Swept source optical coherence tomography angiography in patients treated with hydroxychloroquine: correlation with morphological and functional tests

2019 ◽  
pp. bjophthalmol-2018-313679 ◽  
Author(s):  
Raimondo Forte ◽  
Hanan Haulani ◽  
Agnieszka Dyrda ◽  
Ignasi Jürgens

PurposeTo evaluate swept source optical coherence tomography angiography (SS-OCTA) in patients treated with hydroxychloroquine (HCQ) for more than 5 years and to compare results with the tests currently recommended for screening of HCQ retinopathy.MethodsIn this controlled pilot study, consecutive patients treated with HCQ for more than 5 years underwent SS-OCTA, SS-OCT B-scan and en-face C-scan, fundus autofluorescence (FAF), 10–2 automated visual field (AVF) testing and multifocal electroretinography (mfERG). On SS-OCTA, evaluation of the retinal superficial capillary plexus, middle capillary plexus, and deep capillary plexus (DCP) and the choriocapillaris (CC) was obtained.ResultsWe included 10 patients under HCQ treatment (20 eyes, mean age 38.91±11.73 years) and 18 healthy control patients (36 eyes, mean age 38.87±8.6 years). Mean duration of HCQ treatment was 10.0±3.25 (5–15) years and HCQ cumulative dose/body weight was 15.86±5.56 g/kg. The HCQ group showed a reduction of the vessel density in the 1 mm central, in the nasal and temporal subfields of DCP and in the 1 mm central subfield of CC, an increased foveal avascular zone in the three capillary plexuses, a greater frequency of CC flow voids and a reduced foveal choroidal thickness (p<0.05). Best-corrected visual acuity (BCVA), mfERG, SS-OCT B-scan and C-scan, AVF and FAF were normal in 20/20 eyes (100%).ConclusionsIn patients treated with HCQ for more than 5 years, choroidal thinning and flow abnormalities at SS-OCTA in the retinal capillary plexuses and CC may be observed even if BCVA, FAF, mfERG, AVF and SS-OCT are normal.

2021 ◽  
Vol 14 (5) ◽  
pp. e240208
Author(s):  
Hana A Mansour ◽  
Sami Uwaydat ◽  
Muhamad H Yunis ◽  
Ahmad M Mansour

Optical coherence tomography angiography imaging in two patients with oculocutaneous albinism, one with severe nystagmus, showed persistence of both the superficial and the deep retinal capillary plexus adding another vascular feature to the foveal hypoplasia.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Linning Guo ◽  
Chenlei Zhu ◽  
Ziqi Wang ◽  
Zhiqiang Gao ◽  
Zongduan Zhang ◽  
...  

Purpose. To evaluate the effects of the menstrual cycle on the retinal vascular status of healthy women by optical coherence tomography angiography (OCTA). Materials and Methods. Healthy women with regular natural menstrual cycles of 28 to 30 days were recruited for this prospective study. The women’s retinal vascular status was measured by OCTA at 3 time points: the early follicular, ovulatory, and midluteal phases of the menstrual cycle. The main outcome measures were foveal avascular zone (FAZ) parameters, perfusion density (PD) percentage in the superficial retinal capillary plexus (SCP), and PD percentage in the deep retinal capillary plexus (DCP). The mean arterial pressure (MAP), spherical equivalent (SE), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and axial (AL) were also measured in a same menstrual cycle. Results. In total, 62 right eyes of 62 women were included in the study. The mean age was 27.0 ± 1.73 (range, 24 to 31) years, and the mean menstrual cycle was 28.90 ± 0.84 (range, 28 to 30) days. The mean values of the DCP-PD parameters were significantly decreased in the nasal and inferior ETDRS subfields during the ovulatory phase. The mean DCP-PD in the nasal ETDRS subfield in the early follicular, ovulatory, and luteal phases was 54.11 ± 2.85, 56.39 ± 3.03, and 55.70 ± 3.27, respectively. The mean DCP-PD in the inferior ETDRS subfield in the early follicular, ovulatory, and midluteal phases was 52.90 ± 3.30, 54.86 ± 2.51, and 55.21 ± 2.64, respectively. No significant differences were found in MAP, SE, AL, IOP, FAZ area, or other quadrants of PD parameters, and no significant correlation was found between parameters by OCTA and age, MAP,SE, axial length, or IOP. Conclusions. The DCP-PD decreased in the nasal and inferior ETDRS subfields during the ovulatory phase in our study. This may indicate the need to consider the menstrual phase when interpreting DCP-PD parameters by OCTA in healthy women.


2021 ◽  
pp. bjophthalmol-2021-319540
Author(s):  
Jade Y. Moon ◽  
Itika Garg ◽  
Ying Cui ◽  
Raviv Katz ◽  
Ying Zhu ◽  
...  

Background/aimsPathological myopia (PM) is a leading cause of blindness worldwide. We aimed to evaluate microvascular and chorioretinal changes in different stages of myopia with wide-field (WF) swept-source (SS) optical coherence tomography angiography (OCTA).MethodsThis prospective cross-sectional observational study included 186 eyes of 122 patients who had undergone imaging between November 2018 and October 2020. Vessel density (VD) and vessel skeletonised density (VSD) of superficial capillary plexus, deep capillary plexus and whole retina, as well as foveal avascular zone parameters, retinal thickness (RT) and choroidal thickness (CT), were calculated.ResultsThis study evaluated 75 eyes of 48 patients with high myopia (HM), 43 eyes of 31 patients with mild to moderate myopia and 68 eyes of 53 age-matched controls. Controlling for age and the presence of systemic hypertension, we found that HM was associated with decrease in VD and VSD in all layers on 12×12 mm² scans. Furthermore, HM was associated with a VD and VSD decrease in every Early Treatment Diabetic Retinopathy Study grid, with a larger decrease temporally (βVD=−0.39, βVSD=−10.25, p<0.01). HM was associated with decreased RT and CT. Reduction in RT was outside the macular region, while reduction in CT was in the macular region.ConclusionUsing WF SS-OCTA, we identified reduction in microvasculature and structural changes associated with myopia. Decrease in VD and VSD was greater in the temporal quadrant, and reductions in RT and CT were uneven across the retina. Further work may help identify risk factors for the progression of PM and associated vision-threatening complications.


2018 ◽  
Vol 2 (4) ◽  
pp. 213-218 ◽  
Author(s):  
Rayan A. Alshareef ◽  
Hasenin Al-khersan ◽  
Rami Darwich ◽  
Ayesha Jabeen ◽  
Asiya Jabeen ◽  
...  

Background and Objective: The purpose of this study was to quantify the geometric dimension of the foveal avascular zone (FAZ) area and its index measurement of morphology as a circle (acircularity index) in healthy participants according to age and sex, using optical coherence tomography angiography (OCTA). Study Design/Materials and Method: This is a cross-sectional descriptive study conducted at LV Prasad Eye Institute, India. Written informed consent was obtained from all participants before the study. Deep range imaging-optical coherence tomography (DRI-OCT; Topcon) was performed on right eyes of all participants in this study. The OCTA scans were analyzed and processed; FAZ dimensions and the acircularity index were calculated for both superficial retinal capillary plexus (SCP) and deep retinal capillary plexus (DCP). Results: A total of 88 normal right eyes from 88 participants were included (48 males, 40 females; mean 42 ± 13 years of age). Mean FAZ area for SCP and DCP was 3.37 ± 1.28 mm2 and 2.31 ± 1.12 mm2, respectively. Mean acircularity index for SCP and DCP was 1.76 ± 1.58 and 1.60 ± 0.90, respectively. In the SCP, male sex was correlated with lower FAZ values; however, there was no correlation with age or refractive error. For the DCP, male sex and increasing age correlated with lower FAZ values, but there was no correlation with refractive error. Foveal avascular zone areas decreased 0.0225 mm2 per year in the DCP. The acircularity index of both the SCP and DCP was not correlated with sex, age, or refractive error. Conclusions: Male sex and increasing age were correlated with lower FAZ values in the DCP, while only male sex was correlated with lower FAZ values in the SCP. There was no correlation between sex, age, or refractive error with the acircularity index for both the SCP and DCP.


2019 ◽  
Vol 236 (04) ◽  
pp. 551-554 ◽  
Author(s):  
Stefan Trachsler ◽  
Arthur Baston ◽  
Marcel Menke

Abstract Purpose To compare 4 optical coherence tomography-angiography (OCT-A) devices for foveal avascular zone (FAZ) measurements in healthy subjects. Methods The central retinas of 24 eyes of 12 healthy subjects were scanned with 4 different OCT-A devices (Optovue RTVue-XR, Zeiss Cirrus 5000-HD-OCT, a prototype Spectralis OCT2, Heidelberg Engineering, and Topcon DRI-OCT Triton Swept-source OCT). For the Topcon, Zeiss, and Optovue devices, 3-mm and 6-mm scans were performed. The Heidelberg device only provided 4-mm scans. En-face OCT-A images of the superficial and deep capillary plexus of the macular area were generated. The FAZ areas were measured and compared. Results Twenty-four healthy eyes were included. OCT-A devices showed significant differences in FAZ measurements. The Zeiss OCT-A device measured the smallest values for foveal avascular area (mean 218.7 mm2), followed by the Optovue device (229.6 mm2), the Topcon device (239.3 mm2), and the Heidelberg device (250.4 mm2). Differences were statistically significant for following devices: Heidelberg versus Optovue (p < 0.001), Heidelberg versus Zeiss (p < 0.001), Topcon versus Zeiss (p < 0.001), and Optovue versus Zeiss (p = 0.046). For the Optovue device, FAZ measurements were significantly different between 3 mm (mean 220 mm2) and 6 mm (mean 239.3 mm2, p = 0.007) scans. All other devices showed no significant difference within scan modes. Conclusion Current OCT-A devices provide images that allow such measurements, but values showed significant differences between devices and, for the Optovue instrument, even within scan modes. The data for OCTA measurements cannot be transferred interchangeably between the devices. Therefore, a patient should always be measured with the same device.


2018 ◽  
Vol 103 (9) ◽  
pp. 1289-1295 ◽  
Author(s):  
Meng Tian ◽  
Christoph Tappeiner ◽  
Martin S Zinkernagel ◽  
Wolfgang Huf ◽  
Sebastian Wolf ◽  
...  

PurposeTo evaluate vascular changes in patients with intermediate uveitis with or without retinal vasculitis using swept-source wide-field optical coherence tomography angiography (OCTA).MethodsThis is a prospective cross-sectional study. Consecutive patients with intermediate uveitis were evaluated using wide-field OCTA. Wide-field OCTA and en-face OCT images were analysed for the presence of capillary non-perfusion and reduced perfusion, disruption of ellipsoid zone, and abnormalities on en-face wide-field retinal thickness maps, respectively, and compared with fluorescein angiography (FA) findings in a subcohort.Results164 eyes of 88 patients with intermediate uveitis were included. Areas of capillary non-perfusion and reduced perfusion were more frequently observed in the choroidal OCTA slab (33.3% and 49.4%), choriocapillaris (CC; 31.4% and 48%) and deep capillary plexus (DCP; 9.6% and 34.6%) than in the superficial capillary plexus (SCP; 5% and 26.3%), respectively. Intermediate uveitis with vasculitis presented more frequently with non-perfusion and hypoperfusion in the DCP (p=0.003 and p=0.05, respectively) and SCP (p=0.007 and p=0.005, respectively) than intermediate uveitis without vasculitis. Peripheral capillary leakage on FA correlated with the presence of perivascular, macular and generalised thickening on en-face wide-field thickness maps (p=0.007). Ischaemia on FA was significantly associated with non-perfusion on wide-field OCTA in SCP and DCP (p=0.019 and p=0.027, respectively).ConclusionChanges in the choroid, CC and DCP are more frequently found than in the SCP on wide-field OCTA in intermediate uveitis. While wide-field OCTA is a reliable tool to detect capillary non-perfusion in intermediate uveitis, it was not helpful in determining disease activity.Trial registration numberNCT02811536.


Author(s):  
Anna Lentzsch ◽  
Laura Schöllhorn ◽  
Christel Schnorr ◽  
Robert Siggel ◽  
Sandra Liakopoulos

Abstract Purpose To compare swept-source (SS) versus spectral-domain (SD) optical coherence tomography angiography (OCTA) for the detection of macular neovascularization (MNV). Methods In this prospective cohort study, 72 eyes of 54 patients with subretinal hyperreflective material (SHRM) and/or pigment epithelial detachment (PED) on OCT possibly corresponding to MNV in at least one eye were included. OCTA scans were acquired using two devices, the PLEX Elite 9000 SS-OCTA and the Spectralis SD-OCTA. Fluorescein angiography (FA) was used as reference. Two graders independently evaluated en face OCTA images using a preset slab as well as a manually modified slab, followed by a combination of en face and cross-sectional OCTA. Results Sensitivity (specificity) for the automated slabs was 51.7% (93.0%) for SS-OCTA versus 58.6% (95.3%) for SD-OCTA. Manual modification of segmentation increased sensitivity to 79.3% for SS-OCTA but not for SD-OCTA (58.6%). The combination of en face OCTA with cross-sectional OCTA reached highest sensitivity values (SS-OCTA: 82.8%, SD-OCTA: 86.2%), and lowest number of cases with discrepancies between SS-OCTA and SD-OCTA (4.2%). Fleiss kappa as measure of concordance between FA, SS-OCTA, and SD-OCTA was 0.56 for the automated slabs, 0.60 for the manual slabs, and 0.73 (good agreement) for the combination of en face OCTA with cross-sectional OCTA. Concordance to FA was moderate for the automated slabs and good for manual slabs and combination with cross-sectional OCTA of both devices. Conclusion Both devices reached comparable results regarding the detection of MNV on OCTA. Sensitivity for MNV detection and agreement between devices was best when evaluating a combination of en face and cross-sectional OCTA.


2019 ◽  
Vol 30 (6) ◽  
pp. 1418-1423 ◽  
Author(s):  
Claudio Furino ◽  
Grazia Montrone ◽  
Maria Vittoria Cicinelli ◽  
Stefania Balestra ◽  
Maria Oliva Grassi ◽  
...  

Purpose: To investigate a subset of diabetic patients without diabetic retinopathy with optical coherence tomography angiography, assessing the differences in macular perfusion between diseased eyes and healthy controls. Methods: Monocentric cross-sectional study, including 86 eyes from 43 diabetic patients with no clinical signs of diabetic retinopathy and 78 eyes from 39 controls. Patients underwent 3.0 × 3.0 mm and 4.5 × 4.5 mm swept-source optical coherence tomography angiography. Vessel density (%), foveal avascular zone area (mm2), and avascular density (%) were provided for the superficial capillary plexus and the deep capillary plexus. Results: The foveal avascular zone area at the superficial capillary plexus was larger in the study group compared to controls, irrespective of the area of the slab considered. A meaningful difference was found in the vessel density at the deep capillary plexus of the 3.0 × 3.0 mm slab (p = 0.03). Almost all the variables considered in the study showed a significant within-subject effect. Age significantly correlated with vessel density of superficial capillary plexus on 4.5 × 4.5 mm in both control and diabetic eyes. Conclusion: Diabetic patients with subclinical diabetic retinopathy feature a larger foveal avascular zone at the superficial capillary plexus compared with controls, as well as relative reduction of the vessel density at the deep capillary plexus. These findings might serve as the basis for screening between normal and diabetic subjects.


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