scholarly journals Detection of choroidal hypoperfusion in giant cell arteritis using swept-source optical coherence tomographic angiography

2021 ◽  
Author(s):  
Edward S Lu ◽  
Amy Yuan ◽  
Devon A Cohen ◽  
Raviv Katz ◽  
John B Miller ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Control Patient ◽  
Case Series ◽  
Ocular Involvement ◽  
Optical Coherence ◽  
Swept Source ◽  
Retinal Capillary ◽  
Tomographic Angiography ◽  
Choroidal Perfusion

Objective: To determine whether swept-source optical coherence tomographic angiography (SS-OCTA) can demonstrate choroidal perfusion abnormalities seen on fluorescein angiography (FA) in giant cell arteritis (GCA). Design: Observational case series. Participants: Six eyes of 3 patients with bilateral ischemic optic neuropathy secondary to GCA, and one control patient without ocular involvement from biopsy-confirmed GCA. Methods: En face SS-OCTA (DRI OCT Triton, Topcon, Tokyo, Japan) and FA centered on the macula were obtained at presentation. SS-OCTA was segmented into superficial and deep retinal capillary plexuses and the choriocapillaris laminae. SS-OCTA images were independently analyzed for perfusion abnormalities and compared with corresponding FA images. Main Outcome Measures: Correspondence of choroidal angiographic abnormalities on SS-OCTA and FA. Results: SS-OCTA showed decreased angiographic signal within the choriocapillaris in 5/6 eyes and corresponded to hypoperfusion abnormalities on FA in similar geographic distributions in 5/5 eyes. SS-OCTA also showed dilation of the deep retinal capillary plexus overlying the area of choroidal hypoperfusion in one eye. In the one eye without angiographic signal abnormalities on SS-OCTA, no perfusion changes were noted on FA. One control patient without ocular involvement from biopsy-confirmed GCA did not show choroidal perfusion changes on SS-OCTA or FA. Conclusions: This case series demonstrates comparability between SS-OCTA and FA in detection and characterization of choroidal hypoperfusion secondary to GCA. As a rapid and non-invasive tool, SS-OCTA may serve as a viable alternative to FA in the diagnostic evaluation of GCA.

Optical coherence tomographic angiography identifies peripapillary microvascular dilation and focal non-perfusion in giant cell arteritis

2017 ◽  
Vol 102 (8) ◽  
pp. 1141-1146 ◽  
Author(s):  
Eric D Gaier ◽  
Aubrey L Gilbert ◽  
Dean M Cestari ◽  
John B Miller
Keyword(s):  
Visual Field ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Optic Neuropathy ◽  
Visual Field Loss ◽  
Clinical Severity ◽  
Optical Coherence ◽  
Ischaemic Optic Neuropathy ◽  
Perfusion Defects ◽  
Tomographic Angiography

AimsWe set out to determine the optical coherence tomographic angiography (OCT-A) characteristics of arteritic anterior ischaemic optic neuropathy (AAION) in the context of giant cell arteritis (GCA).MethodsThis is an observational case series of four patients with AAION secondary to GCA, three with unilateral AAION and one with bilateral AAION. We reviewed the charts, fundus photography, visual fields, fluorescein angiography (FA) and OCT-A images for all patients to identify a unifying theme in a range of AAION clinical severity. Imaging of two healthy control eyes from two patients of similar age to the patients in our series were used for comparison.ResultsSuperficial peripapillary capillary dilation was seen in eyes with acute AAION. It was also noted in the fellow eyes of two patients. Retinal capillary perfusion defects corresponded to visual field loss. Dense optic disc oedema and cotton-wool spots imparted blockage effects. OCT-A laminar analysis did not highlight the choroidal/choriocapillaris perfusion defects seen on FA in two patients. Follow-up OCT-A was obtained in two patients and revealed progression to superficial peripapillary capillary attenuation that corresponded with visual field loss.ConclusionsThere are acute and chronic vascular changes in AAION that are detectable by OCT-A that correspond with visual function. Though the microvascular changes seen in GCA and AAION are not specific, the nearly ubiquitous findings among preclinical and clinically affected eyes in this series of patients with GCA support OCT-A as a potentially useful adjunctive diagnostic test in the work-up of ambiguous cases of suspected ischaemic optic neuropathy.

Feasibility and Clinical Utility of Ultra-Widefield–Navigated Swept-Source Optical Coherence Tomography Imaging

2021 ◽  
pp. 247412642199733
Author(s):  
Kyle D. Kovacs ◽  
M. Abdallah Mahrous ◽  
Luis Gonzalez ◽  
Benjamin E. Botsford ◽  
Tamara L. Lenis ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Clinical Utility ◽  
Clinical Decision Making ◽  
Imaging System ◽  
Imaging Modality ◽  
Case Series ◽  
Subretinal Fluid ◽  
Optical Coherence ◽  
Swept Source ◽  
Oct Imaging

Purpose: This work aims to evaluate the clinical utility and feasibility of a novel scanning laser ophthalmoscope-based navigated ultra-widefield swept-source optical coherence tomography (UWF SS-OCT) imaging system. Methods: A retrospective, single-center, consecutive case series evaluated patients between September 2019 and October 2020 with UWF SS-OCT (modified Optos P200TxE, Optos PLC) as part of routine retinal care. The logistics of image acquisition, interpretability of images captured, nature of the peripheral abnormality, and clinical utility in management decisions were recorded. Results: Eighty-two eyes from 72 patients were included. Patients were aged 59.4 ± 17.1 years (range, 8-87 years). During imaging, 4.4 series of images were obtained in 4.1 minutes, with 86.4% of the image series deemed to be diagnostic of the peripheral pathology on blinded image review. The most common pathologic findings were chorioretinal scars (18 eyes). In 31 (38%) eyes, these images were meaningful in supporting clinical decision-making with definitive findings. Diagnoses imaged included retinal detachment combined with retinoschisis, retinal hole with overlying vitreous traction and subretinal fluid, vitreous inflammation overlying a peripheral scar, Coats disease, and peripheral retinal traction in sickle cell retinopathy. Conclusions: Navigated UWF SS-OCT imaging was clinically practical and provided high-quality characterization of peripheral retinal lesions for all eyes. Images directly contributed to management plans, including laser, injection or surgical treatment, for a clinically meaningful set of patients (38%). Future studies are needed to further assess the value of this imaging modality and its role in diagnosing, monitoring, and treating peripheral lesions.

Is there a place for cyclophosphamide in the treatment of giant-cell arteritis? A case series and systematic review

2013 ◽  
Vol 43 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Hubert de Boysson ◽  
Jonathan Boutemy ◽  
Christian Creveuil ◽  
Yann Ollivier ◽  
Philippe Letellier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Case Series

scholarly journals Full-field optical coherence tomography for the diagnosis of giant cell arteritis

2020 ◽  
Author(s):  
Thomas Maldiney ◽  
Hélène Greigert ◽  
Laurent Martin ◽  
Emilie Benoit ◽  
Catherine Creuzot-Garcher ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Artery ◽  
Machine Intelligence ◽  
Vasa Vasorum ◽  
Temporal Artery Biopsy ◽  
Optical Coherence ◽  
Gabor Filtering ◽  
Full Field

AbstractHistopathological examination of temporal artery biopsy (TAB) remains the gold standard for the diagnosis of giant cell arteritis (GCA) but is associated with essential limitations that emphasize the need for an upgraded pathological process. This study pioneered the use of full-field optical coherence tomography (FF-OCT) for rapid and automated on-site pathological diagnosis of GCA. Sixteen TABs (12 negative and 4 positive for GCA) were selected according to major histopathological criteria of GCA following hematoxylin-eosin-saffron-staining for subsequent acquisition with FF-OCT to compare structural modifications of the artery cell wall and thickness of each tunica. Gabor filtering of FF-OCT images was then used to compute TAB orientation maps and validate a potential automated analysis of TAB sections. FF-OCT allowed both qualitative and quantitative visualization of the main structures of the temporal artery wall, from the internal elastic lamina to the vasa vasorum and red blood cells, unveiling a significant correlation with conventional histology. FF-OCT imaging of GCA TABs revealed destruction of the media with distinct remodeling of the whole arterial wall into a denser reticular fibrous neo-intima, which is distinctive of GCA pathogenesis and accessible through automated Gabor filtering. Rapid on-site FF-OCT TAB acquisition makes it possible to identify some characteristic pathological lesions of GCA within a few minutes, paving the way for potential machine intelligence-based or even non-invasive diagnosis of GCA.

scholarly journals Assessment of the Macular Microvasculature in High Myopes With Swept Source Optical Coherence Tomographic Angiography

2021 ◽  
Vol 8 ◽  
Author(s):  
Chee-Wai Wong ◽  
Saiko Matsumura ◽  
Hla Myint Htoon ◽  
Shoun Tan ◽  
Colin S. Tan ◽  
...  
Keyword(s):  
Subsequent Development ◽  
Superficial Layer ◽  
Adolescent And Young Adult ◽  
Pathologic Myopia ◽  
Optical Coherence ◽  
Swept Source ◽  
Retinal Microvasculature ◽  
And Gender ◽  
Tomographic Angiography ◽  
Control Study

Background: The risk of pathologic myopia (PM) increases with worsening myopia and may be related to retinal microvasculature alterations. To evaluate this, we analyzed the macular microvasculature of myopes with swept source-optical coherence tomographic angiography (SS-OCTA) in adolescent and young adult Singaporeans.Methods: This is a prevalent case-control study including 93 young Chinese from the Strabismus, Amblyopia and Refractive error in Singaporean children (STARS, N = 45) study and the Singapore Cohort Study of Risk Factors for Myopia (SCORM, N = 48) studies. Macular vessel density (VD) measurements were obtained from 3 × 3 mm SS-OCTA scans and independently assessed using ImageJ. These measurements were compared between individuals with non-high myopia [non-HM, N = 40; SE >-5.0 diopter (D)] and HM (SE ≤-5.0D, N = 53).Results: The mean macular VD was 40.9 ± 0.6% and 38.2 ± 0.5% in the non-HM and HM, groups, respectively (p = 0.01 adjusted for age and gender). Mean FAZ area in the superficial layer was 0.22 ± 0.02 mm2 in the HM group, which was smaller compared to non-HM group (0.32 ± 0.03 mm2, p = 0.04). Mean deep FAZ area was similar between the two groups (0.45 ± 0.03 mm2 and 0.48 ± 0.04 mm2 in the HM and non-HM groups, respectively, p = 0.70).Conclusions: VD was lower and superficial FAZ area was smaller, in adolescents and young adults with HM compared to non-HM. These findings require validation in prospective studies to assess their impact on the subsequent development of PM.

Association of renal function with retinal vessel density in patients with type 2 diabetes by using swept-source optical coherence tomographic angiography

2020 ◽  
Vol 104 (12) ◽  
pp. 1768-1773 ◽  
Author(s):  
Wei Wang ◽  
Miao He ◽  
Xia Gong ◽  
Lanhua Wang ◽  
Jie Meng ◽  
...  
Keyword(s):  
Renal Function ◽  
Retinal Vessel ◽  
Vessel Density ◽  
Optical Coherence ◽  
Microvascular Damage ◽  
Cross Sectional ◽  
Swept Source ◽  
Patients With Diabetes ◽  
Retinal Vessel Density ◽  
Tomographic Angiography

AimsTo investigate the relationship between retinal vessel density and renal function in patients with diabetes mellitus (DM) using non-invasive optical coherence tomographic angiography (OCTA).MethodsThis prospective cross-sectional study recruited ocular-treatment-naïve patients with DM registered in the community of Guangzhou, China. The retinal vessel density of the superficial capillary plexus in the macula was obtained by using swept-source OCTA imaging. The Xiangya equation was used to calculate the estimated glomerular filtrate rate (eGFR). Participants were divided into the following groups by eGFR: no chronic kidney disease (non-CKD), mild CKD and moderate-to-severe CKD (MS-CKD).ResultsA total of 874 patients with DM (874 eyes), with a mean age of 64.8±7.1 years, were included in the final analysis. The vessel density was significantly lower in patients with CKD than in non-CKD patients in a dose–response pattern, with a parafoveal vessel density of 49.1%±2.1% in non-CKD, 48.4%±1.9% in mild CKD and 47.2%±1.7% in MS-CKD (p<0.001). The sparser retinal capillaries were related to lower eGFR (β=0.037; 95% CI 0.025 to 0.049; p<0.001) and higher microalbuminuria (β = –0.023; 95% CI –0.039 to –0.008; p=0.002). The eGRF was independently associated with parafoveal vessel density (β=0.029; 95% CI 0.016 to 0.042; p<0.001), even after adjusting for other factors.ConclusionRetinal vessel density decreased with renal function impairment, underlining the potential value of OCTA to detect early microvascular damage in the kidney in patients with diabetes.

scholarly journals SAT0230 GIANT CELL ARTERITIS WITH INTRACRANIAL VASCULITIS: A CASE SERIES

2019 ◽  
Author(s):  
Alexander Hawkins ◽  
Catalina Sanchez Alvarez ◽  
Matthew Koster ◽  
Cynthia S. Crowson ◽  
Kenneth J. Warrington
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Case Series
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