Quantitative Analysis of Structural Alterations in the Choroid of Patients With Active Behçet Uveitis

Onal, Sumru; Uludağ, Günay; Oray, Merih; Mengi, Emre; Herbort, Carl P.; Akman, Mehmet; Metin, Mustafa; Akbay, Aylin Koç; Tuğal-Tutkun, İlknur

doi:10.1097/iae.0000000000001587

Cited by 53 publications

(33 citation statements)

References 38 publications

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“…A decreased CVI was observed in other inflammatory disorders. A prospective study investigated choroidal alterations in patients with Behçet uveitis, reporting stromal expansion correlating with retinal vascular staining and leakage on fluorescein angiography [29].…”

Section: In Inflammatory Chorioretinal Disordersmentioning

confidence: 99%

Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter

Iovino

Pellegrini

Bernabei

et al. 2020

JCM

167

128

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Remarkable improvements in optical coherence tomography (OCT) technology have resulted in highly sophisticated, noninvasive machines allowing detailed and advanced morphological evaluation of all retinal and choroidal layers. Postproduction semiautomated imaging analysis with dedicated public-domain software allows precise quantitative analysis of binarized OCT images. In this regard, the choroidal vascularity index (CVI) is emerging as a new imaging tool for the measurement and analysis of the choroidal vascular system by quantifying both luminal and stromal choroidal components. Numerous reports have been published so far regarding CVI and its potential applications in healthy eyes as well as in the evaluation and management of several chorioretinal diseases. Current literature suggests that CVI has a lesser variability and is influenced by fewer physiologic factors as compared to choroidal thickness. It can be considered a relatively stable parameter for evaluating the changes in the choroidal vasculature. In this review, the principles and the applications of this advanced imaging modality for studying and understanding the contributing role of choroid in retinal and optic nerve diseases are discussed. Potential advances that may allow the widespread adoption of this tool in the routine clinical practice are also presented.

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Section: In Inflammatory Chorioretinal Disordersmentioning

confidence: 99%

Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter

Iovino

Pellegrini

Bernabei

et al. 2020

JCM

167

128

View full text Add to dashboard Cite

show abstract

“…However, effacement replaces expansion as the disease progresses and chronic vascular injury settles [35][36][37][38]. Onal [39] et al reported choroidal stromal expansion without any association with ChT in patients with active Behçet's uveitis. It is noteworthy that in our series, none of the patients had an active uveitis or any other ocular involvement and only one patient had clinically active DADA2, suggesting that even under a successful treatment regimen, a mild subclinical inflammation may still exist.…”

Section: Discussionmentioning

confidence: 99%

Choroidal vascularity index as a biomarker of systemic inflammation in childhood Polyarteritis Nodosa and adenosine deaminase-2 deficiency

et al. 2020

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Background/purpose: To assess EDI-OCT (enhanced depth imaging optical coherence tomography) of choroid for inflammatory signs in children with polyarteritis nodosa (PAN) and adenosine deaminase-2 deficiency (DADA-2). Methods: In this cross-sectional study conducted between June 2017 and September 2018, we evaluated children diagnosed with PAN (n = 11) and DADA-2 (n = 4) and an age-and sex-matched control group (n = 15). Demographic and laboratory data were retrospectively analyzed from patient charts. Disease activity was assessed using the pediatric vasculitis activity score (PVAS). Choroidal images were obtained with spectral domain-OCT to measure choroidal thickness (ChT) at 5 points (750 and 1500 μm from the foveal center in the temporal and nasal quadrants and beneath the fovea), and to calculate the total subfoveal choroidal area (TCA), luminal area (LA), stromal area (SA), and the choroidal vascularity index (CVI). Results: The median (min-max) age was 8 (4-16) years in PAN patients, 6 (5-16) years in DADA-2 patients and 8 (8-10) years in control group at the OCT visit (p = 0.214). The ChT at 3 points and the TCA, LA, and SA were higher in children with both PAN and DADA-2 patients compared to those of the control group (p < 0.0001, p = 0.049, p = 0.007, p = 0.007, p = 0.006, p = 0.033, respectively). The CVI was similar in both groups. No association was observed between the OCT findings, PVAS, and the erythrocyte sedimentation rate, and serum leukocyte and C-reactive protein levels. Conclusion: Similar CVI scores were obtained from PAN and DADA2 patients under treatment and from healthy controls. Increased subfoveal ChT without any other signs of ocular involvement may suggest choroidal thickening as a sign of mild subclinical inflammation.

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“…[ 12 ] In contrast, a recent study in patients with Behçet's uveitis using the dual FA/ICGA scoring system showed that choroidal involvement (ICGA score) was insignificant and retinal involvement was highly preponderant over choroidal involvement in 100% (56/56) of the eyes. [ 13 ] This shows that FA/ICGA scoring is probably the best modality to date to evaluate and monitor posterior uveitis in practice and in clinical studies because it allows global and quantitative evaluation of inflammation in posterior uveitis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of retinal and choroidal involvement in sarcoidosis-related chorioretinitis using fluorescein and indocyanine green angiography

Ameen¹,

Herbort

2018

J Ophthalmic Vis Res

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Purpose:To compare the involvement of the retina with that of the choroid in ocular sarcoidosis (OS) using dual fluorescein angiography (FA)/indocyanine green angiography (ICGA).Methods:A retrospective study of 23 patients with the diagnosis of OS was performed. Angiographic signs were quantified following the established FA/ICGA scoring system for uveitis.Results:The choroid was predominantly involved in 19 (82.6%) patients or 87% (40/46) of the eyes, and the retina in 2 (8.7%) patients or 13% (6/46) of the eyes. The mean angiographic score was 7.15 ± 4.5 for the retina (FA) compared to 14.02 ± 4.86 for the choroid (ICGA) (P < 0.0001). In 13% (3/23) of patients, FA did not show retinal inflammation, whereas ICGA was strongly positive, revealing occult choroidal lesions.Conclusion:The choroid is preferentially involved in OS, for which ICGA is the examination of choice. There is a risk of underestimating the global ocular involvement and of missing choroidal involvement if only FA is used. FA/ICGA scoring system allows for quantitative assessment of inflammation in the posterior uvea that occurs in OS; therefore, the system can be useful to quantitatively monitor outcomes in clinical trials.

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Quantitative Analysis of Structural Alterations in the Choroid of Patients With Active Behçet Uveitis

Abstract: There was choroidal stromal expansion which was not associated with thickening of the choroid. Central foveal thickness may be used as a noninvasive measure to assess inflammatory activity in early Behçet uveitis.

Cited by 53 publications

References 38 publications

Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter

Choroidal Vascularity Index: An In-Depth Analysis of This Novel Optical Coherence Tomography Parameter

Choroidal vascularity index as a biomarker of systemic inflammation in childhood Polyarteritis Nodosa and adenosine deaminase-2 deficiency

Comparison of retinal and choroidal involvement in sarcoidosis-related chorioretinitis using fluorescein and indocyanine green angiography

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