Cairo University, 3 Road 217, Degla Maadi, Cairo, 11431, Egypt.
Ministry of Health, Cairo, Egypt.
Int Ophthalmol. 2023 Feb;43(2):597-608. doi: 10.1007/s10792-022-02464-6. Epub 2022 Aug 27.
Using optical coherence tomography angiography (OCTA) to evaluate retinal microvascular changes in sarcoid and tuberculous (TB) posterior uveitis.
Cross-sectional observational study includes 30 eyes. FFA and OCTA images were acquired. OCTA images were analyzed for areas of capillary hypo-perfusion, disorganization of the superficial and deep capillary plexuses (SCP and DCP) and intraretinal cystoid spaces and for measuring the size of the foveal avascular zone and vessel density (VD) in the SCP and DCP.
A total of 11 eyes were associated with TB and 19 with sarcoidosis. By OCTA, 100% had areas of capillary non-perfusion, 36.7% choroidal voids, 30% disorganization of the SCP and DCP and 26.6% intraretinal cystoid spaces. The VD of the DCP was significantly lower in the TB group. On comparing OCTA and FFA, parafoveal ischemia was detected more frequently on OCTA and macular edema more frequently on FFA (P = < 0.001). The BCVA was not significantly correlated with the VD of the SCP or DCP.
OCTA can be used in detection of early microvascular changes, segmenting retinal layers and localizing abnormalities. The presence of these changes may aid in the diagnosis of TB and sarcoid uveitis, for prognosis, follow-up and may be the only choice when FFA is contraindicated.
利用光相干断层扫描血管造影(OCTA)评估结节病和结核性(TB)后葡萄膜炎的视网膜微血管变化。
这是一项横断面观察性研究,共纳入 30 只眼。获取荧光素眼底血管造影(FFA)和 OCTA 图像。对 OCTA 图像进行分析,以评估毛细血管低灌注区、浅层和深层毛细血管丛(SCP 和 DCP)的紊乱以及视网膜内囊样空间,并测量黄斑中心无血管区(FAZ)大小和 SCP 和 DCP 中的血管密度(VD)。
共有 11 只眼与 TB 相关,19 只眼与结节病相关。通过 OCTA,100%的眼存在毛细血管无灌注区,36.7%的眼存在脉络膜空虚,30%的眼存在 SCP 和 DCP 紊乱,26.6%的眼存在视网膜内囊样空间。TB 组的 DCP 的 VD 明显较低。在比较 OCTA 和 FFA 时,OCTA 更频繁地检测到旁中心区缺血,FFA 更频繁地检测到黄斑水肿(P < 0.001)。BCVA 与 SCP 或 DCP 的 VD 无显著相关性。
OCTA 可用于检测早期微血管变化、视网膜分层和定位异常。这些变化的存在可能有助于结节病和结核性葡萄膜炎的诊断、预后、随访,并且在 FFA 禁忌时可能是唯一的选择。