Optical coherence tomography angiography in uveitis

Paris Tranos, Evdoxia-Maria Karasavvidou, Olga Gkorou, Carlos Pavesio

Journal of Ophthalmic Inflammation and Infection


Before the introduction of optical coherence tomography angiography (OCTA) in the early 2000s, dye-based angiography was considered the “gold standard” for the diagnosis and monitoring of ocular inflammation. OCTA is a novel technique, which demonstrates capillary networks based on the amount of light returned from moving blood cells, providing further information on pathophysiological changes in uveitis.

The aim of this review is to describe the basic principles of OCTA and its application to ocular inflammatory disorders. It particularly emphasizes on its contribution not only in the diagnosis and management of the disease but also in the identification of possible complications, comparing it with fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA). Although the advent of OCTA has remarkably enhanced the assessment of uveitic entities, we highlight the need for further investigation in order to better understand its application to these conditions.


In recent years various imaging modalities have emerged facilitating effective investigation, diagnosis and monitoring of ocular disorders [1]. In 2006, Makita et al. first described optical coherence tomography angiography (OCTA), a novel imaging modality which utilizes the advances in OCT technology to provide new insight in retinal microvascular changes, without the requirement of intravenous dye injection. This innovative technique provides high-resolution angiographic information that can be objectively correlated to OCT anatomic findings [2,3,4].

Uveitis is associated with a spectrum of pathologic processes including inflammation, vascular occlusion or leakage, local ischemia, and alteration of cellular mediators. Visually debilitating complications such as macular edema and neovascularization among others may potentially occur. Also, some inflammatory lesions may be difficult to differentiate from a vascular lesion. Early identification and monitoring of these changes may be critical in the optimal management of patients with uveitis. Recent studies suggest that the use of OCTA, in conjunction with the other imaging modalities, can be advantageous in patients with ocular inflammation, revealing features which may improve our knowledge on pathophysiology and natural course of the disease and guide decision making for the uveitis specialist [3].

In this review, a comprehensive overview of the principles of OCTA and its application to ocular inflammatory disorders has been performed.

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Source: Springer