Purpose

To evaluate widefield fundus fluorescein angiography (FFA) findings and optical coherence tomography angiography (OCTA) findings in retinal vasculitis

Methods

In this prospective, longitudinal study consecutive patients with active, resolving, and non-active retinal vasculitis who underwent wide-field FFA and SS-OCTA were included. OCT images were acquired using PLEX Elite 9000 (Carl Zeiss Meditec, Inc, Dublin, California) and wide-field fundus fluorescein angiography (105-degree field of view) was performed with Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany). Images were analyzed for the vascular changes in the superficial ciliary plexus, deep ciliary plexus, and chorio-capillaries using swept-source wide-field OCTA and the pattern of vascular abnormalities like neovascularization, retinal capillary non-perfusion area, and the foveal avascular zone using wide-field fundus fluorescein angiography (FFA) were recorded accordingly. Based on the Clinical picture and FFA findings, the patients were divided into two groups 1. Active and 2. Inactive

Results

Thirty-two patients, were included in the study.Of them, 26 (81.25%) were male. The mean age of the patients was 37.68±12.41 years. Bilateral involvement was observed in 23 (71.9%) patients whereas, 9 (28.1%) had unilateral involvement. According to the disease activity, the eyes were grouped into 1. Active (13 eyes, 27.3%) and 2. Inactive groups (40 eyes, 72.7%). In the Active group, 5 eyes had no neovascularization (NV) or capillary non-perfusion areas (CNP areas), in which OCTA and FFA had similar vascular patterns but eyes with NV and extensive CNP areas are significantly better on FFA when compared to OCTA. On OCTA even though we can see the NV and CNP areas along with other structural vascular changes, there is a chance of missing NV but on FFA, NV and CNP areas are well delineated and better detected (p = 0.05), when compared with OCTA. In eyes with inactive disease, OCTA had a significantly better detection rate of CNP areas and NV when compared with FFA (p=0.05). On OCTA Superficial capillary plexus showed better vascular details than the deep capillary plexus.

Conclusions

In eyes with active disease, FFA is a mandatory investigation,not only to identify the disease activity but also the severity of the disease and area of involvement but in eyes with inactive disease, OCTA is more useful for tracking the vascular and retinal changes than FFA