Diagnosis and Monitoring of Retinal Vasculitis by Widefield Swept Source OCT Angiography

Objectives: To evaluate the utility of widefield montage swept-source OCT angiography (SS-OCTA) in detecting and monitoring retinal vasculitis beyond the posterior pole. Methods: Prospective case series. Patients with clinically diagnosed retinal vasculitis imaged with a same-day widefield SS-OCTA montage and ultra-widefield fluorescein angiography (FA) at 2 or more visits. Five overlapping 12 × 12 mm SS-OCTA scans were acquired to provide imaging of the posterior pole and each quadrant of the near periphery. A color retinal thickness map was superimposed on each 12 × 12 mm en-face flow scan with a customized segmentation to demonstrate perivascular retinal thickening. A composite "montage" image was then created by combining the scans to allow for analysis of the macula and near periphery. Findings were then correlated with the same-day FA, the current "gold standard" diagnostic tool for retinal vasculitis, to assess diagnostic efficacy. Results: SS-OCTA demonstrated perivascular thickening in both the posterior pole and peripheral retina in 30 eyes of 16 patients and was found to be an effective diagnostic tool with good correlation to findings on fluorescein angiography for monitoring retinal vasculitis over time. Conclusions: The widefield SS-OCTA montage expands the visualization of retinal vasculitis into the near periphery, providing a noninvasive tool that may complement FA in the diagnosis and monitoring of retinal vasculitis.