A Novel Method to Detect and Monitor Retinal Vasculitis Using Swept-Source OCT Angiography

Purpose: To introduce a novel method for assessment of retinal vasculitis using swept-source OCT angiography (SS-OCTA). Design: Retrospective case series. Participants: Patients with retinal vasculitis. Methods: The subjects were identified among the clinic population and imaged with 12 x 12-mm SS-OCTA scans centered on the fovea. A custom retina segmentation superimposed the color retinal thickness map on a modified en face flow scan. Findings from en face flow scans were correlated with localized perivascular retinal thickening on B-scans. Results from SS-OCTA were compared with fluorescein angiography (FA) to examine the proportion of perivascular thickening to retinal vascular leakage or staining. Results: Twenty-one patients with retinal vasculitis underwent same-day FA and SS-OCTA. Visible retinal vascular leakage/staining on FA corresponded to increased perivascular retinal thickness on SS-OCTA in 17 patients. Five patients had a second examination with same-day FA and SS-OCTA after treatment of the vasculitis. Three of those 5 patients showed improved retinal vascular leakage/staining on post-treatment FA and decreased perivascular retinal thickness on SS-OCTA scans. Conclusions: Swept-source OCT angiography detects structural retinal thickening secondary to inflammatory retinal vascular leakage. Further studies are required to confirm whether SS-OCTA may serve as a semi-quantitative alternative to FA to diagnose and monitor the response to treatment in patients with retinal vasculitis. Published by Elsevier Inc. on behalf of the American Academy of Ophthalmology