scholarly journals OCT Angiography and En Face OCT Reflectance Aid in Monitoring Subclinical Inflammation in Serpiginous Choroidopathy

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Carl S. Wilkins ◽  
Jorge S. Andrade Romo ◽  
Toco Y. P. Chui ◽  
Richard B. Rosen ◽  
Stephanie Llop

Introduction. We present a case of serpiginous choroidopathy (SC) with novel OCTA and en face OCT reflectance findings which help identify subclinical disease progression. Case Presentation. En face OCT reflectance images demonstrated outer retinal tubules (ORT) at the serpiginous lesion margins of affected and unaffected retina on multimodal imaging. OCTA findings demonstrate variable dropout of choriocapillaris in “normal” retina beyond lesion borders which was not visible on standard imaging and which demonstrated a clear transition zone beyond the ORT. Discussion. This is the first report of choriocapillaris atrophy identified on OCTA not identified on traditional multimodal imaging in serpiginous choroidopathy. Damage to vasculature only visible with OCTA may help characterize the distribution of inflammation, aiding in monitoring of suppression not illustrated by traditional imaging and which may threaten the central macula. ORT in SC suggest death and reorganization of outer segments from dysfunction of the choriocapillaris and RPE, as well as serve to demarcate the area of chronic or old inflammation, supporting the hypothesis that the choriocapillaris is the primary site of inflammation in SC. Based on these findings, we recommend OCTA on all patients with serpiginous choroidopathy to monitor underlying state of inflammation and help determine immunosuppressive threshold.

2017 ◽  
Vol 8 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Sylvia Nghiem-Buffet ◽  
Salomon Yves Cohen ◽  
Audrey Giocanti-Auregan

Background: To report the use of En-face optical coherence tomography (OCT) in a patient treated with docetaxel and tamoxifen for breast cancer for the detection of macular edema (ME) without evidence of leakage on fluorescein angiography (FA). Case Presentation: A 52-year-old woman treated for breast cancer presented with bilateral visual loss for 2 months. FA showed no significant leakage while spectral-domain OCT scans of both eyes showed foveolar and parafoveolar cystic spaces in a moderately thickened macula. En-face OCT segmented at the inner retina showed the petaloid arrangement of cystic cavities, comparable to a cystoid ME. Conclusions: The combined use of tamoxifen could have potentiated the toxic effect of docetaxel on the macula. En-face OCT images may reveal a petaloid aspect of the macula due to cysts in the inner retina segmentation, when FA shows no leakage.


2020 ◽  
Author(s):  
Stamatina A. Kabanarou ◽  
Georgios Bontzos ◽  
Tina Xirou ◽  
Zoi Kapsala ◽  
Eleni Dimitriou ◽  
...  

INTRODUCTION To evaluate the applicability of optical coherence tomography-angiography (OCT-A) for measuring geographic atrophy (GA) areas in age-related macular degeneration (AMD) patients with ‘foveal’ and ‘no foveal’ sparing disease and compare it to other imaging modalities. METHODS A multimodal imaging protocol was applied, using infrared imaging (IR), fundus autofluorescence (FAF), OCT-A and en-face OCT in 35 eyes of 23 AMD patients with GA. Patients were classified in two groups, with and without foveal sparing disease. GA area measurements for all imaging modalities were compared for each group separately. RESULTS The measured GA area was estimated 6.68 ± 3.18 mm2using IR; 6.99 ± 3.09 mm2 using FAF; 6.56 ± 3.11 mm2 using OCT-A and 6.65 ± 3.14 mm2using en-face OCT. There was no statistically significant difference in GA area between different modalities (p=0.977). When separate analysis was conducted for patients with ‘foveal’ and ‘no foveal’ sparing disease, although GA measurements in FAF imaging displayed higher numerical values compared to the other modalities, especially in patients with foveal sparing, no statistically significant difference in GA area was found between the different imaging modalities in either group (p=0.816 for foveal sparing; p=0.992 for no foveal sparing group). CONCLUSIONS OCT-A can be reliably used in the assessment of GA in AMD patients with and without foveal sparing disease. For both groups, measurements are comparable to IR, en-face OCT and FAF, despite the fact that the latter recorded larger area of GA, mainly in the foveal sparing cases.


Genes ◽  
2021 ◽  
Vol 12 (11) ◽  
pp. 1795
Author(s):  
Khaled El Matri ◽  
Yousra Falfoul ◽  
Imen Habibi ◽  
Ahmed Chebil ◽  
Daniel Schorderet ◽  
...  

Purpose: We report the case of a neurologically asymptomatic young boy presenting with an unusual phenotype of CYP2U1 related macular dystrophy associating bilateral macular telangiectasia (MacTel) and fibrotic choroidal neovascularization (CNV), assessed with complete multimodal imaging including optical coherence tomography angiography (OCT-A). Case presentation: A twelve-year-old boy from a non-consanguineous family complained of bilateral progressive visual loss and photophobia. The best-corrected visual acuity was 2/10 on the right eye and 3/10 on the left eye. Fundus examination showed central pigmented fibrotic macular scar and yellowish punctuate deposits in both eyes. En face OCT-A detected typical macular telangiectasia (MacTel) in both eyes with dilated telangiectatic capillaries in the deep capillary plexus associated with vascular anomalies in the superficial and deep capillary plexus. Typical hypo-reflective cavities were observed within the inner foveal layers on structural OCT. En face OCT-A also confirmed the presence of bilateral inactive CNV within the fibrotic scars, showing high-flow vascular network at the level of the subretinal hyperreflective lesions. Whole exome sequencing identified a known homozygous pathogenic variant in CYP2U1 gene (c.1168C > T, p.Arg390*), which is a disease-causing mutation in autosomal recessive spastic paraplegia type 56 (SPG56). The neurological examination was normal, and electromyography and brain magnetic resonance imaging were unremarkable as well. Conclusion: Macular dystrophy can be the first manifestation in SPG56. A particular phenotype with MacTel was observed, and neovascular complications are possible. CYP2U1 should be included in the panels of genes tested for macular dystrophies, especially in the presence of MacTel and/or neurological manifestations.


2021 ◽  
pp. bjophthalmol-2020-318095
Author(s):  
Beatrice Gallo ◽  
Samantha R de Silva ◽  
Omar A Mahroo ◽  
Zubin Saihan ◽  
Praveen J Patel ◽  
...  

Background/aimsTo describe clinical and multimodal imaging features in a cohort of choroidal macrovessels.MethodsDemographics and multimodal imaging features of 16 eyes of 13 patients with choroidal macrovessels were reviewed. The multimodal imaging included colour fundus photography, fundus autofluorescence (FAF), spectral domain enhanced depth imaging optical coherence tomography (OCT), en face OCT, OCT-angiography (OCT-A), B-scan ultrasonography (US), fluorescein angiography (FFA) and indocyanine green angiography (ICGA).ResultsThree patients had bilateral involvement. On colour fundus photography, three patterns were evident (a clearly visible orange-red vessel; a track of pigmentary changes; spots of mild pigmentary changes). Vessel orientation was horizontal (11 eyes), oblique (4 eyes) or vertical (1 eye). In 2 eyes, the vessel was extra-macular. OCT in all cases showed a hyporeflective choroidal area with posterior shadowing and elevation of the overlying retina. Subretinal fluid was present in 4 eyes. FAF (12 eyes) was normal (7 eyes) or showed a hypofluorescent/hyperfluorescent track (4 eyes) or linear hyperautofluorescence (1 eye). En-face OCT (2 eyes) revealed the course of the macrovessel at the level of choroid and choriocapillaris. On OCT-A (2 eyes) the vessel had a reflectivity similar to surrounding vessels but larger diameter. B-scan US (8 eyes) showed a nodular hypoechogenic lesion. FFA (5 eyes) showed early focal hyperfluorescence (4 eyes) not increasing in later phases, or was normal (1 eye). ICGA (6 eyes) showed early hyperfluorescence of the vessel.ConclusionsChoroidal macrovessels can mimic other entities, leading to underdiagnosis. Appreciating relevant features on different imaging modalities will aid a correct diagnosis.


Author(s):  
Hamid Riazi-Esfahani ◽  
Elias Khalili Pour ◽  
Kaveh Fadakar ◽  
Nazanin Ebrahimiadib ◽  
Fariba Ghassemi ◽  
...  

Abstract Background To describe the features of multimodal imaging and the diagnostic role of en face OCT in the paracentral acute middle maculopathy (PAMM) spectrum. Methods In this observational case series, 5 eyes of 5 patients with acute PAMM were identified. Demographic characteristics as well as data regarding the underlying disease, presenting visual acuity (VA) and ophthalmic examination results were recorded. All patients underwent multimodal imaging within 3 days after symptom onset. Results The mean age of patients was 52.2 (range, 33–67) years. Systemic comorbidities including diabetes mellitus and hypertension were identified in two patients. Except for one patient diagnosed with isolated PAMM, other patients had signs of retinal vascular disease such as a cilioretinal artery or branch retinal artery obstruction, non-ischemic central retinal vein occlusion, or a combination of these vascular disorders. The central vision was preserved in two cases; however, the remaining cases presented with profound VA reduction. Different patterns of PAMM including arterial, globular, and fern-like were observed in en face OCT at deep capillary plexus (DCP) level. En face OCT images could precisely delineate the margin of the PAMM area. Optical coherence tomography angiography (OCTA) showed decreased vascular density in DCP. Unresolved projection artifact by conventional OCTA software was observed in DCP and choriocapillaris slabs in all cases. Conclusion En face structural OCT in PAMM can delineate the area of ischemia and the degree of foveal involvement. Unresolved projection artifact by conventional OCTA software in the PAMM area can be seen in DCP and choriocapillaris layers.


2021 ◽  
Vol 21 ◽  
pp. 101012
Author(s):  
Carlos A. Moreira-Neto ◽  
Luiz H. Lima ◽  
Claudio Zett ◽  
Raphael Pereira ◽  
Carlos Moreira
Keyword(s):  

2021 ◽  
Author(s):  
M. Giray Ersoz ◽  
Mumin Hocaoglu ◽  
Isil Sayman Muslubas ◽  
Serra Arf ◽  
Erdost Yildiz ◽  
...  

Abstract Purpose: To investigate choriocapillaris flow voids (FV) with a new optical coherence tomography angiography (OCTA) image processing strategy to exclude artifacts due to vitreous opacities, subretinal pigment epithelium (sub-RPE) fluid and deposits, and subretinal fluid (SRF) by thresholding the en-face OCT image of the outer retina.Methods: This retrospective study included 15 eyes with drusen and 15 eyes with SRF. Number (FVn), average area (FVav), and maximum area (FVmax) of FV and the percentage of the nonperfused choriocapillaris area (PNPCA) obtained using the proposed strategy were compared with those obtained by removing only artifacts due to superficial capillary plexus (SCP).Results: There were three eyes with autosomal dominant drusen and 12 eyes with drusen secondary to non-exudative AMD in the drusen group. SRF group included 15 eyes with active central serous chorioretinopathy. PNPCA, FVav, FVmax, and FVn obtained using the algorithm were significantly lower than those obtained by removing only SCP in both groups (all p< 0.05). The algorithm was able to remove 94.7% of artifacts secondary to vitreous opacities and all artifacts secondary to serous pigment epithelial detachments. Conclusion: Nonperfusion areas of choriocapillaris may be overestimated in eyes with RPE abnormalities and SRF. These areas can be removed using thresholded images of the outer retina en-face OCT scans.


2015 ◽  
Vol 160 (4) ◽  
pp. 786-798.e4 ◽  
Author(s):  
Tharikarn Sujirakul ◽  
Michael K. Lin ◽  
Jimmy Duong ◽  
Ying Wei ◽  
Sara Lopez-Pintado ◽  
...  

2016 ◽  
Vol 7 (2) ◽  
pp. 354-358
Author(s):  
Yu Ichioka ◽  
Akihito Uji ◽  
Nagahisa Yoshimura

Background: To present an intraoperative acute Descemet’s fold formation using swept-source optical coherence tomography (SS-OCT) imaging. Case Report: A 67-year-old man complaining of reduced visual acuity in the left eye. A 25-gauge pars plana vitrectomy combined with phacoemulsification cataract surgery was performed to remove the vitreomacular traction. When hydro-sealing was performed, striae rapidly spread in the cornea. SS-OCT B-scan images performed on postoperative day 1 revealed a wavy Descemet’s membrane that might correspond to Descemet’s folds. Pairs of hypo- and hyperreflective narrow lesions running from the wavy Descemet’s membrane to almost half of the thickness of the whole cornea were observed. En face OCT imaging clearly showed the stromal fold, which continuously spread from the Descemet’s fold. Conclusion: The stromal fold might be due to the focal bulge of the stroma posteriorly caused by the rapid volume increase of the stroma which could push Descemet’s membrane posteriorly, thereby forming a wavy Descemet’s membrane layer.


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