Abstract
Purpose :
To evaluate the use of the flow density map in Optical Coherence Tomography Angiography (OCT-A) in noninfectious uveitic macular edema.
Methods :
Prospective observational study of 11 consecutive uveitis patients, in 16 eyes with 19 disease episodes, measured with density flow OCT-A in the Topcon DRI OCT Triton plus at edema and at remission. Patient mean age and standard deviation (SD) was 39.1 (20.6) years, where 6/11 (55%) were females. Layers were measured with the built-in automatic software layer segmentation as superficial, deep, outer and choriocapillaris, regardless of edema configuration. Density values in the nasal, central, temporal, superior and inferior macular area were recorded. Main outcome measures were visual acuity (VA) at edema and remission, OCT central retinal thickness (CRT) decrease and difference in layer density OCT-A flow at edema and remission. Mean (SD), median and interquartile range (IQR) as well as Wilcoxon rank sum and rank sum exact test was computed.
Results :
The mean (SD) duration of uveitis disease at edema was 7.9 (6.8) years. The uveitis was anterior in 4/11 (36%) and intermediate in 7/11 (64%), where onset was sudden in 5/11 (45%) and insidious in 6/11 (55%). Median (IQR) VA was 0.50 (0.40, 0.75) at edema and 0.90 (0.70, 1.00) at remission, where mean (SD) OCT CRT decreased 154 µm, from mean (SD) 429 (114) µm to 275 (45) µm (p < 0.001).
The mean (SD) density flow in the choriocapillaris was significantly lowered p = 0.001 in the central macular area in edema 44.31 (5.63), compared to remission 50.59 (5.04), see Table 1.
Table 1: Choriocapillaris density flow in edema and remission per macular area
Macular area Edema(1) Remission(1) p-value(2)
Nasal 51.05 (3.29) 53.58 (2.72) 0.015
Central 44.31 (5.63) 50.59 (5.04) 0.001
Temporal 53.30 (3.91) 53.99 (1.33) 0.48
Superior 52.18 (3.97) 52.97 (2.16) 0.54
Inferior 53.21 (3.36) 53.00 (2.12) 0.75
1 Mean (SD)
2 Wilcoxon rank sum exact test; Wilcoxon rank sum test
Conclusions :
In eyes with noninfectious uveitis with macular edema the choriocapillaris density flow in the central macular area is decreased in both anterior and intermediate uveitis. The decreased flow might be a part of the patophysiology of the macula in uveitis. If this reflects the severity or duration of the macular edema, then furhter work can show if it can be used as marker for treatment dosage.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.