Moncef Khairallah

Swept-source OCT Angiography and uveitic cystoid macular edema

Moncef Khairallah, Mohamed Ali Gargouri , Sana Khochtali, Nesrine Abroug, Imen Ksiaa


Affiliation: Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia


Purpose:To describe swept-source optical coherence tomography angiography (SS OCTA) findings in eyes with uveitic cystoid macular edema (CME).


Methods:This prospective observational study included 36 eyes of 32 patients with uveitic CME, and 22 eyes of 11 age-matched control patients. All patients with uveitic CME were evaluated using fluorescein angiography, SS OCT, and SS OCTA.


Results: Intraretinal cystoid spaces devoid of flow were shown by SS OCTA  in  both retinal capillary plexuses in 8 eyes (20%), and only in the deep capillary plexus (DCP) in 28 eyes (80%). Localized areas of retinal capillary non perfusion/hypoperfusion were observed in 95% of eyes in the DCP and in 25 % of eyes in the superficial capillary plexus (SCP) (p<0.001).The foveal avascular zone (FAZ) was significantly larger in the DCP than in the control group (1.308vs 0.449 mm2; p< 0.001). It was not statistically different from that of control eyes in the SCP (0.379 vs 0.377 mm2; p = 0.9). Capillary vessel density was significantly lower in the DCP and the SCP than in the control group (13.82vs15.96 mm-1; p< 0.001 and 15.58 vs 18.27 mm-1; p< 0.001,respectively). Complete resolution of uveitic CME occurred in 11 eyes on SS OCT. Both plexuses recovered their normal pattern in 4 eyes (4/11, 36.4%) on SS OCTA. Cystoid spaces were replaced by areas of capillary rarefaction and/or disorganization in 4 eyes (36.4%) and by grayish areas of capillary nonperfusion/hypoperfusion in 3 eyes (27.2%). In eyes with resolved uveitic CME, both the FAZ and the capillary vessel density significantly improved in the DCP (p = 0.036 and p = 0.036, respectively).

Conclusion: SS OCTA provides a good visualization of perifoveal microvascular changes associated with uveitic CME. Resolution of macular edema on SS OCT may be associated with a partial or complete recovery of the normal pattern of retinal capillary plexuses on SS OCTA.