A systematic review of OCT and OCT angiography in retinal vasculitis

Abstract

Background Retinal vasculitis is a component of uveitis for which the Standardisation of Uveitis Nomenclature (SUN) working group has no standard diagnostic criteria or severity grading. Fluorescein angiography is the gold standard test to assess retinal vasculitis, but is invasive and time-consuming. Optical coherence tomography (OCT) provides non-invasive detailed imaging of retinal structures and abnormalities, including blood vessel architecture and flow with OCT angiography (OCT-A). However, use of OCT in retinal vasculitis beyond assessing macular oedema, is not well established. We conducted a systematic review to understand the features of retinal vasculitis in OCT, Enhanced-depth imaging OCT (OCT-EDI) and OCT-A imaging. Methods The systematic search was done in March 2022 and updated in January 2023, through PubMed, EMBASE and the Web of Science database for studies related to OCT, OCT-EDI and OCT-A findings and retinal vasculitis. Bias assessment was assessed using JBI Critical Appraisal Checklist, and any findings associated with retinal vasculitis were extracted by qualitative analysis. Results We identified 20 studies, including 8 articles on OCT, 6 on OCT-EDI and 6 on OCT-A. The studies included analytical retrospective studies, case-series, and a case–control study. Five OCT studies reported secondary complications could be detected, and four reported retinal thickness alteration in retinal vasculitis. Five studies explored choroidal thickness alteration in OCT-EDI, and four explored capillary density alterations in retinal vasculitis using OCT-A. The heterogeneity in the studies’ analysis and design precluded a meta-analysis. Discussion There were no clear OCT, OCT-EDI or OCT-A findings that demonstrated potential to supersede fluorescein angiography for assessing retinal vasculitis. Some signs of macular structural effects secondary to retinal vasculitis may help prognostication for vision. The OCT signs of inflamed retinal vessels and perivascular tissue is an unexplored area.

Optical Coherence Tomography Angiography Changes in Patients Diagnosed With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

“…Thus, it gives a detailed evaluation of the microvascular network and segmentation of the FAZ, as well as the superficial, deep, and choroidal plexus [33]. During the past few years, a number of systematic reviews and meta-analyses have been published that elucidate the role of OCTA in ophthalmic conditions, their diagnosis, and classification such as diabetic retinopathy (DR), glaucoma, retinal vasculitis, and myopic choroidal neovascularization [34][35][36][37]. A number of recent systematic reviews and meta-analyses have also introduced the invaluable role of OCTA changes in retinal microvascular network as potential novel biomarkers in diseases such as hypertension, multiple sclerosis, Alzheimer's disease, and Parkinson's disease [38][39][40][41].…”

Optical Coherence Tomography: Focus on the Pathology of Macula in Scleritis Patients

“…The results suggest that increased retinal/macular thickness correlates with retinal vasculitis. [37].…”

Assessment of Inner Blood–Retinal Barrier: Animal Models and Methods

“…Structural OCT can monitor and detect vascular fluid leakage and quantify macular volume or non-cystic macular thickening indicative of active vascular leakage for instance, in uveitis [284,285], however, it is unable to directly image the retinal or choroidal vessels [286]. OCT can detect inflamed retinal vessels identified by the hyperreflective vessel walls/lumen, enlarged vessels, thickened perivascular retina, and presence of vitreous inflammatory material in ocular diseases [287,288]. A combinational approach using FFA and spectral domain OCT is more sensitive to detect BRB alterations and sites of fluorescein leakage in DR patients [251].…”