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Sanjay S, Acharya I, Kawali A, Chitturi SP, Mahendradas P. Choroidal and central macular thickness before and after treatment in post fever retinitis. Indian J Ophthalmol 2024; 72:728-734. [PMID: 38648435 PMCID: PMC11168547 DOI: 10.4103/ijo.ijo_1557_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/11/2023] [Accepted: 11/01/2023] [Indexed: 04/25/2024] Open
Abstract
PURPOSE To study the choroidal thickness (CT) and central macular thickness (CMT) in post-fever retinitis (PFR) and their correlation with visual acuity and treatment. METHODS A retrospective, observational study of patients presenting with PFR from 2013 to 2021 and with spectral domain optical coherence tomography (SD-OCT) (Heidelberg®, SpectralisTM, Heidelberg, Germany) images were included. The CT and CMT were measured at presentation and at the final visit. The CT was measured subfoveally and at points 2000 µm superior, inferior, medial, and lateral from the fovea using the caliper tool. RESULTS Seventy-nine eyes of 65 patients were included for this study. The mean age was 39.03 (±16.00) years with female preponderance of 53.84% (n = 35). Mean follow-up duration was 30 days. Mean CT at presentation and at follow-up was 254.12 µm and 241.51 µm, respectively. CT was decreased in majority of the eyes 67.1% (n = 53) from their baseline value. Mean CMTs at presentation and final visit were 454.8 µm and 223.7 µm, respectively. Best corrected visual acuity had a positive correlation with CMT (r = 0.340; P = 0.002) and negligible correlation with CT. A significant decrease in the mean CT was noted in patients who received doxycycline either alone or in combination with a steroid as compared to those who did not receive any treatment (P < 0.001). The significance of which is unknown presently. CONCLUSION CMT has a greater role in determining the final visual outcome than CT. CT can be reduced post-treatment with no effect on vision.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, India
| | - Isha Acharya
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, India
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Sanjay S, Gadde SGK, Agrawal S, Mahendradas P, Govindaswamy N, Kawali A, Jayadev C, Sangai S, Roy AS, Shetty R. Optical coherence tomography angiography (OCTA) of retinal vasculature in patients with post fever retinitis: a qualitative and quantitative analysis. Sci Rep 2021; 11:17647. [PMID: 34480039 PMCID: PMC8417288 DOI: 10.1038/s41598-021-96715-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 08/10/2021] [Indexed: 11/08/2022] Open
Abstract
Post fever retinitis is a heterogenous entity that is seen 2-4 weeks after a systemic febrile illness in an immunocompetent individual. It may occur following bacterial, viruses, or protozoal infection. Optical coherence angiography (OCTA) is a newer non-invasive modality that is an alternative to fundus fluorescein angiography to image the retinal microvasculature. We hereby describe the vascular changes during the acute phase of post fever retinitis on OCTA. Imaging on OCTA was done for all patients with post fever retinitis at presentation with 3 × 3 mm and 8 × 8 mm scans centred on the macula and corresponding enface optical coherence tomography (OCT) scans obtained. A qualitative and quantitative analysis was done for all images. 46 eyes of 33 patients were included in the study. Salient features noted were changes in the superficial (SCP) and deep capillary plexus (DCP) with capillary rarefaction and irregularity of larger vessels in the SCP. The DCP had more capillary rarefaction when compared to the SCP. The foveal avascular zone (FAZ) was altered with an irregular perifoveal network. Our series of post fever retinitis describes the salient vascular features on OCTA. Although the presumed aetiology was different in all our patients, they developed similar changes on OCTA. While OCTA is not useful if there is gross macular oedema, the altered FAZ can be indicative of macular ischemia.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India.
| | | | - Sameeksha Agrawal
- Department of Retina, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Padmamalini Mahendradas
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Nivedhitha Govindaswamy
- Imaging Bio Mechanics and Mathematical Solutions Lab, Narayana Nethralaya Foundation, #258/A Hosur Road, Bommasandra, Bangalore, Karnataka, 560099, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Chaitra Jayadev
- Department of Retina, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Sajjan Sangai
- Department of Retina, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Abhijit Sinha Roy
- Imaging Bio Mechanics and Mathematical Solutions Lab, Narayana Nethralaya Foundation, #258/A Hosur Road, Bommasandra, Bangalore, Karnataka, 560099, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, 121/C. Chord Road, Bangalore, Karnataka, 560010, India
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