June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Long-term quantification of ellipsoid zone changes on optical coherence tomography in patients with Birdshot Chorioretinopathy
Author Affiliations & Notes
  • Mehak Kalra
    Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Sumit Sharma
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Kimberly Baynes
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Jon Whitney
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Peter M Kaiser
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Megan Ann McDonald
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Danielle X Burton
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Bolisa Hang
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Careen Lowder
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Justis P Ehlers
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Mehak Kalra None; Sumit Sharma AbbVie, Allergan, Eyepoint, Clearside, Bausch and Lomb, Genentech, Regeneron, Regenxbio, Apellis, Code C (Consultant/Contractor), Genentech, Roche, IONIS, Santen, Gilead, Code F (Financial Support); Kimberly Baynes None; Jon Whitney None; Peter Kaiser None; Megan McDonald None; Danielle Burton None; Bolisa Hang None; Careen Lowder None; Justis Ehlers Aerpio, Novartis, Zeiss, Alcon, Leica, Santen, Allergan, Genentech, Regeneron, Adverum, Allegro, Thrombogenics, Stealth, Code C (Consultant/Contractor), Aerpio, Boehringer-Ingelheim, Alcon, Allergan, Regeneron, Genentech, Thrombogenics, Novartis, Code F (Financial Support), Leica, Code P (Patent); Sunil Srivastava Novartis, Regeneron, Bausch and Lomb, Eyepoint, Eyevensys, Abbvie, Zeiss, Code C (Consultant/Contractor), Eyepoint, Regeneron, Allergan, Santen, Code F (Financial Support)
  • Footnotes
    Support  NIH-NEI P30 Core Grant
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 4859. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Mehak Kalra, Sumit Sharma, Kimberly Baynes, Jon Whitney, Peter M Kaiser, Megan Ann McDonald, Danielle X Burton, Bolisa Hang, Careen Lowder, Justis P Ehlers, Sunil K Srivastava; Long-term quantification of ellipsoid zone changes on optical coherence tomography in patients with Birdshot Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2023;64(8):4859.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Birdshot chorioretinopathy (BCR) is a rare idiopathic inflammatory disease of progressive retinal dysfunction. Current treatment options for BCR include systemic immunomodulatory therapy (IMT) and surgical fluocinolone acetonide (FA) implants (Retisert, Bausch and Lomb). In this paper we report the long-term outcomes of the ellipsoid zone (EZ) layer in patients with BCR treated either with steroid implants or systemic IMT to evaluate for EZ pathology improvement, progression or stabilization.

Methods : An IRB retrospective chart review of BCR patients who were treated either with a FA implant or systemic IMT was performed. Patients were included if four or more years of OCTs were available. Patients had a baseline OCT before treatment and after treatment at the 1 month, 3 month, 6 month, and yearly time points. Retinal layer segmentation was performed by an artificial intelligence learning model with manual corrections, and EZ layer-associated metrics were analyzed, including the proportion of macular area with ≤20µm, ≤10 µm, or 0 µm EZ-RPE thickness, as well as EZ-RPE central subfield thickness (µm), EZ-RPE panmacular volume (mm3). Clinical information, such as best corrected visual acuity (BCVA), was also collected.

Results : Our cohort included 26 eyes (13 patients) in the FA-implant treated group and 6 eyes (3 patients) in the systemic therapy group. In the 16 eyes treated with FA implant who had data available 5 years after surgery, there was an average of 2.12% decrease in the amount of EZ that was ≤20µm, although this change was variable (range of -10.63% to 9.95%). In this group, the EZ-RPE volume increased by 0.01 mm3 after 5 years, with a range of -0.11 mm3 to 0.11 mm3, and clinically there was a mean change of -3.33 letters. In the 3 eyes treated with systemic IMT who had data available 5 years after presentation, there was on average a 0.35% increase in the amount of EZ ≤20µm, with a range of 0% to 1.05%. In this group, the EZ-RPE volume also increased by 0.01 mm3, with a range in change in volume from -0.08 mm3 to 0.08 mm3, and an increase in BCVA by 1.67 letters on average.

Conclusions : In this study we have shown that in patients with BCR, the EZ retinal layer can be stabilized with both FA implant and systemic IMT. In patients with BCR, EZ layer integrity may be a useful tool to monitor disease severity and to aid in decisions regarding treatment.

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

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×