Lower fractal dimension of retinal vessel for patients with Birdshot chorioretinopathy

Lucas Furnon, José Labarere, Emanuele Trucco, Stephen Hogg, Tom MacGillivray, Christophe Chiquet*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

PURPOSE: 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.

CONCLUSION: 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.

Original languageEnglish
Pages (from-to)392-402
Number of pages11
JournalActa Ophthalmologica
Issue number4
Early online date16 Nov 2022
Publication statusPublished - Jun 2023

Keywords / Materials (for Non-textual outputs)

  • Humans
  • Birdshot Chorioretinopathy
  • Retinal Vasculitis
  • Fractals
  • Retinal Vessels
  • Retina


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