scholarly journals Swept source OCTA reveals a link between choriocapillaris blood flow and vision loss in a case of tubercular serpiginous-like choroiditis

2021 ◽  
Vol 21 ◽  
pp. 101018
Author(s):  
Gayathri C. Tummala ◽  
Zhongdi Chu ◽  
Jessica E. Weinstein ◽  
Ruikang K. Wang ◽  
Kathryn L. Pepple
Keyword(s):  
Blood Flow ◽  
Vision Loss ◽  
Swept Source ◽  
Swept Source Octa

scholarly journals Imaging the Deep Choroidal Vasculature Using Spectral Domain and Swept Source Optical Coherence Tomography Angiography

2018 ◽  
Vol 2 (3) ◽  
pp. 146-154 ◽  
Author(s):  
J. Daniel Diaz ◽  
Jay C. Wang ◽  
Patrick Oellers ◽  
Inês Lains ◽  
Lucia Sobrin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Optical Coherence Tomography Angiography ◽  
Choroidal Blood Flow ◽  
Swept Source ◽  
Blood Flow Signal ◽  
En Face ◽  
Rpe Atrophy ◽  
Choroidal Vasculature ◽  
Choroidal Vessels ◽  
En Face Imaging

Purpose: To evaluate the deeper choroidal vasculature in eyes with various ocular disorders using spectral domain (SD) optical coherence tomography angiography (OCTA) and swept source (SS) OCTA. Methods: Patients underwent OCTA imaging with either SD-OCTA (Zeiss Cirrus Angioplex or Optovue AngioVue) or SS-OCTA (Topcon Triton). Retinal pigment epithelium (RPE) integrity, structural visualization of deep choroidal vessels on en face imaging, and OCTA of deep choroidal blood flow signal were analyzed. Choroidal blood flow was deemed present if deeper choroidal vessels appeared bright after appropriate segmentation. Results: Structural visualization of choroidal vessels was feasible in all eyes by en face imaging. In both SD-OCTA and SS-OCTA, choroidal blood flow signal was present in all eyes with overlying RPE atrophy (100% of eyes with RPE atrophy, 28.6% of all imaged eyes, P < .001). Conclusions: While choroidal vessels can be visualized anatomically in all eyes by en face imaging, choroidal blood flow detection in deep choroidal vessel is largely restricted to areas with overlying RPE atrophy. Intact RPE acts as a barrier for reliable detection of choroidal flow using current OCTA technology, inhibiting evaluation of flow in deeper choroidal vessels in most eyes.

Case 24: Orthostatic Cerebral Hypoperfusion Syndrome with Vision Loss

2019 ◽  
pp. 157-162
Author(s):  
Peter Novak
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Orthostatic Hypotension ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Vision Loss ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Hypoperfusion ◽  
Tilt Test

The tilt test showed orthostatic cerebral hypoperfusion syndrome (OCHOS) with intermittent reduction in cerebral blood flow velocity and vision loss. OCHOS is associated with reduced orthostatic cerebral blood flow velocity without orthostatic hypotension or arrhythmia.

Widefield Swept-Source OCTA in Vogt-Koyanagi-Harada Disease

2020 ◽  
Vol 51 (7) ◽  
pp. 407-412
Author(s):  
Filippos Vingopoulos ◽  
Ying Cui ◽  
Raviv Katz ◽  
Rongrong Le ◽  
Ying Zhu ◽  
...  
Keyword(s):  
Swept Source ◽  
Swept Source Octa

scholarly journals NLRP3 Inflammasome: A Potential Target in Isoflurane Pretreatment Alleviates Stroke-Induced Retinal Injury in Diabetes

2021 ◽  
Vol 15 ◽  
Author(s):  
Hong-Bin Lin ◽  
Ying-Hui Lin ◽  
Jin-Yu Zhang ◽  
Wen-Jing Guo ◽  
Andrea Ovcjak ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Visual Impairment ◽  
Nlrp3 Inflammasome ◽  
Vision Loss ◽  
Critical Role ◽  
Retinal Ischemia ◽  
Inflammasome Activation ◽  
Neuroprotective Effects ◽  
Retinal Injury

Ischemic stroke remains a devastating disease which is the leading cause of death worldwide. Visual impairment after stroke is a common complication which may lead to vision loss, greatly impacting life quality of patients. While ischemic stroke is traditionally characterized by a blockage of blood flow to the brain, this may coincide with reduced blood flow to the eye, resulting in retinal ischemia and leading to visual impairment. Diabetes increases the risk of ischemic stroke and induces diabetic retinopathy; the latter may be more sensitive to the ischemic retinal injury. In diabetic status, the underlying mechanism in stroke-induced retinal injury has not been fully clarified. The NLR pyrin domain containing 3 (NLRP3) inflammasome is an important activator of inflammation, which may play a critical role in catalyzing and forming certain pro-inflammatory cytokines in both cerebral and retinal ischemia. Isoflurane has been demonstrated to inhibit the activation of the NLRP3 inflammasome and show neuroprotective effects. In this study, we established a diabetic mouse model and performed the middle cerebral artery occlusion procedure to induce ischemic stroke. Our results revealed that cerebral ischemia-induced retinal injury in the diabetic model. Isoflurane pretreatment alleviated the cerebral and retinal injury after ischemic stroke. Of note, isoflurane pretreatment inhibited the NLRP3 inflammasome activation in the retina, indicating that isoflurane pretreatment may provide substantial retinal protection in stroke-induced retinal injury in diabetes.

scholarly journals Paramacular Acute Middle Maculopathy Associated with Glyceryl Trinitrate

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Tryfon Rotsos ◽  
Ioannis Giachos ◽  
Konstantinos Tyrlis ◽  
Chrysanthos Symeonidis ◽  
Ekaterini Mani ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Glyceryl Trinitrate ◽  
Vision Loss ◽  
Optical Coherence ◽  
Swept Source ◽  
Nitroglycerin Ointment ◽  
Vascular Abnormalities ◽  
Venous Dilatation ◽  
Capillary Plexus ◽  
Plexiform Layers

An unusual case of nitroglycerin-induced Paracentral Acute Middle Maculopathy (PAMM) is presented. A 50-year-old patient with sudden vision loss and scotoma was followed up with swept-source optical coherence tomography (SS-OCT), optical coherence tomography-angiography (OCT-A), and fluorescein angiography (FA). An anal fissure treated with glyceryl trinitrate (GTN) 0.2% ointment with headache and dizziness after application was reported. Fundoscopy OS revealed mild retinal venous dilatation and tortuosity with scattered blot hemorrhages and subtle, parafoveal, whitish lesions in the outer retina. SS-OCT revealed diffuse, hyperreflective lesions in the inner plexiform (IPL), inner nuclear (INL), and outer plexiform layers (OPL). OCT-A revealed focal dropout in the deep capillary plexus. FA showed masking due to blot hemorrhages and early punctuate leakage in the inner retina. This entity was identified as nitroglycerin-induced PAMM. Over the following 8 months, after discontinuation of the ointment application, the patient was symptom-free with stable visual acuity. OCT revealed INL/OPL thinning and confirmed complete lesion resolution. This first report of retinal vascular abnormalities due to nitrite ointment provides an insight into an unknown side effect of nitroglycerin ointment use. A dose-dependent correlation between GTN application and retinal vascular abnormalities remains to be confirmed.

Anterior segment optical coherence tomography angiography for iris vasculature in pigmented eyes

2020 ◽  
pp. bjophthalmol-2020-316930
Author(s):  
Marcus Ang ◽  
Kavya Devarajan ◽  
Anna CS Tan ◽  
Mengyuan Ke ◽  
Bingyao Tan ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Anterior Segment ◽  
Mean Difference ◽  
Vessel Density ◽  
Optical Coherence ◽  
Swept Source ◽  
Density Measurements ◽  
Stage 1 ◽  
Swept Source Octa

PurposeTo compare anterior segment optical coherence tomography angiography (AS-OCTA) systems in delineating normal iris vessels and iris neovascularisation (NVI) in eyes with pigmented irides.MethodsProspective study from January 2019 to June 2019 of 10 consecutive patients with normal pigmented iris, had AS-OCTA scans with a described illumination technique, before using the same protocol in five eyes with NVI (clinical stages 1–3). All scans were sequentially performed using a spectral-domain OCTA (SD-OCTA), and a swept-source OCTA (SS-OCTA, Plex Elite 9000). Images were graded by two masked observers for visibility, artefacts and NVI characteristics. The main outcome measure was iris vessel density measurements comparing SS-OCTA and SD-OCTA systems.ResultsThe median age of subjects was 28 (20–35) years, and 50% were female. The paired mean difference of iris vessel density measurements was 11.7 (95% CI 14.7 to 8.1; p=0.002), SS-OCTA detecting more vessels than SD-OCTA. The inter-rater reliability for artefact score (κ=0.799, p<0.001) and visibility score (κ=0.722; p<0.001) were substantial. Both AS-OCTA systems were able to detect NVI vessels with a fair agreement (κ=0.588), with clearer NVI characteristics in stage 1/2 compared to stage 3 NVI (mean difference NVI score: 2.7±0.4, p=0.009).ConclusionThe SS-OCTA was better able to delineate iris vessels in normal pigmented irides compared to SD-OCTA. Both AS-OCTA systems identified NVI characteristics based on its atypical configuration or location, but further improvements are needed to allow for more accurate objective, serial quantification for clinical use.

scholarly journals Purtscher-like retinopathy presented a honeycomb-like pattern in optical coherence topography angiography

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bing Li ◽  
Donghui Li ◽  
Youxin Chen
Keyword(s):  
Blood Flow ◽  
Vision Loss ◽  
Acute Onset ◽  
Pathological Process ◽  
Optical Coherence ◽  
Cotton Wool Spots ◽  
Before And After ◽  
Retinal Oedema ◽  
Hypointense Signal ◽  
The Right

Abstract Background To report a case of Purtscher-like retinopathy (PUR) and the optical coherence tomography (OCT) and OCT angiography (OCT-A) findings before and after treatment. Case presentation A 65-year-old male presented with acute onset of vision loss for 2 weeks. Fundus examination revealed cotton-wool spots, retinal haemorrhage, and Purtscher flecken spread around the optic disc in the right eye. He was diagnosed with Purtscher-like retinopathy because he lacked any traumatic medical history. OCT presented some band-like hyperreflective lesions at the inner nuclear layer, which are indicative of paracentral acute middle maculopathy (PAMM). OCT-A revealed apparent reduction in blood flow signal at the deep retina and choriocapillaris layers with a honeycomb-like hypointense signal pattern. After 3 months of follow-up, OCT revealed resolution of retinal oedema, but PAMM lesions remained visible. Based on OCT-A, the honeycomb-like pattern turned into a homogeneous reduction in blood flow with small patches of hypointense signal areas in the choriocapillaris. Conclusion This case presented a new OCT-A sign in PUR with a honeycomb-like hypointense signal at the choriocapillaris layer, indicating the involvement and ischaemia of the choroid during the pathological process.

scholarly journals Effect of vessel enhancement filters on the repeatability of measurements obtained from widefield swept-source optical coherence tomography angiography

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jimmy Hong ◽  
Mengyuan Ke ◽  
Bingyao Tan ◽  
Amanda Lau ◽  
Damon Wong ◽  
...  
Keyword(s):  
Peripheral Region ◽  
Swept Source ◽  
Capillary Plexus ◽  
Flow Void ◽  
Vessel Enhancement ◽  
Good Repeatability ◽  
Perfusion Density ◽  
Superficial Capillary Plexus ◽  
Large Vessels ◽  
Swept Source Octa

AbstractWe assessed the inter-visit repeatability of 15 × 9-mm2 swept-source OCTA (SS-OCTA; PLEX Elite 9000, Carl Zeiss Meditec) metrics in 14 healthy participants. We analysed the perfusion density (PD) of large vessels, superficial capillary plexus (SCP), and deep capillary plexus (DCP) as well as choriocapillaris flow voids in 2 different regions: the macular region and peripheral region. Also, retinal plexus metrics were processed further using different filters (Hessian, Gabor and Bayesian) while choriocapillaris flow voids were calculated with 1 and 1.25 standard deviation (SD) thresholding algorithms. We found excellent repeatability in the perfusion densities of large vessels (ICC > 0.96). Perfusion densities varied with different filters in the macular region (SCP: 24.12–38.57% and DCP: 25.16–38.50%) and peripheral (SCP: 30.52–39.84% and DCP: 34.19–41.60%) regions. The ICCs were lower in the macular region compared to the peripheral region and lower for DCP than for SCP. For choriocapillaris flow voids, the 1.25 SD threshold resulted in fewer flow voids, while a good ICC (ICC > 0.81) was achieved using either threshold settings for flow void features in both regions. Our results suggest good repeatability of widefield SS-OCTA for the measurements of retinal perfusion density and choriocapillaris flow voids, but measurements from different filters should not be interchanged.

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