OCT biomarkers in uveitis.pptx
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This document discusses various aspects of assessing and monitoring uveitis, an inflammatory eye condition, through different grading scales and biomarkers. It outlines several methods for clinically grading uveitis based on factors like anterior chamber cells, vitreous haze, and features seen on optical coherence tomography scans like epiretinal membrane thickness and vitreomacular interface changes. Integrity of the ellipsoid zone layer and measurements of choroidal thickness and vascularity are also mentioned as potential biomarkers for monitoring disease activity and treatment response in conditions like choroiditis. Maintaining control of inflammation and addressing comorbidities can help prevent vision loss from uveitic macular edema.
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OCT biomarkers in uveitis.pptx
- 2. Uveitis assessment is complex •Heterogeneity across the different uveitic phenotypes. •Fluctuations with disease severity and flares.
- 4. The use of OCT in UVEITIS is increasing
- 5. Ideal biomarker for uveitis •reliable. •noninvasive. •easy to acquire in routine clinical practice. •large clinical databases available for validation
- 10. ERM thickness increase with uveitis duration Vitreomacular interface 3rd In most eyes with uveitis and ERM, VA remains stable if ocular inflammation and comorbidities are addressed appropriately.
- 12. Creamy white dots Hyperreflective foci 4TH
- 13. inner retinal ischemia or inflammatory neurodegeneration 5TH DRIL
- 14. most important reversible cause of sight-loss UME 6TH
- 15. why visual acuity may not fully recover to baseline even after UME resolves. irreversible disruption of retinal neural network and permanent visual acuity loss
- 16. Seven-year outcomes of uveitic macular edema: the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study results. Ophthalmology. 2021 May ; 128(5): 719–728 each 100-μm reduction in CST = 6.5-letter increase in VA 20-percent reduction in CST should be used as a clinically meaningful improvement in visual acuity
- 17. placoid syphilis Integrity of ellipsoid zone 7TH
- 18. measurement in the acute stage of choroiditis Choroidal thickness 8TH
- 23. THANK YOU
Editor's Notes
- greater in areas overlying the primary chorioretinal focus. toxoplasmic retinochoroiditis: round hyper-reflective nodule on the outer face of the focally detached posterior hyaloid(yellow arrow), as well as overlying the retina (green arrow). hyper-reflective full thickness retinal lesion (red asterisk
- ERM in IU VMT in sarcoidosis
- COMPLETE PVD
- HRF as deposits located within the walls of intraretinal microaneurysms and scattered throughout all retinal layers, forming confluent plaques in the outer plexiform layers. presence of HRF in the inner and outer retina is associated with worse VA. predict poor treatment response
- derangement of the normal laminar inner retinal structure Foveal DRIL is associated with worse VA at baseline and follow-up visits.Resolution of UME and subretinal fluid occurs after starting treatment. patches of derangement
- neurosensory retina has a degree of elasticity Within limits, the continuity of bipolar cells is maintained even with fluid buildup and the connections between the photoreceptor and ganglion cell layers remain viable. if the edema exceeds elastic limits, bipolar axons snap, compromising transmission pathway.
- Even in the absence of cystoid spaces and SRF, retinal thickness “Non-cystic thickening,” using the central subfield thickness and perivascular thickening are valuable markers of disease activity on OCT active birdshot chorioretinopathy FFA:perivascular leakage immunomodulatory treatment
- EZ integrity reflects the anatomic arrangement of photoreceptor outer segments EZ loss with rapid reconstitution after starting penicillin. intact EZ (arrows) loses its integrity (bracket) within area of UME. mild SRD causing significant EZ disruption degree of EZ disruption has been associated with intensity of corticosteroid therapy required to treat UME
- (i.e., in Vogt-Koyanagi-Harada disease) and for monitoring inflammatory activity.
- ratio of vascular area to the total choroidal area Luminal Area (LA): Area of dark pixels in the choroid Stromal Area (SA): Area of light pixels in the choroid
- 1 retinitis spare RPE and choroid 2 on top of retina 3 intraretinal and fluid and choroid chorioretinitis 4 protrude from choroid to retina through RPE