title: Structural changes of the choroid in sarcoid- and tuberculosis-related granulomatous uveitis.
abstract: OBJECTIVE
  The aim of this study is to characterise the choroidal features of patients diagnosed with sarcoid- and tuberculosis (TB)-associated granulomatous uveitis using spectral domain optical coherence tomography (OCT).
  
  
  METHODS
  Twenty-seven patients (27 eyes) diagnosed with sarcoid- (13 eyes) and TB (14 eyes)-related uveitis were included in this retrospective, cross-sectional study. Over a six-month period, patients diagnosed with sarcoid and TB granulomatous uveitis were scanned using enhanced depth imaging OCT. Clinical and demographical characteristics were recorded, including the method of diagnosis, disease activity, site of inflammation (anterior or posterior), treatments, and visual acuity (VA). Manual segmentation of the choroidal layers was performed using custom image analysis software.
  
  
  RESULTS
  The main outcome measure was OCT-derived thickness measurements of the choroid and choroidal sublayers (Haller's large vessel and Sattler's medium vessel layers) at the macula region. The ratio of Haller's large vessel to Sattler's medium vessel layer was significantly different at the total macula circle in eyes diagnosed with TB uveitis (1.47 (=140.71/95.72 μm)) compared with sarcoid uveitis (1.07 (=137.70/128.69 μm)) (P=0.001). A thinner choroid was observed in eyes with a VA ≥0.3 LogMAR (Snellen 6/12; 198.1 μm (interquartile range (IQR)=147.0-253.4 μm) compared with those with VA <0.3 LogMAR (292.4 μm (IQR=240.1-347.6 μm)) at the total macula circle (P=0.004). At the foveal central subfield, the median choroidal thickness was 336.8 μm (IQR=272.3-375.4 μm) in active compared with 239.3 μm (IQR=195.3-330.9 μm) in quiescent disease (P=0.04).
  
  
  CONCLUSIONS
  A disproportionately enlarged Sattler's layer may indicate a diagnosis of sarcoid-related uveitis, and choroidal thickening may be a feature of active granulomatous uveitis.
authors.affiliation: Medical Retina and Uveitis Service, Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Mehta
authors.affiliation: 1] NIHR Moorfields Biomedical Research Centre, London, UK [2] Institute of Ophthalmology, University London, London, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Sim
authors.affiliation: 1] NIHR Moorfields Biomedical Research Centre, London, UK [2] Institute of Ophthalmology, University London, London, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: Keane
authors.affiliation: 1] Medical Retina and Uveitis Service, Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK [2] Vitreo-Retinal Service, Bristol Eye Hospital, Bristol, UK.
authors.forename: J
authors.initials: J
authors.lastname: Zarranz-Ventura
authors.affiliation: Medical Retina and Uveitis Service, Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Gallagher
authors.affiliation: Medical Retina and Uveitis Service, Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Egan
authors.affiliation: Medical Retina and Uveitis Service, Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Westcott
authors.affiliation: 1] Medical Retina and Uveitis Service, Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK [2] NIHR Moorfields Biomedical Research Centre, London, UK [3] Institute of Ophthalmology, University London, London, UK [4] School of Clinical Sciences, University of Bristol, Bristol, UK.
authors.forename: R W J
authors.initials: RW
authors.lastname: Lee
authors.affiliation: 1] Medical Retina and Uveitis Service, Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK [2] NIHR Moorfields Biomedical Research Centre, London, UK [3] Institute of Ophthalmology, University London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Tufail
authors.affiliation: 1] Medical Retina and Uveitis Service, Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK [2] NIHR Moorfields Biomedical Research Centre, London, UK.
authors.forename: C E
authors.initials: CE
authors.lastname: Pavesio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006099:Granuloma / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications*; D041623:Tomography, Optical Coherence / Q000379:methods; D014392:Tuberculosis, Ocular / Q000150:complications*; D014605:Uveitis / Q000209:etiology / Q000473:pathology*; D014792:Visual Acuity; D055815:Young Adult