Detection of choroidal hypoperfusion in giant cell arteritis using swept-source optical coherence tomographic angiography

ObjectiveTo determine whether swept-source optical coherence tomographic angiography (SS-OCTA) can demonstrate choroidal perfusion abnormalities seen on fluorescein angiography (FA) in giant cell arteritis (GCA). DesignObservational case series. ParticipantsSix eyes of 3 patients with bilateral ischemic optic neuropathy secondary to GCA, and one control patient without ocular involvement from biopsy-confirmed GCA. MethodsEn face SS-OCTA (DRI OCT Triton, Topcon, Tokyo, Japan) and FA centered on the macula were obtained at presentation. SS-OCTA was segmented into superficial and deep retinal capillary plexuses and the choriocapillaris laminae. SS-OCTA images were independently analyzed for perfusion abnormalities and compared with corresponding FA images. Main Outcome MeasuresCorrespondence of choroidal angiographic abnormalities on SS-OCTA and FA. ResultsSS-OCTA showed decreased angiographic signal within the choriocapillaris in 5/6 eyes and corresponded to hypoperfusion abnormalities on FA in similar geographic distributions in 5/5 eyes. SS-OCTA also showed dilation of the deep retinal capillary plexus overlying the area of choroidal hypoperfusion in one eye. In the one eye without angiographic signal abnormalities on SS-OCTA, no perfusion changes were noted on FA. One control patient without ocular involvement from biopsy-confirmed GCA did not show choroidal perfusion changes on SS-OCTA or FA. ConclusionsThis case series demonstrates comparability between SS-OCTA and FA in detection and characterization of choroidal hypoperfusion secondary to GCA. As a rapid and non-invasive tool, SS-OCTA may serve as a viable alternative to FA in the diagnostic evaluation of GCA.