Quantifying Retinal Microvascular Changes in Uveitis Using Spectral-Domain Optical Coherence Tomography Angiography

Alice Y. Kim, Damien C. Rodger, Anoush Shahidzadeh, Zhongdi Chu, Nicole Koulisis, Bruce Burkemper, Xuejuan Jiang, Kathryn L. Pepple, Ruikang K. Wang, Carmen A. Puliafito, Narsing A. Rao, Amir H. Kashani

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To quantify retinal capillary density and morphology in uveitis using spectral-domain optical coherence tomography angiography (SD-OCTA). Design Cross-sectional, observational study. Methods Healthy and uveitic subjects were recruited from 2 tertiary care eye centers. Prototype SD-OCTA devices (Cirrus; Carl Zeiss Meditec, Inc, Dublin, California, USA) were used to generate 3 × 3-mm2 OCTA images centered on the fovea. Subjects were placed into 3 groups based on the type of optical microangiography (OMAG) algorithm used for image processing (intensity and/or phase) and type of retinal segmentation (automatic or manual). A semi-automated method was used to calculate skeleton density (SD), vessel density (VD), fractal dimension (FD), and vessel diameter index (VDI). Retinal vasculature was assessed in the superficial retinal layer (SRL), deep retinal layer (DRL), and nonsegmented retinal layer (NS-RL). A generalized estimating equations model was used to analyze associations between the OCTA measures and disease status within each retinal layer. A P value <.05 was accepted as significant. Reproducibility and repeatability were assessed using the intraclass correlation coefficient (ICC). Results The SD, VD, and FD of the parafoveal capillaries were lower in uveitic eyes compared with healthy eyes in all retinal segments. In addition, SD and VD were significantly lower in the DRL of subjects with uveitic macular edema. There was no correlation in any capillary parameters and anatomic classification of uveitis. Conclusions Quantitative analysis of parafoveal capillary density and morphology in uveitis demonstrates significantly lower capillary density and complexity. SD-OCTA algorithms are robust enough to detect these changes and can provide a novel diagnostic index of disease for uveitis subjects.

Original languageEnglish (US)
Pages (from-to)101-112
Number of pages12
JournalAmerican journal of ophthalmology
Volume171
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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