Multimodality Diagnostic Imaging in a Case of Sympathetic Ophthalmia

Fleischman, David; Say, Emil Anthony T.; Wright, John D.; Landers, Maurice B.

doi:10.3109/09273948.2012.682637

Cited by 26 publications

(20 citation statements)

References 6 publications

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“…[17, 18] The conditions associated with choroidal thickening include Vogt-Koyanagi-Harada disease, sympathetic ophthalmia, Behçet’s disease, and toxoplasma retinochoroiditis. [17, 18] These conditions commonly involve the posterior segment, and choroidal inflammation is considered to be associated with choroidal thickening. Our results indicate that subclinical or latent choroidal inflammation may also be present in active anterior uveitis, although the choroid is anatomically disconnected from the anterior segment.…”

Section: Discussionmentioning

confidence: 99%

Choroidal change in acute anterior uveitis associated with human leukocyte antigen-B27

2017

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PurposeTo evaluate choroidal changes in eyes with acute anterior uveitis associated with human leukocyte antigen (HLA)-B27MethodsIn 44 patients with first-onset, unilateral, acute-onset (<1 week) anterior uveitis for which diagnostic work-ups revealed positivity only for HLA-B27, wide-field three-dimensional volumetric raster scan using swept-source optical coherence tomography was performed for both eyes. Choroidal thickness was measured by automated segmentation and thickness mapping and compared between eyes with uveitis and the fellow eyes at baseline. Choroidal thickness was compared before and after topical and/or systemic corticosteroid therapy. Relative choroidal thickening was defined as the choroidal thickness of the uveitic eye minus that of the corresponding eye and correlated with the degree of intraocular inflammation.ResultsCompared to the fellow eyes, eyes with acute anterior uveitis showed significant choroidal thickening on the subfoveal and parafoveal areas at baseline (all P <0.05). En face choroidal imaging showed dilation of large choroidal vessels on the macula. Relative choroidal thickening significantly correlated with the degree of anterior chamber inflammation at baseline (correlation coefficient = 0.341, P = 0.023). After treating inflammation, the choroid on the macula thinned significantly (from 262.1 ± 66.5 to 239.5 ± 61.0 μm in the subfoveal choroid, P<0.001).ConclusionsEyes with HLA-B27-associated anterior uveitis showed significant choroidal thickening at acute phase that subsequently decreased after treatment, indicating subclinical choroidal inflammation in the eyes. Choroidal thickness might indicate disease activity in acute anterior uveitis associated with HLA-B27.

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Section: Discussionmentioning

confidence: 99%

Choroidal change in acute anterior uveitis associated with human leukocyte antigen-B27

2017

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“…The diagnosis of SO was confirmed by histopathological examination of the left eye after elective enucleation. In this case, reduction in choroidal thickness on EDI-OCT was valuable in monitoring the response to treatment, which was in keeping with an improvement in vision [48]. …”

Section: Edi-oct Scan In Ocular Inflammatory Disordersmentioning

confidence: 98%

“…This patient presented one month after his initial trauma with blurred vision in the right eye [48]. Wide-field FFA showed multiple pinpoint areas of leakage at the right posterior pole, and an EDI-OCT scan revealed subfoveal fluid and a choroidal thickness of more than 500 μ m in that eye.…”

Section: Edi-oct Scan In Ocular Inflammatory Disordersmentioning

confidence: 99%

Examining the Choroid in Ocular Inflammation: A Focus on Enhanced Depth Imaging

Baltmr

Lightman

Tomkins-Netzer

2014

Journal of Ophthalmology

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The choroid is the vascular layer that supplies the outer retina and is involved in the pathogenesis of several ocular conditions including choroidal tumors, age related macular degeneration, central serous chorioretinopathy, diabetic retinopathy, and uveitis. Nevertheless, difficulties in the visualization of the choroid have limited our understanding of its exact role in ocular pathology. Enhanced depth imaging optical coherent topography (EDI-OCT) is a novel, noninvasive technique that is used to evaluate choroidal thickness and morphology in these diseases. The technique provides detailed objective in vivo visualization of the choroid and can be used to characterize posterior segment inflammatory disorders, monitor disease activity, and evaluate efficacy of treatment. In this review we summarize the current application of this technique in ocular inflammatory disorders and highlight its utility as an additional tool in monitoring choroidal involvement in ocular inflammation.

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“…Clinically significant changes in choroidal thickness have been reported in Vogt-Koyanagi-Harada (VKH) syndrome, 7-11 Behçet’s disease, 12-14 sarcoidosis, 15, 16 birdshot chorioretinopathy, 17, 18 idiopathic panuveitis, 19 sympathetic ophthalmia, 20 and posterior scleritis. 21 Although prior studies have assessed the reproducibility of manual choroidal thickness measurements in normal eyes, no such studies have been conducted in uveitic eyes.…”

Section: Introductionmentioning

confidence: 99%

Enhanced Depth Imaging Optical Coherence Tomography in Uveitis: An Intravisit and Interobserver Reproducibility Study

Kim

Knickelbein

Jaworski

et al. 2016

American Journal of Ophthalmology

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Purpose To determine the intravisit and interobserver reproducibility of subfoveal choroidal thickness (SFCT) measurements in patients with non-infectious uveitis. Design Reliability analysis. Methods Two consecutive enhanced depth imaging optical coherence tomography (EDI-OCT) scans were obtained at a single clinic visit for 97 uveitic eyes from patients ≥16 years of age with non-infectious anterior (n = 10), intermediate (n = 11), posterior (n = 26), and panuveitis (n = 13) at the National Eye Institute. SFCT was manually measured by two ophthalmologists using manufacturer’s software. Intravisit and interobserver reproducibility of SFCT measurements were assessed by using the Bland-Altman method to determine the estimate of bias (mean difference in SFCT measurements), 95% limits of agreement, and coefficients of repeatability. The reproducibility of these measurements was also compared between groups by anatomical location and clinical activity. Results Of 97 eyes, 65 (67.0%) were clinically quiet, 18 (18.6%) were minimally active, and 14 (14.4%) were active at the time the scans were obtained. Manual SFCT measurements were reproducible within 32.4 ± 3.8 μm between sessions for the same observer and 51.4 ± 8.5 μm between observers for the same session. Coefficients of repeatability did not differ significantly by anatomical location or disease activity. Conclusions Manual SFCT measurements obtained by EDI-OCT are reproducible in uveitis patients, with coefficients of repeatability that are nearly comparable to those published for normal eyes. This study provides guidance for using manual SFCT measurements in clinical practice, but further studies are still needed to determine its utility in clinical trials.

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Multimodality Diagnostic Imaging in a Case of Sympathetic Ophthalmia

Cited by 26 publications

References 6 publications

Choroidal change in acute anterior uveitis associated with human leukocyte antigen-B27

Choroidal change in acute anterior uveitis associated with human leukocyte antigen-B27

Examining the Choroid in Ocular Inflammation: A Focus on Enhanced Depth Imaging

Enhanced Depth Imaging Optical Coherence Tomography in Uveitis: An Intravisit and Interobserver Reproducibility Study

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