Quantitative Analysis of the Choriocapillaris in Uveitis Using En Face Swept-Source Optical Coherence Tomography Angiography

PURPOSE: To perform a quantitative analysis of chorio-capillaris (CC) flow deficits (FDs) in patients with uveitis. DESIGN: Retrospective cross-sectional study. METHODS: Swept-source optical coherence tomography based angiography (SS-OCTA) macular volume scans (3 x 3 mm and 6 x 6 mm) were obtained using the Plex Elite 9000. En face CC images were generated and analyzed using an automated FD identification algorithm. Three quantitative metrics were determined for each eye: FD number (FDN), mean FD size (MFDS), and FD density (FDD). Quantitative metrics were compared between uveitis and control eyes. The uveitis cohort was further subdivided by the presence or absence of choroidal involvement, and quantitative metrics were compared between subgroups and normal control subjects. RESULTS: A total of 38 eyes from 38 control subjects and 73 eyes from 73 uveitis subjects were included in this study. Eyes with uveitis have significantly larger CC MFDS (3- x 3-mm scans; P < .0001; 6- x 6-mm scans; P < .0001) and higher FDD (P = .0002; P = .0076, respectively) compared to control eyes. Additional analysis determined that these differences were due to the choroidal disease subgroup, which demonstrates significantly larger MFDS (3 x 3 = 1,108 mu m(2); 6 x 6 = 1,104 mu m(2)) compared to both normal control eyes (752 mu m(2); P < .0001; 802 mu m(2); P < .0001, respectively) and uveitis patients without choroidal involvement (785 mu m(2); P < .0001; 821 mu m(2); P < .0001, respectively). No significant differences were found between the quantitative metrics of control subjects and patients without choroidal involvement. CONCLUSIONS: Automated quantification of CC can identify pathological FDs and provide quantitative metrics describing such lesions in patients with uveitis. Posterior uveitis patients have significantly larger CC FDs than patients with other forms of uveitis. (C) 2020 Elsevier Inc. All rights reserved.