Russian Pediatric OphthalmologyRussian Pediatric OphthalmologyРоссийская педиатрическая офтальмология1993-18592412-432XEco-Vector11195510.17816/rpoj111955Original study articleОригинальные исследованияResearch ArticleState of microcirculation in the retina and choroid according to optical coherence tomography with angiography data in children with posterior and panuveitisСостояние микроциркуляции в сетчатке и сосудистой оболочке по данным оптической когерентной томографии с ангиографией у детей с задними и панувеитамиhttps://orcid.org/0000-0002-8251-9775NovikovaOlga V.НовиковаОльга Владимировна
Russian Federation

MD, ophthalmologist

врач-офтальмолог

olganovv@mail.ruhttps://orcid.org/0000-0003-3735-62494111-4330DenisovaEkaterina V.ДенисоваЕкатерина Валерьевна
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

deale_2006@inbox.ruHelmholtz National Medical Research Center of Eye DiseasesНМИЦ глазных болезней им. Гельмгольца2401202317427341710202224102022Copyright ©; 2023, Eco-VectorCopyright ©; 2023, ООО "Эко-Вектор"2023Eco-VectorООО "Эко-Вектор"https://ruspoj.com/1993-1859/article/view/111955

AIM: Retinal and choroidal microvascular changes analysis in children with posterior and panuveitis using optical coherence tomography with angiography (OCTA) and determination of the possibility of using this method in activity assessment and disease monitoring.

MATERIAL AND METHODS: 24 children with uveitis were examined. The age of children was from 8 to 18 years old (38 affected eyes). All included patients were divided into two groups: with posterior uveitis (27 eyes) and with panuveitis (11 eyes). In each of the groups, subgroups with active and inactive uveitis were identified. In addition to the standard examination OCTA was performed. Foveal avascular zone (FAZ) area, perfusion density in the superficial and deep vascular plexuses of the retina (SVRP, DVRP) and also in the layers of choriocapillaries and large and medium vessels of the choroid were studied. The control group consisted of 10 paired healthy eyes.

RESULTS: Аll eyes with posterior and panuveitis were characterized by the irreversible decrease in perfusion density in DVRP. In eyes with active chorioretinitis was also detected the reversible decrease in perfusion density in SVRP, layers of choriocapillaries and large and medium vessels of the choroid. The formation of choroidal neovascular membranes (CNM) in patients with panuveitis with choroiditis was accompanied by the decrease in perfusion density at all levels studied. In eyes with chorioretinitis and CNM the decrease in perfusion density was detected in DVRP and the area of FAZ increased.

CONCLUSION: The features of microcirculation in the chorioretinal complex identified using OCTA in children with posterior and panuveitis can improve the diagnosis and monitoring of these diseases.

Цель. Анализ изменений микроциркуляторного русла сетчатки и сосудистой оболочки у детей с задними и панувеитами по данным оптической когерентной томографии с ангиографией (ОКТА) и определение возможности использования метода в оценке активности и мониторинге заболевания.

Материал и методы. Обследовали 24 ребёнка с увеитами в возрасте от 8 до 18 лет (38 больных глаз). Все дети были разделены на 2 группы: с задними увеитами (27 глаз) и панувеитами (11 глаз). В каждой из групп были выделены подгруппы с активным и неактивным увеитом. Помимо стандартного обследования, проводили ОКТА. Анализировали площадь фовеолярной аваскулярной зоны (ФАЗ), перфузионную плотность в поверхностном и глубоком сосудистых сплетениях сетчатки (ПССС, ГССС), слое хориокапилляров и собственно сосудистой оболочке. Группу контроля составили 10 парных здоровых глаз.

Результаты. Для всех глаз с задними и панувеитами было характерно необратимое снижение плотности перфузии в ГССС. При активных хориоретинитах, кроме того, выявлялось снижение перфузионной плотности в ПССС, слое хориокапилляров и слое собственных сосудов хориоидеи, которое было обратимым. Формирование хориоидальных неоваскулярных мембран (ХНМ) у пациентов с панувеитом с хориоидитом сопровождалось уменьшением перфузионной плотности на всех исследуемых уровнях, при хориоретинитах — на уровне ГССС и увеличением площади ФАЗ.

Заключение. Выявленные с помощью оптической когерентной томографии с ангиографией особенности микроциркуляции в хориоретинальном комплексе у детей с задними и панувеитами позволяют усовершенствовать диагностику и мониторинг этих заболеваний.

posterior uveitispanuveitisoptical coherence tomography with angiographychildrenchoroidal neovascularisationзадний увеитпанувеитоптическая когерентная томография с ангиографиейдетихориоидальная неоваскуляризацияKatargina LA, Khvatova AV. Endogennye uveity u detei i podrostkov. Moscow: Meditsina; 2000. (In Russ).Катаргина Л.А., Хватова А.В. Эндогенные увеиты у детей и подростков. Москва: Медицина, 2000.Guseva MR. The clinical-and-epidemiological specifity of uveitis in children. The Russian Annals of Ophthalmology. 2004;120(1):15–19. (In Russ).Гусева М.Р. Клинико-эпидемиологические особенности увеитов у детей // Вестник Офтальмологии. 2004. Т. 120, № 1. С. 15–19.Smith JA, Mackensen F, Sen HN, et al. Epidemiology and course of disease in childhood uveitis. Ophthalmology. 2009;116(8):1544–1551,1551.e1. doi: 10.1016/j.ophtha.2009.05.002. Erratum in: Ophthalmology. 2011;118(8):1494.Smith J.A., Mackensen F., Sen H.N., et al. Epidemiology and course of disease in childhood uveitis // Ophthalmology. 2009. Vol. 116, N 8. Р. 1544–1551, 1551.e1. doi: 10.1016/j.ophtha.2009.05.002. Erratum in: Ophthalmology. 2011. Vol. 118, N 8. P. 1494.Ghassemi F, Fadakar K, Bazvand F. The Quantitative Measurements of Vascular Density and Flow Areas of Macula Using Optical Coherence Tomography Angiography in Normal Volunteers. Ophthalmic Surg Lasers Imaging Retina. 2017;48(6):478–486. doi: 10.3928/23258160-20170601-06Ghassemi F., Fadakar K., Bazvand F. The Quantitative Measurements of Vascular Density and Flow Areas of Macula Using Optical Coherence Tomography Angiography in Normal Volunteers // Ophthalmic Surg Lasers Imaging Retina. 2017. Vol. 48, N 6. Р. 478–486. doi: 10.3928/23258160-20170601-06Waizel M, Todorova MG, Terrada C, et al. Superficial and deep retinal foveal avascular zone OCTA findings of non-infectious anterior and posterior uveitis. Graefes Arch Clin Exp Ophthalmol. 2018;256(10):1977–1984. doi: 10.1007/s00417-018-4057-yWaizel M., Todorova M.G., Terrada C., et al. Superficial and deep retinal foveal avascular zone OCTA findings of non-infectious anterior and posterior uveitis // Graefes Arch Clin Exp Ophthalmol. 2018. Vol. 256, N 10. Р. 1977–1984. doi: 10.1007/s00417-018-4057-yLiang A, Zhao C, Jia S, et al. Retinal Microcirculation Defects on OCTA Correlate with Active Inflammation and Vision in Vogt-Koyanagi-Harada Disease. Ocul Immunol Inflamm. 2021;29(7–8):1417–1423. doi: 10.1080/09273948.2020.1751212Liang A., Zhao C., Jia S., et al. Retinal Microcirculation Defects on OCTA Correlate with Active Inflammation and Vision in Vogt-Koyanagi-Harada Disease // Ocul Immunol Inflamm. 2021. Vol. 29, N 7–8. Р. 1417–1423. doi: 10.1080/09273948.2020.1751212Fan S, Lin D, Hu J, et al. Evaluation of microvasculature alterations in convalescent Vogt-Koyanagi-Harada disease using optical coherence tomography angiography. Eye (Lond). 2021;35(7):1993–1998. doi: 10.1038/s41433-020-01210-5Fan S., Lin D., Hu J., et al. Evaluation of microvasculature alterations in convalescent Vogt-Koyanagi-Harada disease using optical coherence tomography angiography // Eye (Lond). 2021. Vol. 35, N 7. Р. 1993–1998. doi: 10.1038/s41433-020-01210-5Karaca I, Yılmaz SG, Afrashi F, Nalçacı S. Assessment of macular capillary perfusion in patients with inactive Vogt-Koyanagi-Harada disease: an optical coherence tomography angiography study. Graefes Arch Clin Exp Ophthalmol. 2020;258(6):1181–1190. doi: 10.1007/s00417-020-04676-xKaraca I., Yılmaz S.G., Afrashi F., Nalçacı S. Assessment of macular capillary perfusion in patients with inactive Vogt-Koyanagi-Harada disease: an optical coherence tomography angiography study // Graefes Arch Clin Exp Ophthalmol. 2020. Vol. 258, N 6. Р. 1181–1190. doi: 10.1007/s00417-020-04676-xMandadi SKR, Agarwal A, Aggarwal K, et al. Novel findings on optical coherence tomography angiography in patients with tubercular serpiginous-like choroiditis. Retina. 2017;37(9):1647–1659. doi: 10.1097/IAE.0000000000001412Mandadi S.K.R., Agarwal A., Aggarwal K., et al. Novel findings on optical coherence tomography angiography in patients with tubercular serpiginous-like choroiditis // Retina. 2017. Vol. 37, N 9. Р. 1647–1659. doi: 10.1097/IAE.0000000000001412Pichi F, Sarraf D, Morara M, et al. Pearls and pitfalls of optical coherence tomography angiography in the multimodal evaluation of uveitis. J Ophthalmic Inflamm Infect. 2017;7(1):20. doi: 10.1186/s12348-017-0138-zPichi F., Sarraf D., Morara M., et al. Pearls and pitfalls of optical coherence tomography angiography in the multimodal evaluation of uveitis // J Ophthalmic Inflamm Infect. 2017. Vol. 7, N 1. Р. 20. doi: 10.1186/s12348-017-0138-zMontorio D, Giuffrè C, Miserocchi E, et al. Swept-source optical coherence tomography angiography in serpiginous choroiditis. Br J Ophthalmol. 2017;102(7):991–995. doi:10.1136/bjophthalmol-2017-310989Montorio D., Giuffrè C., Miserocchi E., et al. Swept-source optical coherence tomography angiography in serpiginous choroiditis // Br J Ophthalmol. 2017. Vol. 102, N 7. Р. 991–995. doi: 10.1136/bjophthalmol-2017-310989De Carlo TE, Bonini Filho MA, Adhi M, et al. Retinal and choroidal vasculature in birdshot chorioretinopathy analyzed using spectral domain optical coherence tomography angiography. Retina. 2015;35(11):2392–2399. doi: 10.1097/IAE.0000000000000744De Carlo T.E., Bonini Filho M.A., Adhi M., et al. Retinal and choroidal vasculature in birdshot chorioretinopathy analyzed using spectral domain optical coherence tomography angiography // Retina. 2015. Vol. 35, N 11. Р. 2392–2399. doi: 10.1097/IAE.0000000000000744Cheng L, Chen X, Weng S, et al. Spectral-Domain Optical Coherence Tomography Angiography Findings in Multifocal Choroiditis With Active Lesions. Am J Ophthalmol. 2016;169:145–161. doi: 10.1016/j.ajo.2016.06.029Cheng L., Chen X., Weng S., et al. Spectral-Domain Optical Coherence Tomography Angiography Findings in Multifocal Choroiditis With Active Lesions // Am J Ophthalmol. 2016. N 169. Р. 145–161. doi: 10.1016/j.ajo.2016.06.029Levison AL, Baynes KM, Lowder CY, et al. Choroidal neovascularisation on optical coherence tomography angiography in punctate inner choroidopathy and multifocal choroiditis. Br J Ophthalmol. 2017;101(5):616–622. doi: 10.1136/bjophthalmol-2016-308806Levison A.L., Baynes K.M., Lowder C.Y., et al. Choroidal neovascularisation on optical coherence tomography angiography in punctate inner choroidopathy and multifocal choroiditis // Br J Ophthalmol. 2017. Vol. 101, N 5. Р. 616–622. doi: 10.1136/bjophthalmol-2016-308806Pichi F, Sarraf D, Arepalli S, et al. The application of optical coherence tomography angiography in uveitis and inflammatory eye diseases. Prog Retin Eye Res. 2017;59:178–201. doi: 10.1016/j.preteyeres.2017.04.005Pichi F., Sarraf D., Arepalli S., et al. The application of optical coherence tomography angiography in uveitis and inflammatory eye diseases // Prog Retin Eye Res. 2017. N 59. Р. 178–201. doi: 10.1016/j.preteyeres.2017.04.005Jabs DA, Nussenblatt RB, Rosenbaum JT, et al. Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol. 2005;140(3):509–516. doi: 10.1016/j.ajo.2005.03.057Jabs D.A., Nussenblatt R.B., Rosenbaum J.T., et al. Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop // Am J Ophthalmol. 2005. Vol. 140, N 3. Р. 509–516. doi: 10.1016/j.ajo.2005.03.057Lumbroso B, Rispoli M, Savastano MC. Longitudinal optical coherence tomography-angiography study of type 2 naive choroidal neovascularization early response after treatment. Retina. 2015;35(11):2242–2251. doi: 10.1097/IAE.0000000000000879Lumbroso B., Rispoli M., Savastano M.C. Longitudinal optical coherence tomography-angiography study of type 2 naive choroidal neovascularization early response after treatment // Retina. 2015. Vol. 35, N 11. Р. 2242–2251. doi: 10.1097/IAE.0000000000000879Al-Sheikh M, Iafe NA, Phasukkijwatana N, et al. Biomarkers of neovascular activity in age-related macular degeneration using optical coherence tomography angiograph. Retina. 2018;38(2):220–230. doi: 10.1097/IAE.0000000000001628Al-Sheikh M., Iafe N.A., Phasukkijwatana N., et al. Biomarkers of neovascular activity in age-related macular degeneration using optical coherence tomography angiograph // Retina. 2018. Vol. 38, N 2. Р. 220–230. doi: 10.1097/IAE.0000000000001628Coscas GJ, Lupidi M, Coscas F, et al. Optical coherence tomography angiography versus traditional multimodal imaging in assessing the activity of exudative age-related macular degeneration: A New Diagnostic Challenge. Retina. 2015;35(11):2219–2228. doi: 10.1097/IAE.0000000000000766Coscas G.J., Lupidi M., Coscas F., et al. Optical coherence tomography angiography versus traditional multimodal imaging in assessing the activity of exudative age-related macular degeneration: A New Diagnostic Challenge // Retina. 2015 Vol. 35, N 11. Р. 2219–2228. doi: 10.1097/IAE.0000000000000766