Comparison of Indocyanine Green Angiography and Swept-Source Wide-Field Optical Coherence Tomography Angiography in Posterior Uveitis

Tian, Meng; Zeng, Guodong; Tappeiner, Christoph; Zinkernagel, Martin; Wolf, Sebastián; Munk, Marion R.

doi:10.3389/fmed.2022.853315

Cited by 7 publications

(8 citation statements)

References 30 publications

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“…The limited field of view in commercially available instruments is a major disadvantage, as is the case for OCT, when compared to dye exams. The presentation of the retinal vasculature and choriocapillaris without the use of a dye was a revolution which led to theories that OCT-A could replace the dye exams which is absolutely not the case [24,25], but nevertheless stimulated the publication of articles attempting to oppose the two methodologies [26,27]. Indeed, OCT-A is of limited practical value in everyday routine clinical practice with limited valueadded information after other multimodal investigations have been performed [28].…”

Section: Optical Coherence Tomography Angiography (Oct-a)mentioning

confidence: 99%

Review on imaging methods in non-infectious posterior uveitis, principles, relevance, and practical clinical applications to disease entities

Papasavvas

Herbort

2023

Oftalmol Zh

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The work-up and diagnosis of posterior uveitis rely heavily on multiple imaging methods that have become available beyond the mere photographic imaging and fluorescein angiography (FA) used to image uveitis in the past. Global assessment and precise follow-up of posterior uveitis were achieved with the development of indocyanine green angiography (ICGA) since the mid-1990ties that, together with FA, made it possible to perform dual FA and ICGA giving information on both the retina and the choroidal compartment. Further non-invasive imaging methods were developed subsequently that contributed to additional valuable information completing the dual FA/ICGA basic appraisal of uveitis, including (1) optical coherence tomography (OCT) giving a quasi-histological morphology of retinal structures of the posterior pole, (2) enhanced-depth imaging OCT (EDI-OCT) allowing to image the choroidal compartment and (3) blue light fundus autofluorescence (BAF) showing the integrity or damage of the retinal pigment epithelium, the photoreceptors and the outer retina. OCT-angiography (OCT-A) became available more recently and presented the advantage to image the retinal and choroidal circulations without needing dye injections, necessary for dual FA/ICGA. This review article will illustrate the principles, relevance and practical applications of these different imaging methods used in uveitis by examining the main categories of non-infectious posterior uveitis entities including (1) retinal inflammatory disorders, inflammatory diseases of the outer retina and of the choriocapillaris (choriocapillaritis) and stromal choroiditis.

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Section: Optical Coherence Tomography Angiography (Oct-a)mentioning

confidence: 99%

Review on imaging methods in non-infectious posterior uveitis, principles, relevance, and practical clinical applications to disease entities

Papasavvas

Herbort

2023

Oftalmol Zh

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“…Images created by OCT-A montage are often used to compare with FA-ICGA, but the creation of this montage has many technical difficulties and, in the majority of cases, needs special software. As it is mentioned by Eastline et al, their study showed that 100% of montage-wide field OCTA images present artifacts, including but not limited to displacement-, shadowing- and artifact and vessel displacement [ 11 , 12 ]. Hypopyon, vitritis, and exudative detachment of the retina can also affect the quality of OCT-A…”

Section: Oct-a Technologymentioning

confidence: 99%

“…While OCT-A is very performing in analyzing retinal vessels in the posterior pole and can show choriocapillaris non-perfusion in some instances, it is ill-suited to analyze the choroidal stroma. It is, therefore, not surprising that there are so few publications on the use of OCT-A in the VKH [ 12 , 51 ]. Despite the inadequacy of the method for stromal choroiditis, rare reports tried to show the utility of OCT-A in the 6 × 6 posterior pole area analyzed by OCT-A [ 12 , 51 ].…”

Section: Use Of Oct-a In Clinical Practice For Specific Uveitis Condi...mentioning

confidence: 99%

“…It is, therefore, not surprising that there are so few publications on the use of OCT-A in the VKH [ 12 , 51 ]. Despite the inadequacy of the method for stromal choroiditis, rare reports tried to show the utility of OCT-A in the 6 × 6 posterior pole area analyzed by OCT-A [ 12 , 51 ]. Such findings were certainly interesting but cannot be systematized and, therefore, cannot be used for disease management, especially when knowing that the bulk of lesions in VKH is situated outside this posterior pole area ( Figure 5 ).…”

Section: Use Of Oct-a In Clinical Practice For Specific Uveitis Condi...mentioning

confidence: 99%

“…As a general observation, OCT-A studies in uveitis are mostly unsatisfactory as the unconscious or open purpose of the authors is to make the method look as if it could in future replace FA and ICGA. With this perspective in mind, an attempt was made to compare OCT-A to ICGA in posterior uveitis [ 12 ]. Methodologically the study was flawed for several reasons.…”

Section: Use Of Oct-a In Clinical Practice For Specific Uveitis Condi...mentioning

confidence: 99%

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Benefits and Limitations of OCT-A in the Diagnosis and Follow-Up of Posterior Intraocular Inflammation in Current Clinical Practice: A Valuable Tool or a Deceiver?

Herbort¹,

Papasavvas²,

Tuğal-Tutkun

2022

Diagnostics

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Purpose: Optical coherence tomography angiography (OCT-A) has been applied to uveitis and intraocular inflammation since its availability after 2014. The imaging of retinal and choroidal vascularization without the use of dyes was a major development and represented a potentially valuable tool in ocular research. In addition to such use, OCT-A is often put forward as being able to potentially replace invasive methods needing dye injection, such as fluorescein angiography (FA) and indocyanine green angiography (ICGA). The aim of this review was to establish whether OCT-A was sufficiently useful in everyday routine clinical practice to monitor disease evolution and to perform treatment adjustments to the extent that it could reliably replace the standard dye methods. Methods: Selective literature review and analysis of own data and experience. Results: OCT-A is a technologically high-grade imaging modality allowing to analyze retinal circulation in inflammatory diseases of the posterior pole with a high sensitivity useful for research purposes. However, there is no evidence that it reaches equal effectiveness in the routine management of posterior uveitis involving the retina. OCT-A is unable to show leakage. In choriocapillaritis involving pre-capillary vessels, it shows capillary drop-out but does not seem to have an advantage over ICGA except that it can be repeated easily, not being invasive, and so allows a closer follow-up. It is, however, less useful in end-choriocapillary non-perfusion, such as in MEWDS. For choroidal stromal inflammation, OCT-A is ill-suited as it only shows inconsistent secondary circulatory changes produced by choroidal foci. OCT-A seems to be useful in the diagnosis and follow-up of inflammatory chorioneovascularisation (iCNV), although dye exams are more precise in showing the activity of the iCNV. Conclusion: In summary, OCT-A is a very sensitive modality for the retinal circulation in uveitis for research purposes; it is sometimes useful for close follow of choriocapillary drop-out but not in end-capillary non-perfusion. Its use for monitoring purposes in stromal choroiditis, however, is questionable. Its claim to possibly replace classical angiographic work-up for the practical management of posterior uveitis is largely overrated.

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Clinical Utilisation of Wide-Field Optical Coherence Tomography and Angiography: A Narrative Review

Nissen,

Vergmann

2024

Ophthalmol Ther

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Many important abnormalities of the vitreous, retina and choroid are predominantly located in the peripheral retina. In some retinal diseases with both central and peripheral manifestations, pathological structural or vascular changes can be apparent in the periphery before they are detectable in the central retina. Conventional optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) imaging only cover the most posterior 30° of the retina. Wide-field OCT (WF-OCT), though offering detailed cross-sectional imaging of the peripheral retina, is not yet systematically used in clinical practice. This narrative review provides a presentation of the utilisation of WF-OCT and WF-OCT-A in the diagnosis and monitoring of a variety of ophthalmological diseases and discusses the advantages and limitations of the technology. With the rapidly developing technology, multiple WF-OCT and WF-OCT-A devices are now commercially available and enable the clinician to obtain scans within a field of view up to 200°. As detailed in this review, several studies have shown promising results in the application of WF-OCT and WF-OCT-A in diseases of the retina, choroid and vitreous, such as retinal vein occlusion, diabetic retinopathy, ocular oncology, paediatric ophthalmology, uveitis and lesions of the vitreo–retinal interface. In conclusion, WF-OCT and WF-OCT-A can reliably produce high-quality, non-invasive images of the vitreous, retinal, and choroidal structures and vascularity covering the posterior pole as well as the mid and far periphery. These methods can be a valuable part of a multimodal imaging approach in the management of a variety of ocular conditions. Future studies are warranted to investigate the patient outcome benefits of implementation of WF-OCT and WF-OCT-A imaging in a real-life clinical setting.

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Comparison of Indocyanine Green Angiography and Swept-Source Wide-Field Optical Coherence Tomography Angiography in Posterior Uveitis

Cited by 7 publications

References 30 publications

Review on imaging methods in non-infectious posterior uveitis, principles, relevance, and practical clinical applications to disease entities

Review on imaging methods in non-infectious posterior uveitis, principles, relevance, and practical clinical applications to disease entities

Benefits and Limitations of OCT-A in the Diagnosis and Follow-Up of Posterior Intraocular Inflammation in Current Clinical Practice: A Valuable Tool or a Deceiver?

Clinical Utilisation of Wide-Field Optical Coherence Tomography and Angiography: A Narrative Review

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