Lower fractal dimension of retinal vessel for patients with Birdshot chorioretinopathy. 2023

Lucas Furnon, and José Labarere, and Emanuele Trucco, and Stephen Hogg, and Tom MacGillivray, and Christophe Chiquet
Univ Grenoble Alpes, Department of Ophthalmology, Grenoble, France.

OBJECTIVE To identify the retinal vessel vasculature parameters associated with birdshot chorioretinopathy (BSCR). METHODS This retrospective observational study included 28 prevalent cases of BSCR with a median time from diagnosis of 6 years and 28 controls matched for age, arterial hypertension, diabetes and refraction. Forty-five-degree fundus images of both dilated eyes were acquired with a fundus camera (Canon CR-2, Tokyo, Japan). The summary diameter of the arterial retinal vessels (central retinal artery equivalent, CRAE), venous retinal vessels (central retinal vein equivalent, CRVE), vascular tortuosity and fractal dimension (FD) were measured using VAMPIRE software. Retinal vasculitis was characterized using fluorescein angiography and active choroiditis using indocyanine green angiography. RESULTS At baseline, BSCR was associated with lower FD compared with matched controls (mean difference, -0.04; 95% confidence interval [CI], -0.06 to -0.02, p < 0.001). No other VAMPIRE parameters (CRAE, CRVE, arterial and venous tortuosity) differed. Among BSCR patients, retinal vein vasculitis was associated with higher CRAE (mean difference, 21 μ; 95% CI, 2.6-40, p = 0.03), venous tortuosity (geometric mean ratio, 1.79; 95% CI, 1.18-2.72, p = 0.007) and FD (mean difference, -0.04; 95% CI, -0.06 to -0.01, p = 0.007). Resolution of retinal vein vasculitis during follow-up was paralleled by decrease in CRAE, CRVE and venous tortuosity values and increase in venous FD, respectively. CONCLUSIONS BSCR is associated with lower FD value, suggesting that chronic retinal inflammation induces microvascular remodelling. Efficient treatment of retinal vasculitis may reverse changes in retinal vascular parameters. Changes in retinal vascular parameters could be potentially useful for assessing patients with BSCR disease.

UI MeSH Term Description Entries
D012160 Retina The ten-layered nervous tissue membrane of the eye. It is continuous with the OPTIC NERVE and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the CHOROID and the inner surface with the VITREOUS BODY. The outer-most layer is pigmented, whereas the inner nine layers are transparent. Ora Serrata
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000080365 Birdshot Chorioretinopathy A form of chorioretinitis characterized by multiple small, cream-colored LESIONS, symmetrically scattered mainly around the OPTIC DISK. These lesions are the most distinctive sign and often appear at the level of the RETINAL PIGMENT EPITHELIUM but, on occasion, suggest an even deeper infiltration and may ultimately lead to visual loss. An association with HLA-A29 antigen (see HLA-A ANTIGENS) has been observed in nearly all patients. Birdshot Chorioretinitis,Birdshot Retinochoroiditis,Birdshot Retinochoroidopathy,Birdshot Chorioretinopathies,Birdshot Retinochoroiditides,Birdshot Retinochoroidopathies,Chorioretinitis, Birdshot,Chorioretinopathy, Birdshot,Retinochoroiditis, Birdshot,Retinochoroidopathy, Birdshot
D012171 Retinal Vessels The blood vessels which supply and drain the RETINA. Pecten Oculi,Retinal Vasculature,Retinal Blood Vessels,Retinal Blood Vessel,Retinal Vasculatures,Retinal Vessel,Vasculature, Retinal,Vessel, Retinal,Vessel, Retinal Blood
D017709 Fractals Patterns (real or mathematical) which look similar at different scales, for example the network of airways in the lung which shows similar branching patterns at progressively higher magnifications. Natural fractals are self-similar across a finite range of scales while mathematical fractals are the same across an infinite range. Many natural, including biological, structures are fractal (or fractal-like). Fractals are related to "chaos" (see NONLINEAR DYNAMICS) in that chaotic processes can produce fractal structures in nature, and appropriate representations of chaotic processes usually reveal self-similarity over time. Fractal
D031300 Retinal Vasculitis Inflammation of the retinal vasculature with various causes including infectious disease; LUPUS ERYTHEMATOSUS, SYSTEMIC; MULTIPLE SCLEROSIS; BEHCET SYNDROME; and CHORIORETINITIS. Vasculitis, Retinal

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