Validity of Spectral-Domain Optical Coherence Tomography Angiography for Detection of Retinal Vasculitis.

BACKGROUND AND

OBJECTIVE

The aim of this study was to evaluate the validity and accuracy of spectral-domain optical coherence tomography angiography (SD-OCTA) in detecting small-vessel retinal vasculitis (RV) at the posterior pole.

PATIENTS AND

METHODS

In this prospective study, subjects with and without retinal vasculitis on fundus fluorescein angiography (FFA) were identified among the clinic population and imaged with 8 × 8-mm SDOCTA scans centered on the fovea. Retinal vasculitis was detected using a customized method based on increased perivascular retinal thickness on OCTA. Three reviewers evaluated the FFA and composite en-face scans on SD-OCTA. The method's accuracy was assessed by obtaining sensitivity, specificity, negative predictive value, and positive predictive values, together with 95% confidence intervals, where the gold standard was the consensus FFA result.

RESULTS

Eighteen eyes without RV and 34 eyes with RV were selected for evaluation. The consensus sensitivity and specificity were 88.2% (P < .0001) and 77.7% (P = .0184), respectively. Several distinct patterns were recognized on OCTA scans based on retina vessel staining, leakage, cystoid macular edema, and ischemia.

CONCLUSIONS

SD-OCTA is a valid and accurate noninvasive imaging tool that detects small-vessel RV at the posterior pole using customized scans across a wide range of RV etiologies. Future studies combining wide-field images and en-face scans may demonstrate OCTA's usefulness in detecting and monitoring retinal vasculitis.