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

Abstract Objective To introduce a novel method for assessment of retinal vasculitis using Swept Source OCT Angiography (SS-OCTA). Design Retrospective case series Subjects 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 to 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 five showed improved retinal vascular leakage/staining on post-treatment FA as well as decreased perivascular retinal thickness on SS-OCTA scans. Conclusions SS-OCTA detects structural retinal thickening secondary to inflammatory retinal vascular leakage. Further studies are required to confirm if OCT angiography may serve as a semi-quantitative alternative to FA to diagnose and monitor the response to treatment in patients with retinal vasculitis.