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.

scholarly journals Assessment of Vascular Change Using Swept-Source Optical Coherence Tomography Angiography: A New Theory Explains Central Visual Loss in Behcet’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Thanapong Somkijrungroj ◽  
Sritatath Vongkulsiri ◽  
Wijak Kongwattananon ◽  
Peranut Chotcomwongse ◽  
Sasivarin Luangpitakchumpol ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Optical Coherence Tomography Angiography ◽  
Vision Loss ◽  
Age At Onset ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Swept Source ◽  
Capillary Plexus ◽  
Macular Ischemia

Objective. To evaluate retinal vascular structural change in ocular Behcet’s using optical coherence tomography angiography (OCTA) and fluorescein angiography (FA). Methods. An analytic cross-sectional study of 37 eyes of 21 Behcet’s uveitic patients was performed. Foveal retinal thickness (FRT), perifoveal hypoperfusion areas in superficial capillary plexus (SCP), and deep capillary plexus (DCP) were measured with swept-source optical coherence tomography and OCTA. FA images were used for assessing the vascular features and correlation. Results. Twenty-one patients were enrolled (52.4% males). The average age at onset was 36.7 ± 12.93 years. The median of disease duration was 5 years (1–25). FRT was 118.1 ± 52.35 μm, which correlated with visual acuity (95% CI −60.47, −13.92). Using OCTA, the area of hypoperfusion in SCP (0.47 ± 0.17 mm2) was smaller than that in DCP (1.94 ± 3.87 mm2) (p<0.001). Superficial to deep capillary plexus nonperfusion (SCP : DCP) ratio was 0.57 ± 0.27 which had the positive coefficient correlation with visual acuity (95% CI −0.644, −0.015). Conclusions. OCTA is an alternative noninvasive method to monitor macular ischemia in Behcet. Behcet’s uveitis affects DCP more than SCP. Decreasing SCP : DCP ratio and decrease FRT correlates with poor visual acuity. Macular ischemia and DCP loss can be found early and can explain vision loss in Behcet.

Retinal microcirculation abnormalities in patients with systemic sclerosis: an explorative optical coherence tomography angiography study

Rheumatology ◽  
2021 ◽  
Author(s):  
Adriano Carnevali ◽  
Giuseppe Giannaccare ◽  
Valentina Gatti ◽  
Caterina Battaglia ◽  
Giorgio Randazzo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Flow Index ◽  
Digital Ulcers ◽  
Optical Coherence ◽  
Vascular Abnormalities ◽  
Capillary Plexus ◽  
Retinal Microcirculation ◽  
Vascular Plexuses

Abstract Objectives To investigate subclinical and clinical abnormalities in retinal and choroidal vascular plexuses in patients with SSc by means of optical coherence tomography angiography (OCT-A). Methods A total of 20 consecutive SSc patients were recruited and compared with 20 healthy subjects. Quantitative analysis of vessel density (VD), choriocapillaris plexus flow index (CCP-FI) and choroidal vascularity index were performed on OCT-A images in the superficial capillary plexus (SCP), deep capillary plexus (DCP) and CCP for all patients. Images were further reviewed by two independent readers for the assessment of qualitative abnormalities, including tortuosity, rarefaction areas, megacapillaries and macular-foveal capillaries. Results The DCP-VD in the whole scan and in the perifoveal, superior, inferior, nasal and temporal regions was significantly lower in the SSc group. The CCP-FI was significantly higher in SSc patients. When comparing SSc patients with and without digital ulcers, significantly decreased SCP-VD was demonstrated in the whole, perifoveal, superior, inferior, temporal and nasal regions. No difference in any of the OCT-A parameters was observed when comparing patients with and without interstitial lung disease. Qualitative analysis of OCT-A revealed at least one abnormality in 95% of patients. Conclusion We showed the ability of OCT-A to disclose early ocular vascular abnormalities in patients with SSc. Our results may represent a hypothesis-generating basis for exploring the potential role of OCT-A in diagnosis, monitoring and prognosis stratification in SSc.

scholarly journals Early Retinal Flow Changes after Vitreoretinal Surgery in Idiopathic Epiretinal Membrane Using Swept Source Optical Coherence Tomography Angiography

2019 ◽  
Vol 8 (12) ◽  
pp. 2067 ◽  
Author(s):  
Rodolfo Mastropasqua ◽  
Rossella D’Aloisio ◽  
Pasquale Viggiano ◽  
Enrico Borrelli ◽  
Carla Iafigliola ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Epiretinal Membrane ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Vascular Changes ◽  
Ilm Peeling ◽  
Swept Source ◽  
Idiopathic Epiretinal Membrane ◽  
Capillary Plexus ◽  
Superficial Capillary Plexus

(1) Background: The aim of this observational cross-sectional work was to investigate early retinal vascular changes in patients undergoing idiopathic epiretinal membrane (iERM) surgery using swept source optical coherence tomography angiography (SS-OCTA); (2) Methods: 24 eyes of 24 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling were evaluated pre- and postoperatively using SS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). For each eye, five 6x6-mm OCTA volume scans were acquired by two observers independently. The en face images of superficial capillary plexus (SCP) were then exported to imageJ and a semi-automated algorithm was used for subsequent quantitative analysis. Perfusion density (PD), vessel length density (VLD), vessel diameter index (VDI) and vessel tortuosity (VT) of SCP were evaluated in both the parafoveal (2.5 mm diameter) and perifoveal areas (5.5 mm diameter); (3) Results: At OCTA analysis statistically significant differences were found between controls and diseased eyes for all parameters in parafoveal and perifoveal regions (p < 0.001; p < 0.05) except for perifoveal VLD. During 6-month follow up, both anatomical/perfusion and functional parameters showed a statistically significant improvement if compared to preoperative values. In detail, at one-month post vitrectomy, VLD and VT significantly changed in parafoveal region (p = 0.043; p = 0.045), while PD and VDI showed a trend of increase in both parafoveal and perifoveal region. At 6 months after surgery, PD, VLD and VT of parafoveal region significantly improved (p = 0.021, p = 0.018, p = 0.047 respectively). (4) Conclusions: SS-OCTA provides a quantitative and qualitative analysis of the superficial capillary plexus allowing for early vascular changes assessment after vitrectomy with iERM and ILM peeling.

VASCULAR ABNORMALITIES IN DIABETIC RETINOPATHY ASSESSED WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY WIDEFIELD IMAGING

Retina ◽  
2019 ◽  
Vol 39 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Karen B. Schaal ◽  
Marion R. Munk ◽  
Iris Wyssmueller ◽  
Lieselotte E. Berger ◽  
Martin S. Zinkernagel ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Swept Source ◽  
Vascular Abnormalities

scholarly journals Vascular Abnormalities in Peripapillary and Macular Regions of Behcet's Uveitis Patients Evaluated by Optical Coherence Tomography Angiography

2021 ◽  
Vol 8 ◽  
Author(s):  
Chun Yan ◽  
Fan Li ◽  
Min Hou ◽  
Xiaoyuan Ye ◽  
Lishi Su ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Vascular Density ◽  
Optical Coherence ◽  
Flow Area ◽  
Vascular Abnormalities ◽  
Behçet’S Uveitis ◽  
Capillary Plexus ◽  
Area And Perimeter ◽  
Healthy Eyes

Purpose: To investigate the involvement of peripapillary zone vascular abnormalities in Behcet's uveitis (BU) and associated visual dysfunction. We evaluated the retinal and choroidal microvascular features in both macular and peripapillary areas of BU patients to identify vascular abnormalities contributing to reduced best-corrected visual acuity (BCVA) using optical coherence tomography angiography (OCTA).Methods: A prospective, observational study was conducted in 24 eyes of 13 patients with BU and 24 eyes of 15 healthy participants as controls. They received a standard eye examination and were recorded by OCTA measurements of macular and peripapillary areas. The vascular densities of superficial capillary plexus (SCP) and deep capillary plexus (DCP), choroidal flow area, radial peripapillary capillary network (RPCN) density, foveal avascular zone (FAZ) area and perimeter, full retinal thickness (FRT), and peripapillary retinal nerve fiber layer thickness (pRNFLT) were measured.Correlations among microvascular, structural, and functional changes were assessed.Results: Our findings uncovered that the vascular density was significantly reduced in the peripapillary zone of BU eyes compared to healthy eyes, especially in the inferior subfield of the RPCN. The vascular densities of SCP and DCP quadrants within the macular zone had no significant difference between BU and control groups except for DCP density of the nasal parafoveal quadrant. Both FAZ area and perimeter were greater but without statistical significance in the BU group. Compared to healthy eyes, the choriocapillaris flow area was smaller while the FRT and pRNFLT were greater in the BU group. Notably, there was a significant correlation between the reduction in RPCN vascular density and decreased BCVA in BU patients.Conclusion: Based on OCTA, vascular changes associated with BU are more prominent in the peripapillary zone than those in the macular zone. The vascular density of the RPCN could serve as a sensitive indicator to monitoring BU pathogenic progression and treatment response using a non-invasively method of OCTA.

Reproducibility of macular and optic nerve head vessel density measurements by swept-source optical coherence tomography angiography

2019 ◽  
Vol 30 (4) ◽  
pp. 756-763 ◽  
Author(s):  
José Ignacio Fernández-Vigo ◽  
Bachar Kudsieh ◽  
Ana Macarro-Merino ◽  
Pedro Arriola-Villalobos ◽  
José María Martínez-de-la-Casa ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Optical Coherence Tomography Angiography ◽  
Central Zone ◽  
Vessel Density ◽  
Optical Coherence ◽  
Outer Retina ◽  
Swept Source ◽  
Capillary Plexus

Purpose: To assess the reproducibility of swept-source optical coherence tomography angiography (SS-OCTA) for macular and optic nerve head (ONH) vessel density (VD). Methods: Cross-sectional study using the Triton OCTA (Topcon, Tokyo, Japan), for VD (%) measurements in 40 eyes of 40 healthy subjects on two 6 × 6 mm scans of the macula and ONH across five subfields (central, superior, inferior, temporal, and nasal) at different segmentation levels: superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina, and choriocapillaris. Reproducibility values were summarized as intraclass correlation coefficients (ICCs) and coefficients of variations (CV). Results: ICCs for the macular VD measurements in the central zone were 0.874, 0.770, 0.575, 0.718 at the levels SCP, DCP, outer retina, and choriocapillaris, respectively, while worse ICCs were obtained for the parafoveal subfields (ICC ⩽ 0.589); CVs were 2.8%–6.7%. The reproducibility of the ONH superficial VD was ICC = 0.941 for the papillary region and was ICC = 0.499–0.853 for the peripapillary zone; CVs ranged from 4.8% to 17%. Peripapillary VD showed an ICC = 0.533–0.770 in the DCP layer, and 0.572–0.828 in the choriocapillaris. Lowest VD were obtained for the macular SCP and DCP (23% and 22%, respectively), in the foveal zone, while greatest VD were recorded in the nasal and temporal peripapillary subfields at the level of the choriocapillaris (both 68%). Conclusions: The new SS-OCTA software served to quantify macular and ONH VD with a reproducibility that was good in the central zones (foveal and papillary, respectively) and moderate in the peripheral zones (parafoveal and peripapillary).

scholarly journals Detection rate of diabetic macular microaneurysms comparing dye-based angiography and optical coherence tomography angiography

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Martin Stattin ◽  
Anna-Maria Haas ◽  
Daniel Ahmed ◽  
Ulrike Stolba ◽  
Alexandra Graf ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Microvascular Dysfunction ◽  
Optical Coherence ◽  
Swept Source ◽  
Explorative Study ◽  
Capillary Plexus ◽  
Imaging Methodology ◽  
The Mean ◽  
Superficial Capillary Plexus

Abstract Diabetic maculopathy (DM) is a microvascular dysfunction clinically characterized by microaneurysms (MA) leading to edema and central visual deprivation. This prospective explorative study investigated 27 eyes of 17 patients with DM by fluorescein/indocyanine green angiography (FA/ICGA; SPECTRALIS HRA-OCT, Heidelberg Engineering) and by swept source-optical coherence tomography angiography (SS-OCTA; DRI-OCT Triton Plus, Topcon) to identify clinically relevant MAs. The SS-OCTA cubes were split into the superficial capillary plexus (SCP) and the deep capillary plexus (DCP) according to the automated segmentation. The images of all modalities were superimposed for alignment by an Early Treatment Diabetic Retinopathy Study grid overlay and compared to each other. In total, the mean number of MAs in FA was 33.4 ± 22 (standard deviation) (median 27.5 [q1:21.75;q3:38.25]), in ICGA 24.9 ± 16.9 (17.5 [14;35]), in the SCP 6.5 ± 3.7 (5.5 [3.75;9.25]) and in the DCP 18.1 ± 10.5 (18.5 [10.75;23.5]). Mixed effects models between ICGA and the DCP were borderline significant (p = 0.048; 95% confidence interval 0.21 to 13.49), whereas all other imaging methods differed significantly. Quantitative analysis of MAs in DM showed a plausible agreement between ICGA and the DCP in SS-OCTA. These findings contribute to the imaging methodology in DM.

scholarly journals Early alterations in retinal microvasculature on swept-source optical coherence tomography angiography in acute central serous chorioretinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dominika Podkowinski ◽  
Bernhard Foessl ◽  
Luis de Sisternes ◽  
Sophie Beka ◽  
Anna-Sophie Mursch-Edlmayr ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Retinal Blood Flow ◽  
Optical Coherence ◽  
Swept Source ◽  
Retinal Microvasculature ◽  
Significant Difference ◽  
Capillary Plexus ◽  
Acute Central Serous Chorioretinopathy

AbstractThe purpose of the study was to evaluate the retinal blood flow in patients with acute central serous chorioretinopathy (CSC) over an observational period of 1 month using swept-source optical coherence tomography (SS-OCTA), focusing especially on changes in the area of subretinal fluid (A-SRF). We correlated these findings with conventional indocyanine green angiography (ICGA). ICGA and SS-OCTA images were collected and analyzed of 12 eyes of 12 patients. The A-SRF was annotated and a qualitative analysis of choriocapillaris, the vessel density (VD) and perfusion density (PD) of the retinal superficial capillary plexus (SCP) and the deep capillary plexus (DCP) was performed in A-SRF and the unaffected remaining area (RA). The VD and PD in the DCP were statistically significantly lower in A-SRF than in the RA at baseline. (VD: p = 0.014; PD: p = 0.036). After 1 month, there was a statistically significant difference in the VD and PD of the DCP (VD: p = 0.015; PD: p = 0.014), and for the PD of the SCP between the A-SRF and the RA (p = 0.015), with lower values in the A-SRF. We found low perfused areas in choriocapillaris corresponding to hypofluorescent areas on ICGA. In conclusion there is a difference in VD and VD of the DCP in the area of SRF in acute CSC. These alterations may lead to a chronic change in the microvasculature and potentially to morphological changes.

scholarly journals Optical Coherence Tomography (Angiography) Biomarkers in the Assessment and Monitoring of Diabetic Macular Edema

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Corina-Iuliana Suciu ◽  
Vlad-Ioan Suciu ◽  
Simona-Delia Nicoara
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Choroidal Thickness ◽  
Outer Segment ◽  
Vision Loss ◽  
Foveal Avascular Zone ◽  
Vascular Density ◽  
Optical Coherence ◽  
Capillary Plexus

Retinopathy is one of the most severe diabetes-related complications, and macular edema is the major cause of central vision loss in patients with diabetes mellitus. Significant progress has been made in recent years in optical coherence tomography and angiography technology. At the same time, various parameters have been attributed the role of biomarkers creating the frame for new monitoring and treatment strategies and offering new insights into the pathogenesis of diabetic retinopathy and diabetic macular edema. In this review, we gathered the results of studies that investigated various specific OCT (angiography) parameters in diabetic macular edema, such as central subfoveal thickness (CST), cube average thickness (CAT), cube volume (CV), choroidal thickness (CT), retinal nerve fiber layer (RNFL), retinal thickness at the fovea (RTF), subfoveal choroidal thickness (SFCT), central macular thickness (CMT), choroidal vascularity index (CVI), total macular volume (TMV), central choroid thickness (CCT), photoreceptor outer segment (PROS), perfused capillary density (PCD), foveal avascular zone (FAZ), subfoveal neuroretinal detachment (SND), hyperreflective foci (HF), disorganization of the inner retinal layers (DRIL), ellipsoid zone (EZ), inner segment/outer segment (IS/OS) junctions, vascular density (VD), deep capillary plexus (DCP), and superficial capillary plexus (SCP), in order to provide a synthesis of biomarkers that are currently used for the early diagnosis, assessment, monitoring, and outlining of prognosis.

scholarly journals Widefield Swept-Source Optical Coherence Tomography Angiography Assessment of Choroidal Changes in Vogt-Koyanagi-Harada Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Yujing Qian ◽  
Jingyuan Yang ◽  
Anyi Liang ◽  
Chan Zhao ◽  
Fei Gao ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Disease Activity ◽  
Optical Coherence Tomography Angiography ◽  
Comprehensive Evaluation ◽  
Cross Sectional Study ◽  
Optical Coherence ◽  
Flow Area ◽  
Cross Sectional ◽  
Swept Source ◽  
Vascular Abnormalities

Purpose: To investigate choroidal changes in patients with Vogt-Koyanagi-Harada disease (VKH) using widefield swept-source optical coherence tomography angiography (SS-OCTA).Methods: In this cross-sectional study, 133 eyes of 69 patients with VKH (52 eyes of 28 active VKH patients and 81 eyes of 41 inactive VKH patients) and 104 eyes of 52 age and sex matched healthy volunteers were imaged using a widefield SS-OCTA instrument. On 12 mm × 12 mm OCTA scans, mean choroidal thickness (MCT), choroidal vascularity index (CVI), choriocapillaris (CC) flow area, and mean retinal thickness (MRT) were separately calculated in the fovea (diameter of 1 mm) and in concentric rings with different radii (1–3, 3–6, 6–9, and 9–12 mm).Results: Eyes with active VKH showed significant increases in MCT, CVI, and MRT, and decreased CC flow area in all central and peripheral regions (0–1, 1–3, 3–6, 6–9, and 9–12 mm) than in the healthy eyes (p ≤ 0.01) and inactive VKH eyes (p &lt; 0.05). Inactive VKH eyes only showed marked decrease in CC flow area in all regions compared with controls (p &lt; 0.05). Flow voids were observed in 51 of 52 (98.1%) active VKH eyes and 50 of 81 (61.7%) inactive VKH eyes on 12 mm × 12 mm OCTA. The MCT of all regions was significantly correlated with age, disease duration, and disease activity, whereas CVI was associated with age and disease activity. The CC flow void was related to visual acuity in all regions (p &lt; 0.05).Conclusion: Widefield SS-OCTA enables a more comprehensive evaluation of chorioretinal changes in patients with VKH disease. Structural and vascular abnormalities are observed in both the central and peripheral choroid and are closely correlated with disease activity.

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