Multimodal Imaging in Retinal Vasculitis

ABSTRACT

Retinal vasculitis presents with inflammation involving the retinal vasculature as an isolated disease or in combination with other ocular or systemic conditions. This entity may be associated with a wide variety of clinical manifestations such as vascular sheathing, cotton-wool spots, retinal ischemia, and neovascularization. Often, retinal vasculitis and its complications lead to diagnostic challenges in identifying the exact etiology of the inflammation. Ancillary investigations such as fundus photography, fluorescein angiography, and more recently, adaptive optics imaging and optical coherence tomography angiography, may provide valuable information that help in establishing the exact diagnosis and initiation of appropriate therapy. In the index review, multimodal imaging features of retinal vasculitis are described. In addition, detection of vascular inflammation using novel noncontact imaging techniques has been highlighted.

Keywords:

• Fundus fluorescein angiography
• indocyanine green angiography
• Multimodal imaging
• occlusive vasculitis
• optical coherence tomography angiography
• periphlebitis
• retinal vasculitis
• ultra-wide field fundus photography

SUMMARY AND CONCLUSIONS

This review highlights the relevance of various imaging modalities in the diagnosis and management of retinal vasculitis. Imaging techniques such as FA, including UWF FA, greatly aid in determining the activity of retinal vasculitis and improvement or worsening compared to previous visits. Thus, FA serves as a valuable tool in monitoring the response to therapy and development of complications such as neovascularization in patients with retinal vasculitis. ICGA helps in evaluating the choroidal vasculature and changes in choroidal circulation such as vasculitis and occlusion. Novel technologies such as adaptive optics imaging and OCTA provide newer opportunities to assess the retinochoroidal vasculature and improve our understanding of the pathophysiology and natural history of retinal diseases such as vasculitis. In summary, various imaging modalities complement each other when used in combination for assessment of patients with retinal vasculitis.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.