients.

This is a 2020 ARVO Annual Meeting abstract.