Semi-automated choroidal volume metrics utilizing swept source optical coherence tomography in patients with active and inactive sarcoidosis.

Abstract

Purpose : To measure choroidal volume utilizing swept source OCT in patients with active and inactive sarcoid associated uveitis to assess correlation between choroidal volume, clinical disease activity, and treatment effects.

Methods : This is an IRB approved review of patients with sarcoidosis imaged with the Zeiss PLEX Elite 9000 SS-OCT system in a prospective study (NCT04704609). 6mmx6mm image scans at 100 kHz were obtained. Choroidal volume was measured utilizing choroidal analysis metric (software version 2.2.0.875). Disease activity was determined through review of clinical exam and ophthalmic imaging.

Results : 186 eyes of 93 biopsy proven sarcoidosis patients were identified. 57 patients were female and 36 were male. 29 patients were black and 62 were white. Average age was 58 (range 26 - 83) 36 patients had two or more visits. Choroidal volume was successfully measured in all patients. 331 images were analyzed and 179 required manual correction. The average choroidal volume in female patients was 9.17 mm³ while the average volume in males was 11.14 mm³. In those patients between the ages of 31 and 59 (n=47) the average volume was 11.62 mm³, while in those 60 and older the average volume was 8.50 mm³ (n=45).

Of 16 active patients with multiple visits, 12 showed improvement in choroidal thickness. 3 active patients had initial improvement of choroidal volume with treatment with worsening of thickness with disease re-activation. This improvement correlated with clinical activity seen in patient exams, imaging, and treatment. As an example, one active patient with choroid volume of 9.50 mm³ in both eyes; over 1 year on methotrexate, her choroidal volume improved to 8.25 mm³. A second active patient had a choroidal volume of 8.1 mm³ and 6.4 mm³ (OD and OS) and was treated with intravitreal steroids bilaterally. 3 months later his disease activity improved and choroidal volume improved to 7.5 mm³ and 5.5 mm³ respectively.

Conclusions : Choroidal volume analysis as measured on SS-OCT is feasible in patients with sarcoid associated uveitis. Choroidal volume was larger in younger patients and in men. In those patients with multiple imaging visits, we found correlation between improvement in choroidal volume and clinical disease activity. Choroidal volume as measured by SS-OCT could be used as a non-invasive metric of disease activity in sarcoid associated uveitis.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.