High-Resolution OCT of Retinal Vessels in Eyes with Vascular Leakage.

PURPOSE: To identify and compare qualitative and quantitative retinal venous wall alterations associated with fluorescein angiography (FA)-documented vascular leakage in eyes with retinal vein occlusion (RVO) and active uveitis using high-resolution OCT (High-Res OCT), and to assess their longitudinal evolution after uveitis remission.

DESIGN

Prospective, observational, cross-sectional and longitudinal study.

PARTICIPANTS

Twenty-nine eyes from 25 adults with FA-confirmed perivenular leakage due to new-onset RVO (16 eyes) or active uveitis (13 eyes). A subset of uveitis eyes underwent follow-up imaging after clinical remission.

METHODS

High-resolution OCT line scans were acquired longitudinally along leaking retinal veins. Qualitative features (wall splitting, outer fuzziness, hyporeflective spaces) and quantitative metrics (lumen diameter, inner and outer vessel wall thickness, and overlying inner retinal layer thickness) were assessed and compared between RVO and uveitis and against age-, sex-, and laterality-matched healthy control vessels. Longitudinal changes were analyzed in uveitis eyes after remission.

MAIN OUTCOME MEASURES: High-resolution OCT qualitative features and quantitative measurements of retinal venous wall and perivascular structure.

RESULTS

Forty leaking retinal veins (21 RVO, 19 uveitis) were analyzed. Eyes with RVO demonstrated greater lumen diameter (median, 180 μm vs. 122 μm; P < 0.001), increased inner retinal thickness, and hyporeflective inner retinal spaces, without significant outer wall involvement. In contrast, uveitis eyes showed greater outer wall thickness (median, 16.5 μm vs. 11.0 μm; P = 0.001), frequent outer fuzziness (89.5%), and wall splitting (37.5%), without luminal enlargement. Compared with matched healthy controls, RVO vessels exhibited increased lumen diameter, whereas uveitis vessels showed selective outer wall thickening. In longitudinal uveitis analysis, outer wall thickening and wall splitting resolved after remission, while outer fuzziness partially persisted.

CONCLUSIONS

High-resolution OCT identified different patterns of retinal venous wall involvement associated with vascular leakage in eyes with RVO and uveitis. These findings support further evaluation of High-Res OCT as an imaging modality for characterizing retinal vascular leakage and monitoring inflammatory disease activity.

FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.