Ultra-Widefield Indocyanine Green Angiography in Uveitis

Area of Science:

• Ophthalmology
• Medical Imaging
• Inflammatory Eye Diseases

Background:

• Uveitis diagnosis can be challenging due to posterior segment inflammation.
• Conventional imaging may not fully capture peripheral retinochoroidal involvement in uveitis.

Purpose of the Study:

• To determine the added diagnostic value of ultra-widefield indocyanine green angiography (UWF-ICGA) in evaluating various forms of uveitis.
• To assess the extent of peripheral retinochoroidal lesions in uveitis patients using UWF-ICGA.

Main Methods:

• Retrospective observational study of 343 eyes with posterior uveitis, panuveitis, or vasoproliferative tumors.
• Utilized Optos Silverstone device for ultra-widefield indocyanine green angiography (UWF-ICGA).
• Primary outcome: percentage of eyes with lesions extending beyond the vortex veins.

Main Results:

• UWF-ICGA identified peripheral pathological findings in 71.4% of uveitis cases.
• Extreme peripheral involvement was noted in 100% of ampiginous choroiditis and vasoproliferative tumor cases.
• Peripheral lesions were detected in 11.1% to 93.9% of various other uveitis subtypes, including Vogt-Koyanagi-Harada disease and birdshot chorioretinitis.

Conclusions:

• UWF-ICGA significantly expands diagnostic capabilities for uveitis by visualizing peripheral retinochoroidal inflammation.
• This advanced imaging technique aids in detecting inflammatory activity often missed by conventional methods.
• Integration of UWF-ICGA can influence therapeutic decisions and improve disease monitoring accuracy in uveitis patients.