Quantitative Analysis of the Choriocapillaris in Uveitis Using En Face Swept-Source Optical Coherence Tomography Angiography

• Published in: American journal of ophthalmology Vol. 218; pp. 17 - 27
• Main Authors: Chu, Zhongdi, Weinstein, Jessica E., Wang, Ruikang K., Pepple, Kathryn L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2020; Elsevier Limited
• Subjects: Algorithms; Automation; Disease; Edema; Medical imaging; Quantitative analysis; Software; California
• ISSN: 0002-9394; 1879-1891; 1879-1891
• DOI: 10.1016/j.ajo.2020.05.006

To perform a quantitative analysis of choriocapillaris (CC) flow deficits (FDs) in patients with uveitis. Retrospective cross-sectional study. Swept-source optical coherence tomography based angiography (SS-OCTA) macular volume scans (3 × 3 mm and 6 × 6 mm) were obtained using the Plex Elite 9000. En face CC images were generated and analyzed using an automated FD identification algorithm. Three quantitative metrics were determined for each eye: FD number (FDN), mean FD size (MFDS), and FD density (FDD). Quantitative metrics were compared between uveitis and control eyes. The uveitis cohort was further subdivided by the presence or absence of choroidal involvement, and quantitative metrics were compared between subgroups and normal control subjects. A total of 38 eyes from 38 control subjects and 73 eyes from 73 uveitis subjects were included in this study. Eyes with uveitis have significantly larger CC MFDS (3- × 3-mm scans; P < .0001; 6- × 6-mm scans; P < .0001) and higher FDD (P = .0002; P = .0076, respectively) compared to control eyes. Additional analysis determined that these differences were due to the choroidal disease subgroup, which demonstrates significantly larger MFDS (3 × 3 = 1,108 μm2; 6 × 6 = 1,104 μm2) compared to both normal control eyes (752 μm2; P < .0001; 802 μm2; P < .0001, respectively) and uveitis patients without choroidal involvement (785 μm2; P < .0001; 821 μm2; P < .0001, respectively). No significant differences were found between the quantitative metrics of control subjects and patients without choroidal involvement. Automated quantification of CC can identify pathological FDs and provide quantitative metrics describing such lesions in patients with uveitis. Posterior uveitis patients have significantly larger CC FDs than patients with other forms of uveitis. •Automated analysis of en face swept-source optical coherence tomography images identifies significant differences in choriocapillaris blood flow between patients with posterior uveitis and control subjects, by using 3 quantitative metrics.