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Detection of Choroidal Hypoperfusion in Giant Cell Arteritis Using Swept-Source Optical Coherence Tomographic Angiography.

46 Objective: To determine whether swept-source optical coherence tomographic angiography (SS- 47 OCTA) can demonstrate choroidal perfusion abnormalities seen on fluorescein angiography (FA) 48 in giant cell arteritis (GCA). 49 Design: Observational case series. 50 Participants: Six eyes of 3 patients with bilateral ischemic optic neuropathy secondary to GCA, 51 and one control patient without ocular involvement from biopsy-confirmed GCA. 52 Methods: En face SS-OCTA (DRI OCT Triton, Topcon, Tokyo, Japan) and FA centered on the 53 macula were obtained at presentation. SS-OCTA was segmented into superficial and deep retinal 54 capillary plexuses and the choriocapillaris laminae. SS-OCTA images were independently 55 analyzed for perfusion abnormalities and compared with corresponding FA images. 56 Main Outcome Measures: Correspondence of choroidal angiographic abnormalities on SS- 57 OCTA and FA. 58 Results: SS-OCTA showed decreased angiographic signal within the choriocapillaris in 5/6 eyes 59 and corresponded to hypoperfusion abnormalities on FA in similar geographic distributions in 60 5/5 eyes. SS-OCTA also showed dilation of the deep retinal capillary plexus overlying the area 61 of choroidal hypoperfusion in one eye. In the one eye without angiographic signal abnormalities 62 on SS-OCTA, no perfusion changes were noted on FA. One control patient without ocular 63 involvement from biopsy-confirmed GCA did not show choroidal perfusion changes on SS- 64 OCTA or FA. 65 Conclusions: This case series demonstrates comparability between SS-OCTA and FA in 66 detection and characterization of choroidal hypoperfusion secondary to GCA. As a rapid and 67