Background: Uveitis is a relatively common, potentially sight-threatening intraocular inflammatory disorder and represents a major cause of blindness worldwide. Its incidence ranges from 20 to 50 cases per 100,000 persons per year, with a prevalence of 100 to 150 per 100,000. The aim of this work was evaluating macular vascular changes using Optical Coherence Tomography Angiography (OCT-A) in different cases of Uveitis (anterior, intermediate, and posterior).
Methods: This cross-sectional study was conducted on 66 participants 37 in the patient group with uveitis and 29 age-matched healthy volunteers as control group. Intraocular Pressure (IOP) was measured using mechanical Haag-Streit AT900 Goldmann applanation tonometer. Posterior segment examined with slit-lamp biomicroscopy using a +90D lens and Binocular indirect ophthalmoscope, HEINE HEINE Optotechnik, omega 500, Germany with a +20D lens. OCTA was performed using the Optovue AngioVue system (Optovue Inc., Fremont, CA, USA). Pupils were dilated with 1% cyclopentolate before imaging.
Results: Patients with uveitis had significantly reduced superficial and deep retinal vessel densities compared with controls across the whole retina and all parafoveal and perifoveal regions (all P < 0.001). Foveal avascular zone (FAZ) area, FAZ perimeter, and blood flow density of the outer retina were comparable between groups, whereas choriocapillaris flow density was significantly lower in the uveitis group (P = 0.009). When uveitis subtypes were compared, BCVA differed significantly among anterior uveitis, posterior uveitis, and panuveitis (P < 0.001), with posterior uveitis showing worse visual acuity, while IOP did not differ (P = 0.183). Deep vessel densities were largely similar, apart from a difference in the parafoveal temporal region (P = 0.022) without significant post-hoc differences.
Conclusions: OCTA detects subclinical retinal and choroidal microvascular changes in uveitis, with reduced vessel density especially in the deep plexus closely associated with visual function, supporting its role as a prognostic and monitoring biomarker.
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