Abstract
Purpose :
To highlight the utility of en face swept-source optical coherence tomography angiography (SS-OCTA) in assessing macrophage-like cells (MLCs) on the retinal surface of patients with active uveitis and their response to anti-inflammatory treatment.
Methods :
In this prospective, single center study, twenty eyes from active uveitis patients were analyzed using six 6×6 mm macular scans at three timepoints: active inflammation (baseline), clinically improving (T1), and resolved inflammation (T2). MLCs were visualized using 6 consecutive 3μm en face OCT slabs on the inner limiting membrane, and posteriorly registered and averaged to increase the sign to noise ratio. The variation of MLCs number, density and size over time was assessed and MLCs measurements were compared with clinical inflammation grading.
Results :
At baseline, MLCs count was significantly higher (552.5) than healthy controls (478.2 MLCs), with a density of 15.3 cells/mm2. MLCs number decreased significantly to 394.8 (p = 0.007) at T1, with a density of 10.9 cells/mm2 (p = 0.007). MLCs size reduced from 979.2 μm2 to 907.2 μm2 at T1 (p = 0.009) and remained stable at T2 (p = 0.3). Correlation coefficients between inflammatory parameters (AC cells and NEI haze) and MLCs count indicated a positive correlation at baseline (r = 0.53), weakening at T1 (r = 0.36), and becoming negative at T2 (r = -0.24).
Conclusions :
En face SS-OCTA revealed increased MLCs number and size in active uveitis, likely due to circulating monocyte recruitment. Post-inflammation control, MLC number, size, and density significantly decreased, returning to normal despite residual AC cells or vitreous haze.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.