Optical coherence tomography for evaluating the retina and choroid in children with intermediate uveitis

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Abstract

Intermediate uveitis refers to the inflammation of the vitreous, ciliary body, and peripheral regions of the retina, and it is associated with rapid progression of macular edema and epiretinal membranes. Optical coherence tomography (OCT) examination of the retina and choroid in adult patients with intermediate uveitis demonstrates thickening in the central retina and absence of choroidal changes. Similar studies in children are lacking.

Aim: of our study was to analyze quantitative and qualitative changes in the retina and choroid in children with intermediate uveitis using OCT and to determine the possibility of using of these data for monitoring and evaluation of disease activity.

Material and methods: Twenty children with intermediate uveitis (39 eyes) aged 7–17 years were examined. In addition to standard ophthalmologic examination, all children were examined using OCT with the enhanced depth image module (EDI-OCT). The thicknesses of the retina and choroid were measured manually in the foveal zone and up to 3 mm in the nasal quadrant temporally, above, and below the fovea. Sixteen children (31 eyes) were examined for differences in disease activity and duration. The OCT examination results of the eyes of patients were compared with those of the healthy eyes (according to literature data).

Results: A significant increase in retinal thickness due to edema was observed across all measuring points in eyes with active inflammation as compared with eyes with inactive uveitis and healthy eyes. Macular edema was detected in 83% and 71% of the patients with active and moderate inflammation, respectively. Edemas were cystoid in 10% and diffuse in 90% of the patients. Analyses revealed a strong negative correlation between retinal thickness and uveitis duration. Choroid thickness varied only slightly among patients, with no significant differences across stages of inflammatory activity.

Conclusion: Our results confirm that macular edema has a higher rate of progression in children with active intermediate uveitis and that uveitis duration and central retinal thickness caused by macular edema resorption and by dystrophic processes are strongly negatively correlated. Uveitis inflammatory activity does not affect the thickness of the choroid in the central zone.

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About the authors

Olga V. Novikova

Helmholtz National Medical Research Center of Eye Diseases

Author for correspondence.
Email: olganovv@mail.ru
ORCID iD: 0000-0002-8251-9775

MD

Russian Federation, Moscow, 105062

Lyudmila A. Katargina

Helmholtz National Medical Research Center of Eye Diseases

Email: info@igb.ru
ORCID iD: 0000-0002-4857-0374

MD, PhD, Professor

Russian Federation, Moscow, 105062

Ekaterina V. Denisova

Helmholtz National Medical Research Center of Eye Diseases

Email: deale_2006@inbox.ru
ORCID iD: 0000-0003-3735-6249

MD, Phd

Russian Federation, Moscow, 105062

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Supplementary files

Supplementary Files
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1. Fig. 1. Patient L. Macular OCT, active uveitis, diffuse macular edema. Note. Аrrows indicate extended due to edema hyporeflective space between outer limiting membrane and outer plexiform layer. Retina is “sponge-like” due to microcysts. Its thickness increased.

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2. Fig. 2. Patient K. Macular OCT, active uveitis, cystoid macular edema. Note. Arrows indicate big cystoid spaces in foveal zone, which deform foveal curvature. Retinal thickness increased.

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3. Fig. 3. Patient F. Macular OCT, active intermediate uveitis. Note. This figure demonstrates macular OCT of patient F. with active intermediate uveitis. Retinal layers are differentiated, foveal curvature is not changed, retinal thickness slightly increased. There are no cystoid spaces, but the reflectivity of retina decreased. It is probably the sign of intraretinal accumulation of fluid.

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4. Fig. 4. Patient F. Macular OCT, inactive intermediate uveitis. Note. This figure demonstrates macular OCT of patient F. with inactive intermediate uveitis (medicine remission). Retinal layers are clearly differentiated, foveal curvature is not changed.

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5. Fig. 5. Patient M. Macular OCT. Traction edema. Note. Arrow indicates epiretinal membrane, traction causes thickness increasing and deformation of retina. Foveal curvature is smoothed, cystoid spaces are absent, retinal thickness increased.

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6. Fig. 6. Correlation between retinal thickness and disease duration (nasal).

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7. Fig. 7. Correlation between retinal thickness and disease duration (temporal).

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8. Fig. 8. Correlation between retinal thickness and disease duration (suprafoveal).

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9. Fig. 9. Retinal thickness of the left eye of patient A., correlation with disease duration.

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