The role of OCTA in the diagnosis and follow-up of inflammatory choroidal neovascularization in serpiginous-like choroiditis
Purpose
Ocular tuberculosis may present as Serpiginous-Like Choroiditis (SLC). The development of inflammatory choroidal neovascularization (CNV) confers a worse long-term visual prognosis. Fluorescein and indocyanine green angiography remain gold-standard for CNV diagnosis. However, more recently, optical coherence tomography angiography (OCTA) offered a valuable tool in the diagnosis and follow-up of neovascular complications in SPC.
Methods
Retrospective, observational study of SLC patients monitored in the ocular immunology department of Centro Hospitalar Lisboa Ocidental (Portugal) from January 2012 to September 2022. All patients with a SLC diagnosis underwent an interferon-gamma release assay (IGRA) and/or Mantoux test (MT).
Results
Twenty-two eyes of 11 patients were included (mean age 59.0±13.6 years, mean follow-up 5.9±2.8 years). 9 (81.8%) patients had a positive IGRA and 3 (27.1%) a positive MT. CNV was diagnosed in 10 (45.5%) eyes of 7 (63.6%) patients. Mean time from SLC diagnosis to CNV detection was 3.4±3.5 years. After 2018, all patients were diagnosed with CNV using OCTA. 7 (70.0%) eyes were treated with intravitreal anti-VEGF agents (mean 4±11 injections) and showed good anatomical results in OCTA. In this report, eyes with CNV showed a lower final visual acuity versus eyes without neovascular complications (p=0.04).
Conclusion
Introduction of OCTA in our clinical practice revealed to be an essential tool in the evaluation of SLC patients: previous findings attributed to the inflammatory disease were successfully diagnosed as CNV. Hence, this study highlights the importance of multimodal imaging in prompt detection and follow-up after treatment of CNV in SLC.
Conflict of interest
No
Authors 1
Last name
GUEDES
Initials of first name(s)
M
Department
Centro Hospitalar Lisboa Ocidental
City
Lisbon
Country
Portugal
Authors 2
Last name
BAPTISTA
Initials of first name(s)
ML
Department
Centro Hospitalar Lisboa Ocidental
City
Lisbon
Country
Portugal
Authors 3
Last name
ROMANA
Initials of first name(s)
J
City
Lisbon
Country
Portugal
Authors 4
Last name
MADEIRA
Initials of first name(s)
F
City
Lisbon
Country
Portugal
Authors 5
Last name
CORDEIRO
Initials of first name(s)
M
City
Lisbon
Country
Portugal
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