11 research outputs found

    Choroidal change in acute anterior uveitis associated with human leukocyte antigen-B27

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    <div><p>Purpose</p><p>To evaluate choroidal changes in eyes with acute anterior uveitis associated with human leukocyte antigen (HLA)-B27</p><p>Methods</p><p>In 44 patients with first-onset, unilateral, acute-onset (<1 week) anterior uveitis for which diagnostic work-ups revealed positivity only for HLA-B27, wide-field three-dimensional volumetric raster scan using swept-source optical coherence tomography was performed for both eyes. Choroidal thickness was measured by automated segmentation and thickness mapping and compared between eyes with uveitis and the fellow eyes at baseline. Choroidal thickness was compared before and after topical and/or systemic corticosteroid therapy. Relative choroidal thickening was defined as the choroidal thickness of the uveitic eye minus that of the corresponding eye and correlated with the degree of intraocular inflammation.</p><p>Results</p><p>Compared to the fellow eyes, eyes with acute anterior uveitis showed significant choroidal thickening on the subfoveal and parafoveal areas at baseline (all P <0.05). En face choroidal imaging showed dilation of large choroidal vessels on the macula. Relative choroidal thickening significantly correlated with the degree of anterior chamber inflammation at baseline (correlation coefficient = 0.341, P = 0.023). After treating inflammation, the choroid on the macula thinned significantly (from 262.1 ± 66.5 to 239.5 ± 61.0 μm in the subfoveal choroid, P<0.001).</p><p>Conclusions</p><p>Eyes with HLA-B27-associated anterior uveitis showed significant choroidal thickening at acute phase that subsequently decreased after treatment, indicating subclinical choroidal inflammation in the eyes. Choroidal thickness might indicate disease activity in acute anterior uveitis associated with HLA-B27.</p></div

    Multimodal Imaging Including Optical Coherence Tomography Angiography in Serpiginous Choroiditis

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    <p><i>Purpose</i>: To report multimodal imaging in patients with serpiginous choroiditis.<i>Methods</i>: A 60-year-old woman with active serpiginous choroiditis in the right eye was evaluated during the disease course with multimodal imaging, which included fluorescein angiography, swept-source optical coherence tomography (SS-OCT), OCT angiography, fundus autofluorescence (FAF), and retromode imaging.<i>Results</i>: The patient had subretinal, yellowish lesion on the macula at presentation. The margin of the lesion was remarkable in FAF and retromode imaging. SS-OCT scans revealed slightly thickened hyporeflective space and tiny hyperreflective spots at the choriocapillaris level. OCT angiography demonstrated decreased vascularity on the choriocapillaris. Although the area was partially replaced with irregular capillaris, the photoreceptor defect persisted following systemic corticosteroid therapy.<i>Conclusions</i>: Multimodal imaging shows that inflammation of the choriocapillaris is a main pathology of serpiginous choroiditis. The destruction of the choriocapillaris may lead to the photoreceptor disruption, resulting in permanent visual loss in serpiginous choroiditis.</p

    En face choroidal imaging in an eye with acute anterior uveitis and the fellow eye.

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    <p>The choriocapillaris or Sattler’s layer shows no remarkable change between uveitic and fellow eyes or before and after the treatment in the uveitic eye. However, the Haller’s layer in the eye with active uveitis shows dilation of the large choroidal vessels on the macular area at baseline (Box 1) compared to images obtained after treatment (Box 2) or fellow eye, which is more remarkable in magnified images on the macular area (lower).</p

    Swept-source optical coherence tomography (SS-OCT) B-scan images in three representative patients with unilateral, acute, anterior uveitis.

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    <p>Compared to the fellow eyes (right), the eyes with acute anterior uveitis (left) show choroidal thickening of the macular area, which can be also determined by numerical values of choroidal thicknesses of the thickness maps (right side of each figure). Choroidal thickness decreased after topical and/or systemic corticosteroid therapy in the eyes with uveitis. In the fellow eyes, however, there were no significant changes in choroidal thickness before and after the treatment. The numbers within parentheses indicate the grades of anterior chamber inflammation.</p

    A photographic example of fundus photography and swept-source optical coherence tomography in an eye with acute anterior uveitis associated with human leukocyte antigen (HLA)-B27, covering a 12 (horizontal) × 9 (vertical)-mm area (box in left).

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    <p>Automated measurement of choroidal thickness by automated segmentation, which demarcates the outer border of the retinal pigment epithelium and the inner border of chorioscleral interface (indicated by lines), was performed using software provided by the manufacturer. A choroidal thickness map (upper right) was generated, and subfoveal choroidal thickness and parafoveal choroidal thicknesses were used for our analyses. Peripapillary thicknesses were also measured by automated segmentation and thickness mapping (lower), and the thicknesses on 4 quadrants (lower right) were used for our analyses. N = nasal; S = superior; T = temporal; I = inferior.</p

    Comparison of macular and peripapillary choroidal thicknesses before and after treatment of anterior uveitis.

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    <p>Subfoveal and parafoveal choroidal thickness thinned significantly following treatment (all P <0.05). Peripapillary choroidal thicknesses show significant difference only in nasal and temporal quadrants. Asterisk (*) indicates statistical significance (P <0.05).</p

    Comparison of macular and peripapillary choroidal thicknesses between eyes with acute anterior uveitis and the fellow eyes.

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    <p>There are significant differences in subfoveal and parafoveal choroidal thicknesses between the uveitic and fellow eyes. Asterisk (*) indicates statistical significance (P <0.05).</p

    Demographic data and clinical characteristics of included patients.

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    <p>Data are presented as number of patients (%) or mean ± standard deviation.</p

    Independent, non-derived stereometric parameters of the optic nerve and nerve fiber layer in HIV+ patients compared to HIV-seronegative controls.

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    <p>HIV+ = subjects who are human immunodeficiency virus (HIV) positive, HIV- = subjects who are HIV negative controls, CD4 = CD4 cell count, SD = standard deviation, RNFL = retinal nerve fiber layer, mm–millimeter.</p><p>*—statistically significant</p><p>Independent, non-derived stereometric parameters of the optic nerve and nerve fiber layer in HIV+ patients compared to HIV-seronegative controls.</p
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