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.
Highlights
Srinivasan Sanjay 1*, Santosh Gopi Krishna Gadde 2, Sameeksha Agrawal[2], Padmamalini Mahendradas 1, Nivedhitha Govindaswamy[3], Ankush Kawali 1, Chaitra Jayadev 2, Sajjan Sangai 2, Abhijit Sinha Roy 3 & Rohit Shetty 4
Scan areas of 3 × 3 mm and 8 × 8 mm centred on the fovea for imaging both superficial and deep retinal plexus were obtained separately for each patient similar to what we have described e arlier[13]
We have previously reported that a significant vascular loss in different grades of diabetic retinopathy at the level of deep vascular plexus after removal of projection artifacts
Summary
Srinivasan Sanjay 1*, Santosh Gopi Krishna Gadde 2, Sameeksha Agrawal[2], Padmamalini Mahendradas 1, Nivedhitha Govindaswamy[3], Ankush Kawali 1, Chaitra Jayadev 2, Sajjan Sangai 2, Abhijit Sinha Roy 3 & Rohit Shetty 4. The OCTA, being rapid, non-invasive and repeatable, is useful for the assessment of the foveal avascular zone (FAZ) and microvascular changes along with segmental imaging and evaluation of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in several retinal vascular diseases[6,7,8,9,10,11]. Despite the lack of standardised protocols for image acquisition and interpretation of image scans, OCTA is widely used for the detection of pathophysiology, early diagnosis, treatment and determination of the progression in patients, especially with vascular pathology[4] It provides good delineation of the pathology along with volumetric data with the ability to show both structural and blood flow information[5]. It can be vital in understanding the vascular changes in eyes with post fever retinitis
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