Abstract
Purpose :
Whilst choroidal thickness (CT) may reduce at resolution in eyes with active uveitis, it is unclear what choroidal changes contribute to this reduction in CT. The choroidal vascularity index (CVI), defined as the ratio of luminal area to the circumscribed total choroidal area (TCA), serves as a quantitative biomarker for choroidal vasculature assessment and may provide insight. In active uveitic eyes, CVI reduction at follow-up may arise due to an increase in stromal area from post-inflammatory fibrosis, choroidal vessel attenuation resulting in luminal area reduction, or both. However, not all studies studying active uveitis have reported CVI reduction at follow-up.
Methods :
Embedded within a broader CVI-related systematic review, this study considered articles published through 2023. 1210 articles were identified. After applying the inclusion and exclusion criteria, 304 articles remained after full-text review. Further identifying studies with CVI data for active uveitic eyes at baseline and at follow-up, 295 articles were excluded, leaving nine articles eligible for a systematic review and meta-analysis. A meta-analysis was conducted to determine standardised mean differences (SMD) via random-effects models in CVI, CT, and TCA between baseline and at follow-up.
Results :
A total of 194 patients (mean age of 37.52 ± 12.60 years; 88 females) with 225 active uveitic eyes were studied. CVI was reduced (SMD: -0.45; 95% CI: [-0.89, -0.00]; p<0.05) at follow-up (mean duration of 4.45 ± 2.19 months) compared to baseline. TCA was not significantly different (SMD: 0.20; 95% CI: [-0.03, 0.43]; p=0.09), whilst CT was reduced compared to baseline (SMD: -0.47; 95% CI: [-0.83, -0.11]); p=0.01).
Conclusions :
As CVI was reduced at follow-up in tandem with CT, the effect of choroidal vessel attenuation on total choroidal area possibly outweighs that of consequent post-inflammatory fibrosis. This is consistent with the nonsignificant (p=0.09) trend of a reduced TCA at follow-up. Thus, CVI may be useful in elucidating the pathophysiology of the resolution phase in active uveitic eyes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.