7/27/2019 apao - aios

1/30

Combined Spectral Domain Optical coherence tomography

(SD OCT) , Fluorescein angiography(FA), Indocyanine Green

Angiography (ICGA) and Autofluorescence (AF) features of

Posterior Uveitis

Dr Navneet Mehrotra

Dr Manish Nagpal

7/27/2019 apao - aios

2/30

Financial disclosure

Authors have no financial interest in any of theproducts used

7/27/2019 apao - aios

3/30

Purpose :

To correlate simultaneous FA, ICGA, AF andSDOCT characteristics in cases of posterioruveitis using Spectralis.

7/27/2019 apao - aios

4/30

Materials and Methods

128 eyes of 64 patients of posterior uveitisunderwent imaging using spectralis

Patients with different uveitis entities wereincluded like serpeginous like choroiditis, VKH

7/27/2019 apao - aios

5/30

Serpeginous choroiditis

Serpeginous like choroiditis

Multifocal choroiditis

VKH

Toxoplasma retinochoroiditis

Choroiditis mass

7/27/2019 apao - aios

6/30

FA characteristics

FA characteristics in case of choroiditis include -

- In early phase, new lesions block the backgroundfluorescence.

- In due course leakage of dye appears in and

around the active lesions- Staining in healed lesions

- Window defect in previously scarred lesions

7/27/2019 apao - aios

7/30

Fluorescein angiography

FA early phase

FA late phase

7/27/2019 apao - aios

8/30

Simultaneous

FA and ICG

FA ICG

7/27/2019 apao - aios

9/30

Simultaneous

FA and ICG

FA ICG

7/27/2019 apao - aios

10/30

Simultaneous FA and ICGFA ICG

7/27/2019 apao - aios

11/30

Simultaneous ICG and OCTICG OCT

7/27/2019 apao - aios

12/30

Simultaneous

AF and OCT

Pre treatment

Post treatment

7/27/2019 apao - aios

13/30

Results

33 eyes

Active phase confluenthypofluorescent lesions inICG

Resolution phase

segmentation of confluentlesions

Active phase

After treatment

7/27/2019 apao - aios

14/30

Simultaneous FA and ICG

Active phase

After treatment

FA ICG

FA ICG

7/27/2019 apao - aios

15/30

Results

21 eyes

Active phase

Peripapillary elevation in OCT

Simultaneous AF and OCT

AF OCT

7/27/2019 apao - aios

16/30

SimultaneousAF and OCT

Pre treatment

Post treatment

7/27/2019 apao - aios

17/30

Results

91 eyes

Active phase

Hypofluorescent dots in ICG

7/27/2019 apao - aios

18/30

Active area : ICG - OCT

Hyporeflectivity in choroidal region corresponding to dots in ICG

ICG OCT

7/27/2019 apao - aios

19/30

Simultaneous FA ICG and AF - OCT

Hyperautofluorescencecorresponds to thehypofluorescence inICG

FA ICG

AF OCT

7/27/2019 apao - aios

20/30

Results

12 eyes

Hyperfluorescent dots adjacent to disc in ICG

FA ICG

7/27/2019 apao - aios

21/30

Results

66 eyes

Reduction in hyperautofluorescence inresolving phase

Active phase After treatment

7/27/2019 apao - aios

22/30

Simultaneous AF and OCT

Pre treatment

Post treatment

AF OCT

AF OCT

7/27/2019 apao - aios

23/30

Simultaneous FA and ICG

Lesion size in ICG more than that seen in FA

FA ICG

7/27/2019 apao - aios

24/30

Simultaneous FA

and ICG

Decrease inhypofluorescentdark dotsfollowingtreatment in ICG

Pre treatment

Post treatment

FA ICG

FA ICG

7/27/2019 apao - aios

25/30

Follow up case ofserpeginous likechoroiditis

After 3 mnths

7/27/2019 apao - aios

26/30

Healed serpeginous like choroiditis

AF OCT

7/27/2019 apao - aios

27/30

Simultaneous FA and

ICG

Large choroidal vessels visible in ICG suggestive of healed choroiditis

periphery

FA

FA

ICG

ICG

7/27/2019 apao - aios

28/30

Simultaneous FA OCT of an active area

FA

7/27/2019 apao - aios

29/30

Conclusion

Simultaneous imaging helps in diagnosis andfollow-up of patients with posterior uveitic

diseases

7/27/2019 apao - aios

30/30

Thank you