Subclinical Peripheral Vascular Leakage in Demyelinating Disease-Associated Uveitis.
Most clinically inactive uveitis eyes still show peripheral vascular leakage on angiography.
Subclinical Peripheral Vascular Leakage in Demyelinating Disease-Associated Uveitis.
To evaluate the cross-sectional association between clinical examination findings and angiographic disease activity in demyelinating disease-associated uveitis, and to describe longitudinal trends in clinical, ultrawidefield fluorescein angiography (ultrawidefield fluorescein angiography) leakage, and optical coherence tomography (optical coherence tomography) markers.
A total of 58 eyes from 30 patients with confirmed demyelinating disease (predominantly multiple sclerosis) and concurrent uveitis evaluated at a tertiary referral center.
roughly 7 in 10 symptom-free eyes still leaked, showing quiet exams miss ongoing damage
AC and vitreous inflammation significantly improved following acute flare (P < .001 and P = .01, respectively), as did macular IRF (P = .001) and subretinal fluid (P < .001).
Total anatomic burden of angiographic leakage was highest at initial presentation and did not change significantly between acute flare and most recent encounter (P = .78).
In a multivariable generalized estimating equations model, far-peripheral (Zone 3) leakage did not significantly predict concurrent IRF (OR = 2.33, 95% CI 0.62-8.73, P = .21).
Cumulative structural damage, including epiretinal membrane and macular atrophy, increased significantly over time (P < .05 and P = .04, respectively).
The high prevalence of subclinical peripheral vascular leakage on ultrawidefield fluorescein angiography in clinically inactive eyes demonstrates clinical examination and optical coherence tomography may not capture the full spectrum of angiographic abnormalities in demyelinating disease-associated uveitis.
This observational clinical-angiographic discordance suggests that ultrawidefield fluorescein angiography may provide complementary information for disease staging and monitoring.
Prospective studies are needed to determine whether angiographic findings should influence therapeutic endpoints.