Tubercular retinal vasculitis in widefield optical coherence tomography angiography

Purpose: To demonstrate the utility of widefield swept-source optical coherence tomography angiography (SS-OCTA) in identifying microvascular abnormalities in patients with presumed tubercular retinal vasculitis (TRV). Observations: We present a case series of three patients with presumed TRV confirmed by positive QuantiFERON-TB Gold testing. All patients exhibited clinical signs of occlusive retinal vasculitis, including perivascular inflammation, peripheral capillary nonperfusion, and neovascular complications. Widefield SS-OCTA (DREAM OCT, Intalight) using a single-shot 26 × 21-mm scan revealed peripheral nonperfusion and vascular remodeling with features of retinal neovascularization, consistent with findings from fluorescein angiography (FA). Clinical improvement was observed following antitubercular therapy and anti-inflammatory treatment. Conclusions and importance: Widefield OCTA provided detailed visualization of peripheral retinal changes associated with TRV, including nonperfusion area, collateral vessel formation, and neovascular tufts, highlighting its potential as a noninvasive complementary modality to FA in managing TRV.