scholarly journals Immediate Choroidal Expansion after Bleb Needling

2020 ◽  
Vol 11 (3) ◽  
pp. 658-667
Author(s):  
Maria Marenco ◽  
Aldo Vagge ◽  
Carlo E. Traverso ◽  
Michele Iester

The purpose was to report a case of immediate choroidal expansion after a needling procedure. This is a retrospective case report of an 80-year-old male with pseudoexfoliative glaucoma who underwent Xen 45 Gel stent implantation and then trabeculectomy in the right eye. During follow-up, several bleb needling procedures were required to treat bleb fibrosis. Before and after the last bleb needling, spectral-domain optical coherence tomography (SD-OCT) was performed to investigate choroidal changes. SD-OCT was also repeated 1 week later. SD-OCT showed instant choroidal expansion (both in the macular and peripapillary area) that was quite sustained throughout the 1 week-follow-up and after 5 months. Bleb needling can cause immediate choroidal expansion that can be quite sustained throughout several months of follow-up. SD-OCT is essential for detecting choroidal changes.

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Jeanne M. Gunzinger ◽  
Katrin Fasler ◽  
Daniel Barthelmes ◽  
Peter Maloca ◽  
Pascal W. Hasler ◽  
...  

The purpose of the study was to analyze imaging findings in spectral domain en face optical coherence tomography (SD OCT) in patients with laser‐induced and solar maculopathies focusing on the possible regeneration of the ellipsoid zone. In a retrospective case series of 3 patients (4 eyes) with solar maculopathy and 2 patients (3 eyes) with laser‐induced maculopathy who underwent a comprehensive ocular examination, ellipsoid zone (EZ) was segmented from SD OCT data. Evaluation of EZ in en face OCT revealed a hyporeflective lesion surrounded by a hyperreflective border. The area of EZ alteration was measured manually in en face OCT. All patients showed partial EZ regeneration. Mean EZ alteration decreased from 0.12 mm2 (range: 0.05–0.32) at baseline to 0.07 mm2 (range: 0.01–0.22) at last follow‐up (p=0.018, mean follow‐up: 372 days; range: 115–592). Mean best visual acuity (BVA) improved from 20/36 at baseline to 20/30 (p=0.018). In conclusion, en face OCT imaging clearly delineated the area of EZ alteration in patients with laser‐induced and solar maculopathies. Follow-up showed significant reformation of the EZ as well as improvement of BVA.


2019 ◽  
Vol 10 (3) ◽  
pp. 384-390
Author(s):  
Maria Marenco ◽  
Luigi Borgia ◽  
Aldo Vagge ◽  
Michele Iester

The aim of this study is to report a case of choroidal congestion after trabeculectomy. This is a retrospective case report. An 85-year-old male with advanced open-angle glaucoma underwent trabeculectomy in both eyes and during follow-up he complained of visual impairment in the right eye. Thus, spectral domain optical coherence tomography (OCT) was performed and showed choroidal congestion in one eye 1 month after surgery together with a decrease of visual acuity. Symptoms and exam findings resolved with systemic steroids after a 6-month follow-up. OCT is essential for detecting choroidal congestion. This finding can be a possible complication after trabeculectomy and can benefit from steroid treatment.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Eduardo Morizot ◽  
Camila Schiavo Froner

Abstract Purpose To report a case of multifocal choroiditis (MC) that has relapsed as choroidal neovascularization in the contralateral eye followed by a mixed aspect of multiple evanescent white dot syndrome (MEWDS) and MC. Methods Retrospective case report and literature review. The clinical findings were documented by fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography (OCT-A). Results The authors describe the case of a 39-year-old woman with prior ocular history of presumed MEWDS in her left eye, which developed into MC 7 years later in the same eye and 11 years later in the right eye, starting as choroidal neovascularization and developing into MEWDS. OCT-A showed neovessel in a supposedly active MC area outside the macular region in right and left eyes. OCT showed increased choroidal thickness in both eyes and a choroidal neovascularization in the right eye, treated using anti- VEGF therapy. Conclusion This case corroborates the proximity of some inflammatory diseases such as MC and MEWDS. OCT-A has opened new horizons for the better understanding of some retinal diseases by providing more thorough and promising morphological analyses using enhanced tools.


2015 ◽  
Vol 234 (3) ◽  
pp. 160-166 ◽  
Author(s):  
Young-Joon Jo ◽  
Hyung-Bin Lim ◽  
Soo-Hyun Lee ◽  
Jung-Yeul Kim

Purpose: To evaluate the effects of retinal angiography, using fluorescein and indocyanine green dyes, on optical coherence tomography (OCT) measurements. Methods: In total, 76 eyes from 76 consecutive patients were included. Macular cube 512 × 128 combination scanning and optic disc 200 × 200 scanning using spectral-domain (SD)-OCT were performed twice, before and after retinal angiography, with fluorescein or indocyanine green. Signal strength, regional retinal thickness of the 9 Early Treatment Diabetic Retinopathy Study subfields, total macular volume, and retinal nerve fiber layer thickness obtained before and after angiography were compared. Repeatability was also investigated. Results: Comparing the results of OCT measured before and after retinal angiography, there was no statistically significant difference in any parameter assessed. The interclass correlation values for each measurement were all >0.808 (range 0.808-0.999). Conclusion: Retinal angiography using fluorescein and indocyanine green dyes has no significant effect on OCT measurements.


2020 ◽  
Vol 9 (6) ◽  
pp. 1618 ◽  
Author(s):  
Gilda Cennamo ◽  
Daniela Montorio ◽  
Roberta Bernardo ◽  
Antonio Farella ◽  
Raffaele Liuzzi ◽  
...  

In this prospective study, we investigated the structural and vascular retinal changes at baseline and after Ranibizumab injections at the last follow up to one year in patients affected by Radiation Maculopathy (RM) after plaque brachytheraphy in choroidal melanoma, using Spectral Domain Optical Coherence Tomography (SD-OCT) and OCT Angiography (OCTA). A total of 40 eyes with RM of 40 patients (18 females, 22 males, mean age 51.9 ± 11 years) that underwent ruthenium-106 plaque brachytherapy were included. All patients received one monthly intravitreal injection of Ranibizumab (Pro Re Nata regimen). We analyzed the Foveal Avascular Zone (FAZ) area, the retinal vessel density (VD) of the superficial capillary plexus (SCP) and of the deep capillary plexus (DCP), using OCTA, and we detected the Central Foveal Thickness (CFT) by SD-OCT at baseline and after treatment. At the last follow up, we found a significant improvement of the CFT (p < 0.001) while OCTA parameters revealed no change in VD of the SCP (p = 0.402), DCP (p = 0.282), and FAZ area (p = 0.255), resulting in a stabilization of the visual acuity (p = 0.210) respect to baseline. The absence of functional improvement, despite the anatomical recovery of the macula, could be due to the absence of improvement in FAZ area and in retinal VD after treatment. OCTA parameters could represent predictive biomarkers to anti-vascular endothelial growth factor (anti-VEGF) intravitreal response and to help to better understand the physiopathological mechanisms of the RM.


Lupus ◽  
2019 ◽  
Vol 28 (4) ◽  
pp. 555-559 ◽  
Author(s):  
D Martín-Iglesias ◽  
J Artaraz ◽  
A Fonollosa ◽  
A Ugarte ◽  
A Arteagabeitia ◽  
...  

Objective The objective of this report is to analyse retinal changes over a five-year period, assessed by spectral domain-optical coherence tomography (SD-OCT), in patients from the Lupus-Cruces cohort treated with hydroxychloroquine (HCQ). Methods SD-OCT screening was performed annually between 2012 and 2017. Average macular thickness (AMT), ganglion cell layer thickness (GCLT) and qualitative data of retinal pigment epithelium (RPE) and external retina (ExtR) were collected prospectively. We compared data from 2012 (first) and 2017 (second) SD-OCT. Results We studied 110 patients and 195 eyes. No cases of HCQ toxicity were detected. At the time of the second SD-OCT, 99% patients had taken a daily dose of HCQ ≤5 mg/kg/day. The median time on HCQ was 133 months. The mean AMT and GCLT were significantly lower in both eyes at the second SD-OCT; however, all the differences were clinically insignificant at less than 1%. Qualitative analysis of RPE and ExtR showed no significant changes. Similar results were found among patients with risk factors for retinopathy. The comparison of patients with and without risk factors showed no differences. Conclusions This study shows clinically irrelevant retinal changes in an SLE cohort on HCQ treatment over a five-year follow-up. Our findings support the safety of long-term HCQ at doses ≤5 mg/kg/day.


2020 ◽  
pp. 112067212095759
Author(s):  
Meriem Ouederni ◽  
Hela Sassi ◽  
Zied Chelly ◽  
Fehmy Nefaa ◽  
Monia Cheour

Purpose: Since its first description by Chang et al. in 1995, the diagnosis of Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome has been based on the findings of Fundus Fluorescein Angiography (FFA). Our purpose was to describe the utility of optical coherence tomography angiography (OCT-A) in its diagnosis and management. Case description: A 40-year-old female presented with bilateral blurred vision. Her best corrected visual acuity was at 8/10. Fundus examination revealed blurred disc margins, perivascular exudates, arterial sheaths and retinal hemorrhages bilaterally. FFA showed staining of the optic disc with dye leakage in the right eye, a punctuate hyperfluorescence of the temporosuperior artery in the left eye, bilateral vascular sheathing and capillary dropout. OCT-A showed simultaneous presence of papillary aneurysm and neovascularization of the optic nerve head in the right eye, a papillary aneurysm in the left eye and bilateral capillary non-perfusion. Our patient was diagnosed with IRVAN syndrome. Oral steroids associated with panretinal laser photocoagulation and intravitreal injection of bevacizumab in the right eye resulted in vanishing of the papillary neovascularization with no recurrence on OCT-A at 10-month follow-up. Conclusions: OCT-A is an additional tool to FFA for visualization of arterial macroaneurysms and retinal neovascularization without the interference of dye leakage. It well demarcates nonperfused areas and ensures follow-up of retinal neovascularization. Its limitations are the limited field of view and the low sensitivity in detecting arteriolar dilations. Thus, OCT-A is unable to outplace FFA but should be considered alternately with it for non-invasive follow-up of IRVAN syndrome.


2016 ◽  
Vol 7 (3) ◽  
pp. 450-456 ◽  
Author(s):  
Davide Allegrini ◽  
Giovanni Montesano ◽  
Alfredo Pece

Iris nevus is common: 6% of patients with suspected iris melanoma have lesions other than melanoma, and 36% of them are nevi. Iris nevus turns into melanoma in approximately 8% of cases at a mean of 15 years. This case report provides the first description of an iris tumor examined with iris optical coherence tomography angiography (OCTA) compared to iris fluorescein angiography (IFA). A 60-year-old man with a diagnosis of iris nevus in the left eye was referred to our department for IFA and iris OCTA. The iris vasculature in IFA was visible only in the early phases, but not clearly. OCTA, however, gave visualization of the vascular network and very precisely defined the vessels of the whole lesion, except for the pupillary portion, which was masked by superficial pigment accumulations. IFA and iris OCTA can add information about the vascular architecture compared to slit-lamp biomicroscopy, ultrasound biomicroscopy, and anterior-segment OCT. However, IFA is time-consuming and invasive and can – very occasionally – cause serious adverse reactions. In contrast, OCTA defines the texture of the iris vasculature better. In conclusion, OCTA is a new method, easy to execute, needing no dye injection, and provides useful information on the vascular network of iris lesions. It could therefore be helpful in the diagnosis and follow-up of these lesions.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Flore De bats ◽  
Benjamin Wolff ◽  
Vivien Vasseur ◽  
Aude Affortit ◽  
Laurent Kodjikian ◽  
...  

Purpose. The recent use of “en-face” enhanced-depth imaging spectral-domain optical coherence tomography (EDI SD-OCT) helps distinguish the retinal layers involved in the physiopathology of multiple evanescent white dot syndrome (MEWDS).Methods. Four patients presenting with MEWDS underwent a comprehensive ocular examination including C-scan (“en-face”) EDI SD-OCT at the initial visit and during follow-up.Results. C-scans combined with the other multimodal imaging enabled the visualization of retinal damage. Acute lesions appeared as diffuse and focal disruptions occurring in the ellipsoid and interdigitation zones. The match between autofluorescence imaging, indocyanine green angiography, and “en-face” OCT helped identify the acute microstructural damages in the outer retina further than the choroid. Follow-up using “en-face” EDI-OCT revealed progressive and complete recovery of the central outer retinal layers.Conclusion. “En-face” EDI SD-OCT identified the site of initial damage in MEWDS as the photoreceptors and the interdigitation layers rather than the choroid. Moreover, “en-face” OCT is helpful in the follow-up of these lesions by being able to show the recovery of the outer retinal layers.


2021 ◽  
Vol 8 ◽  
Author(s):  
Min Fu ◽  
Pan Hu ◽  
Gang Zhang ◽  
Ludonghan Huang ◽  
Huan Xu ◽  
...  

Significance: Perifoveal exudative vascular anomalous complex (PEVAC) is a unique clinical lesion. It manifests as isolated lesions and is easily misdiagnosed. Thus far, few PEVAC case reports have been published. PEVAC is typically inconsistent with other reported macular lesions.Purpose: To report our 24-month follow-up experience on the treatment of PEVAC with a micropulse laser (MPL).Case Report: A 56-year-old Chinese woman with no history of other diseases complained of decreased vision in her left eye that had persisted for more than 1 year. Comprehensive ophthalmic examinations were performed, including a vision test, slit lamp fundus exam, optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A), fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA). Intravitreal injection of ranibizumab was ineffective, and bleeding, exudation and visual acuity were not improved. After two rounds of micropulse laser (MPL) treatment, the patient was followed up, and the prognosis was good.Conclusion: PEVAC is very rare, and early diagnosis is important, as the lesions readily cause irreversible damage. Our results indicate that an MPL can be used as an alternative treatment for PEVAC patients.


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