a Advanced Eye Centre, Post Graduate Institute of Medical Education & Research , Chandigarh , India.
Ocul Immunol Inflamm. 2016 Dec;24(6):631-636. doi: 10.3109/09273948.2015.1099681. Epub 2016 Jan 6.
To assess the utility of ultra-wide field (UWF) versus conventional fundus imaging in the management of tubercular (TB) posterior uveitis.
Twenty-two consecutive patients (33 eyes) diagnosed with TB posterior uveitis in a tertiary care center who underwent UWF fundus photography and fluorescein angiography (FA) between July 2014 and March 2015 were included. Complete clinical and imaging records of the patients were retrospectively reviewed. A circle simulating the central 75-degree field was drawn on UWF pseudocolor and fluorescein angiography images. Findings within the circle were compared with the information yielded by the complete image and its impact on patient management was noted.
The clinical manifestations of posterior tubercular uveitis included retinal vasculitis (17 eyes), multifocal serpiginoid choroiditis (13 eyes), choroidal granulomas (2 eyes) and intermediate uveitis (1 eye). UWF imaging revealed additional capillary non-perfusion areas, neovascularization, active vasculitis, and peripheral choroiditis lesions in 30/33 eyes (90.9%), which influenced treatment decision in 15 eyes (45.5%).
UWF imaging is useful in the detection of peripheral pathologies in tubercular posterior uveitis that may influence management decisions, such as addition of immunosuppressive therapy or scatter laser photocoagulation.
评估超广角（UWF）与传统眼底成像在结核性（TB）后葡萄膜炎治疗中的应用价值。
2014 年 7 月至 2015 年 3 月，在一家三级护理中心，对 22 例连续确诊为 TB 后葡萄膜炎的患者（33 只眼）进行了 UWF 眼底摄影和荧光素血管造影（FA）检查。回顾性分析了患者的完整临床和影像学记录。在 UWF 假彩色和荧光血管造影图像上绘制一个模拟中央 75 度视野的圆。比较圈内的发现与完整图像提供的信息及其对患者管理的影响。
后结核性葡萄膜炎的临床表现包括视网膜血管炎（17 只眼）、多灶性匐行性脉络膜炎（13 只眼）、脉络膜肉芽肿（2 只眼）和中间葡萄膜炎（1 只眼）。UWF 成像在 30/33 只眼（90.9%）中发现了额外的毛细血管无灌注区、新生血管、活动性血管炎和周边脉络膜病变，这影响了 15 只眼（45.5%）的治疗决策。
UWF 成像有助于发现结核性后葡萄膜炎的周边病变，这些病变可能影响治疗决策，如免疫抑制治疗或散在激光光凝的添加。
