Adaptive optics imaging of retinal vasculitis

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Abstract

Purpose

To document perivascular infiltrates in the retina using high resolution flood illumination adaptive optics (AO) imaging in patients with retinal vasculitis.

Methods

The charts of five subjects with retinal vasculitis showing evidence of perivascular infiltrates by means of AO imaging (rtx1 camera, Imagine Eye, Orsay, France) were reviewed.

Results

Diagnoses included primary idiopathic retinal vasculitis (n=1), Lyme’s disease (n=2), TB related retinal vasculitis (n=1) and idiopathic retinitis, vasculitis and aneurysm (IRVAN; n=1). Using AO imaging, perivascular infiltrates appeared as discrete, linear areas of opacification along the veins, often surrounding the venous narrowing. AO imaging was more sensitive that either fundus photographs or fluorescein angiography for their detection. Follow-up examinations (n=3) showed a changing pattern of narrowing of the vessel lumen, and eventual disappearance of these perivascular infiltrates. In the IRVAN case, inflammatory infiltrates were found around arterioles and veins as well, suggesting an inflammation induced-phenomenon.

Conclusion

AO imaging has a higher sensitivity than fundus photographs or fluorescein angiography to detect perivascular inflammatory infiltrates. Vascular inflammation is strongly linked to changes in vascular lumen diameter. AO imaging may have a particular interest when diagnosis and following subjects with retinal vasculitis.

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