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EDI‐OCT is less suited for close monitoring of primary stromal choroiditis when compared to Indocyanine green angiography
Author(s) -
Herbort C.P.,
Balci O.,
Gasc A.,
Jeannin B.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0326
Subject(s) - medicine , indocyanine green angiography , ophthalmology , vogt–koyanagi–harada disease , uveitis , indocyanine green , choroiditis , choroidal neovascularization , occult , angiography , retinal , radiology , fluorescein angiography , surgery , pathology , alternative medicine
Purpose Investigate the performance, utility, and precision, of enhanced depth imaging optical coherence tomography thickness (EDI‐OCT‐T), versus indocyanine green angiography (ICGA), in tracking any fluctuation in the activity of primary stromal choroiditis (PSC) in response to therapy during long‐term follow‐up. Methods Patients with a diagnosis of PSC; Vogt Koyanagi Harada (VKH) or birdshot retinochoroiditis (BRC), with untreated initial disease with long‐term follow‐up including both ICGA and EDI‐OCT, were recruited at the Centre for Ophthalmic Specialized care, Lausanne, Switzerland. Angiography signs were quantified according to established dual FA and ICGA scoring systems for uveitis. Changes in ICGA score, and EDI‐OCT‐T, in response to therapy, were assessed. Results Among 1829 uveitis patients seen from 1995 to 2015, 59 patients (3.2%) were diagnosed with PSC of which 4 patients (2 BRC and 2 VKH) fulfilled the restrictive inclusion criteria. Mean EDI‐OCT‐T decreased from 672 ± 101 μ m at entry to 358.5 ± 44.5 μ m in a mean of 26.5 months at stabilization. Mean ICGA scores decreased from 28 ± 4.2 at entry, to 5 ± 7 at stabilization. Only ICGA was sufficiently sensitive and reactive to detect disease recurrencies and efficacy or absence of effect of successive treatment changes, detected in 7 instances during follow‐up, but not recorded by EDI‐OCT. Conclusions This pilot study showed that ICGA was the more sensitive methodology; able to promptly identify evolving subclinical and occult choroidal disease and flag occult recurrence and/or therapeutic responses that were otherwise missed by EDI‐OCT. Although EDI‐OCT‐T showed a linear decrease, these changes were too sluggish to be relied upon for close follow‐up and timely adjustment of therapy.