Treatment Outcomes of Presumed Rickettsial Retinitis: Evidence from OCTA Based Quantitative Analysis

ABSTRACT

Aim

To quantify retinal ischemia following presumed rickettsial retinitis (RR). To compare outcomes between initial treatment with Doxycycline (Group 1) versus steroids (Group 2).

Methods

Retrospective analysis of patients with presumed RR was done. ImageJ software was used to obtain %area of ischemia on swept-source optical coherence tomography angiography (SS-OCTA).

Results

Eleven eyes of 8 patients belonged to Group1 and 6 eyes of 3 patients belonged to Group 2. The BCVA improved from logMAR 0.8 ∓ 0.7 to logMAR 0.06 ∓ 0.08 (p < 0.002) and central foveal thickness (CFT) changed from 479μ ∓ 341.3μ to 163.5μ ∓ 20.5μ (p < 0.005) after a median of 5 weeks in Group 1. In Group 2, BCVA improved from logMAR 1.03 ∓ 0.05 to logMAR 0.23 ∓ 0.23 (p < 0.004) and CFT changed from 286.5μ ∓ 158.8μ to 177.5μ ∓ 25.9μ (>0.05) following a mean of 11 weeks. Mean %area of ischemia was 4.6 ∓ 1.5 in Group 1 and 13.9 ∓ 4.1 in Group 2.

Conclusion

Analysis of flow deficit on SS-OCTA confirms that treatment with Doxycycline in presumed RR results in less ischemia and quicker recovery than initial treatment with steroids.

KEYWORDS:

• Acute multifocal retinitis
• epidemic retinitis
• optical coherence tomography angiography
• post fever retinitis
• Rickettsia

Acknowledgments

Mr. Syed Mohammed, optometrist for capturing and retrieving the clinical images.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The principal investigator and co-authors had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of analysis.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.