Swept-Source OCT Angiography of Serpiginous Choroiditis

Area of Science:

• Ophthalmology
• Medical Imaging
• Choroid Diseases

Background:

• Serpiginous choroiditis (SC) is an inflammatory condition affecting the choroid.
• The primary site of SC pathology remains debated, with varying involvement of retinal layers.
• Non-invasive imaging modalities are crucial for understanding SC progression and treatment response.

Purpose of the Study:

• To quantify choriocapillaris lesions in active and quiescent serpiginous choroiditis (SC).
• To utilize swept-source optical coherence tomography angiography (SS-OCTA) and en-face imaging for lesion analysis.
• To compare SS-OCTA findings with traditional multimodal imaging and assess treatment effects.

Main Methods:

• A prospective observational case series involving patients with SC.
• SS-OCTA imaging of active and quiescent SC lesions before and after anti-inflammatory treatment.
• En-face analysis of choriocapillaris (CC-slab) and outer nuclear layer (ONL-slab) with semi-automated MATLAB quantification.

Main Results:

• Choriocapillaris lesions were identified in four of six eyes, correlating with indocyanine green angiography.
• CC-slab lesion area increased with disease activity and decreased with treatment, larger than ONL-slab and autofluorescence lesions.
• Active CC-slab lesions resolved without scarring after treatment, suggesting choriocapillaris as the primary site.

Conclusions:

• En-face SS-OCTA analysis of choriocapillaris flow voids is a non-invasive method for detecting SC lesions.
• Findings support the hypothesis that the choriocapillaris is the primary site of pathology in SC.
• SS-OCTA offers a promising, non-invasive approach for monitoring SC activity and guiding treatment.