scholarly journals Myopic Simple Hemorrhage Presenting as Radial Hemorrhage in Henle’s Fiber Layer

2021 ◽  
pp. 446-450
Author(s):  
Marco Mazzola ◽  
Laura Premoli ◽  
Cristian Metrangolo ◽  
Jennifer Cattaneo ◽  
Elias Premi ◽  
...  
Keyword(s):  
High Myopia ◽  
Sudden Onset ◽  
Fiber Layer ◽  
Characteristic Finding ◽  
Macular Telangiectasia ◽  
Complete Restoration ◽  
Retinal Capillary ◽  
Capillary Plexus ◽  
Specific Sign ◽  
The Right

This case report describes a simple hemorrhage (SH) presenting as radial hemorrhage in Henle’s fiber layer (HFL) in a patient with high myopia. A 26-year-old girl with high myopia was referred to our center for sudden onset of decreased vision and a central scotoma in the right eye (OD). Best corrected visual acuity (BCVA) was 20/100 OD. Fundus examination showed a stellate intraretinal hemorrhage in the fovea of the OD. The hemorrhage was organized in a peculiar petaloid pattern with feathery distal edges, suggesting localization within the radially oriented HFL. The presence of both choroidal neovascularization and microvascular abnormalities consistent with macular telangiectasia type 2 (MacTel 2) were excluded. Based on these findings, a diagnosis of myopic SH was made. At 4-month follow-up BCVA OD spontaneously improved to 20/40, without any treatment been ever administered to the patient. Spectral-domain optical coherence tomography OD showed reabsorption of the hemorrhage and almost complete restoration of the foveal architecture. The intraretinal location and spread of the hemorrhage into the HFL in our patient are an unusual presentation of SH, which vividly highlights the anatomy of the fovea. Since fibers in HFL are quite delicate and loosely arranged, this layer is very susceptible to deposition of transudates, exudates, hemorrhage, and other products. Radial hemorrhage in HFL has been originally reported in 4 patients as complication of MacTel 2. It has been previously postulated that it may represent a characteristic finding in MacTel 2 that may develop as a result of microvascular abnormalities of the deep retinal capillary plexus. On the contrary, our data suggest that radial hemorrhage in the HFL does not represent a characteristic finding of MacTel 2, but must rather be considered a non-specific sign with multiple possible etiologies.

scholarly journals Parafoveal and Peripapillary Perfusion Predict Visual Field Recovery in Chiasmal Compression due to Pituitary Tumors

2020 ◽  
Vol 9 (3) ◽  
pp. 697 ◽  
Author(s):  
Ga-In Lee ◽  
Kyung-Ah Park ◽  
Sei Yeul Oh ◽  
Doo-Sik Kong
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Pituitary Tumors ◽  
Vessel Density ◽  
Mean Deviation ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Chiasmal Compression ◽  
Retinal Capillary ◽  
Capillary Plexus

Background: To evaluate the potential of vessel density alterations for predicting postoperative visual field (VF) improvement in chiasmal compression using optical coherence tomography angiography (OCT-A). Methods: The study investigated 57 eyes of 57 patients diagnosed with pituitary tumors and 42 eyes of 42 age and refractive error matched controls. All eyes with chiasmal compression for which preoperative optical coherence tomography (OCT) and OCT-A, and pre- and postoperative VF data were available. Preoperative vessel densities of superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment were utilized by OCT-A. Results: Preoperative peripapillary retinal nerve fiber layer and ganglion cell layer complex thickness and vessel densities of SRCP and RPC segments in eyes with chiasmal compression were significantly reduced compared with healthy controls (p < 0.001, p < 0.001, p = 0.007, and p = 0.020, respectively). In multivariate regression analysis, preoperative perimetric mean deviation (MD) (p = 0.002) and vessel density of SRCP (p = 0.025) were correlated significantly with postoperative perimetric MD. Spearman’s correlation analysis revealed significant correlations between preoperative MD on perimetry (r = 0.443, p = 0.001), vessel densities of SRCP (r = 0.288, p = 0.035) and RPC segment (r = 0.347, p = 0.009), and postoperative perimetric MD. Conclusions: Structural degeneration referred to as microvascular alterations measured by OCT-A and preoperative VF defects were associated with worse postoperative VF prognosis. Parafoveal and peripapillary vessel densities may serve as a sensitive, structural prognostic factors in the preoperative judgement of chiasmal compression.

scholarly journals Optical Coherence Tomography Angiography of Purtscher Retinopathy after Severe Traffic Accident in 16-Year-Old Boy

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Hassan Hamoudi ◽  
Marie Krogh Nielsen ◽  
Torben Lykke Sørensen
Keyword(s):  
Optical Coherence Tomography ◽  
Traffic Accident ◽  
Fundus Photography ◽  
Ophthalmological Examination ◽  
Optical Coherence ◽  
Spectral Domain Oct ◽  
Retinal Capillary ◽  
Capillary Plexus ◽  
The Right ◽  
Purtscher Retinopathy

Purpose. To describe optical coherence tomography (OCT) angiography (OCTA) in a case of Purtscher retinopathy. Methods. A 16-year-old male underwent ophthalmological examination including color fundus photography, spectral domain OCT, OCTA, and microperimetry. Examination was performed 10 days, 1 month, and 6 months after the trauma. Diagnosis was based on the characteristic clinical presentation. Patients. A single patient case. Results. Only the right eye was affected, and all examinations of the left eye were normal. The visual acuity of the right eye was 0.03 (Snellen equivalent) at 10 days and at one month, improving to 0.16 at 6 months. The imaging confirmed the findings of Purtscher retinopathy with ischemic whitening of the retina and retinal hemorrhages and thickened inner retina on OCT. Microperimetry showed reduced sensitivity in the central macula of the right eye. OCTA revealed nonperfusion in both the superficial and the deep retinal capillary plexus of the right eye. Conclusion. The OCTA in traumatic Purtscher retinopathy following traffic accident showed nonperfusion in both the superficial and the deep capillary plexus of the retina. OCTA is a valuable noninvasive diagnostic examination in Purtscher retinopathy, and fluorescein angiography became redundant in this case.

scholarly journals Macular Dystrophy with Bilateral Macular Telangiectasia Related to the CYP2U1 Pathogenic Variant Assessed with Multimodal Imaging Including OCT-Angiography

Genes ◽  
2021 ◽  
Vol 12 (11) ◽  
pp. 1795
Author(s):  
Khaled El Matri ◽  
Yousra Falfoul ◽  
Imen Habibi ◽  
Ahmed Chebil ◽  
Daniel Schorderet ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Brain Magnetic Resonance Imaging ◽  
Pathogenic Variant ◽  
Macular Dystrophy ◽  
Macular Telangiectasia ◽  
Whole Exome ◽  
En Face Oct ◽  
En Face ◽  
Capillary Plexus ◽  
The Right

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.

scholarly journals Changes in parafoveal and peripapillary perfusion after decompression surgery in chiasmal compression due to pituitary tumors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ga-In Lee ◽  
Kyung-Ah Park ◽  
Sei Yeul Oh ◽  
Doo-Sik Kong
Keyword(s):  
Pituitary Tumors ◽  
Plexiform Layer ◽  
Vessel Density ◽  
Decompression Surgery ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
Chiasmal Compression ◽  
Retinal Capillary ◽  
Capillary Plexus ◽  
Radial Peripapillary Capillary

AbstractWe evaluated changes in parafoveal and peripapillary vessel density in chiasmal compression after decompression surgery using optical coherence tomography angiography (OCT-A). Sixty-two eyes with chiasmal compression for which preoperative and postoperative (4–6 months) OCT, OCT-A, visual field (VF), and comprehensive ophthalmic data were available, and 44 healthy eyes were evaluated. Vessel densities of the superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment were assessed using OCT-A. The postoperative measurements were compared with preoperative data. Preoperative peripapillary retinal nerve fiber layer, macular ganglion cell-inner plexiform layer thickness, and vessel densities of SRCP and RPC segments in patients’ eyes were significantly reduced compared to those of healthy controls (P < 0.0001, P < 0.0001, P = 0.0052, and P = 0.0085, respectively). Vessel densities were significantly decreased in the SRCP (P < 0.0001), DRCP (P = 0.0017), and RPC segments (P < 0.0001) after surgery compared to the preoperative values. Significant associations between the postoperative SRCP and DRCP vessel density changes and preoperative SRCP (r =  − 0.3195, P = 0.0114) and DRCP (r =  − 0.5165, P < 0.0001) vessel densities were found, respectively. There were also significant associations between postoperative SRCP vessel density changes and VF changes (r =  − 0.2586, P = 0.0424). These findings indicate that decreased perfusion around the optic nerve head and on the macula associated with chiasmal compression could further progress after decompression surgery. Further functional and longer-term clinical studies are needed to elucidate the clinical implications of these findings.

scholarly journals Macula Structure and Microvascular Changes in Recent Small Subcortical Infarct Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Yungang Cao ◽  
Jueyue Yan ◽  
Zhenxiang Zhan ◽  
Yuanbo Liang ◽  
Zhao Han
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Fiber Layer ◽  
Cross Sectional ◽  
Microvascular Changes ◽  
Retinal Capillary ◽  
Capillary Plexus ◽  
Subcortical Infarct

Purpose: This study aimed to assess the macula structure and capillaries in the macula and optic nerve head in recent small subcortical infarct (RSSI) patients.Methods: This observational cross-sectional study included 40 RSSI patients and 46 healthy controls. Optical coherence tomography angiography was used to image the capillaries in the macula and optic nerve head. An inbuilt algorithm was used to measure the densities in the microvasculature of the macula [superficial retinal capillary plexus (SRCP) and deep retinal capillary plexus (DRCP)] and optic nerve head [radial peripapillary capillary (RPC)] and thickness around the optic nerve head, peripapillary retinal nerve fiber layer (pRNFL).Results: Densities in RPC (P &lt; 0.001), SRCP (P = 0.001), and DRCP (P = 0.003) were reduced in RSSI patients when compared with healthy controls. The pRNFL thickness was thinner (P &lt; 0.001) in RSSI patients than healthy controls. In the RSSI group, the SRCP density significantly correlated with the DRCP density (rho = 0.381, P = 0.042). The pRNFL thickness displayed a significant relationship with the RPC density (rho = 0.482, P = 0.003) in the RSSI group.Conclusions: RSSI patients showed interrupted capillary plexuses leading to its significant impairment and neurodegeneration. Our report provides insight into the macula capillary microcirculation changes in RSSI.

Progressive macular ischemia in retinal vasculopathy with cerebral leukodystrophy

2021 ◽  
pp. 112067212110446
Author(s):  
Che-Yuan Kuo ◽  
Po-Kang Lin ◽  
Bin-Wen Soong ◽  
Shih-Jen Chen
Keyword(s):  
Sudden Onset ◽  
Posterior Pole ◽  
Long Term Outcomes ◽  
Capillary Plexus ◽  
The Right ◽  
Superficial Capillary Plexus ◽  
Valuable Role ◽  
Over Time ◽  
Macular Ischemia

Purpose: We present a case of retinal vasculopathy with cerebral leukodystrophy and review the usefulness of optical coherence tomography angiography (OCT-A) in the assessment of long-term outcomes. Case description: A 31-year-old woman developed sudden-onset scotoma in her right eye. Fundus examination and fluorescein angiography showed a patch of soft exudate and capillary nonperfusion in the posterior pole and outside the vascular arcades. OCT-A revealed that the initial vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the right eye were 32% and 49.2%, respectively. Interestingly, over time, the VD of the SCP and DCP gradually decreased to 23.1% and 26.2%, respectively. In contrast, the initial VD of the SCP and DCP of the left eye were both stable at 44.3% and 56.2%, respectively, and only decreased slightly to 39.3% and 45.7%, respectively, over time. The average VD loss of the SCP and DCP, assessed over 1 year, was 8% and 13%, respectively, in the right eye, and 3% and 6%, respectively, in the left eye. Conclusion: Based on this case report, in which we demonstrated a long-term decline in VD of the macula in a young woman with mild retinal vasculopathy with cerebral leukodystrophy, we suggest that there is a potential and valuable role for OCT-A in this rare disease.

Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

2014 ◽  
Vol 17 (4) ◽  
pp. 196
Author(s):  
Erhan Kaya ◽  
Halit Yerebakan ◽  
Daniel Spielman ◽  
Omer Isik ◽  
Cevat Yakut
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Right Coronary Artery ◽  
Type A ◽  
Sudden Onset ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Syndrome ◽  
Bentall Procedure ◽  
The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

OCT retinal angiography features in patients with rheumatoid arthritis: A pilot study

2021 ◽  
pp. 112067212110356
Author(s):  
Pierluigi Iacono ◽  
Stefano Da Pozzo ◽  
Alberto Bedendo ◽  
Alessandro Arrigo ◽  
Mariacristina Parravano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Foveal Avascular Zone ◽  
Value Assessment ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Retinal Capillary ◽  
Capillary Plexus ◽  
Potential Applications ◽  
Treatment Naïve ◽  
Retinal Microcirculation

Purpose: To evaluate the superficial (SCP) and deep retinal capillary plexus (DCP) by mean of optical coherence tomography angiography (OCTA) in treatment-naïve patients affected by rheumatoid arthritis (RA). Methods: Between March 2019 and January 2020, patients with recent diagnosis of “definite RA” based on 2010 Rheumatoid Arthritis Classification Criteria were included in a Prospective, observational single center case-control study carried out at G.B. Bietti Foundation. Data were compared with those of 16 healthy age- and sex-matched subjects. Values of the vessel density (VD) of SCP and DCP, central foveal thickness (CFT), foveal avascular zone (FAZ) were collected by mean of OCTA. Main outcome measure was the VD alteration of SCP and DCP in treatment-naïve RA-patients. Results: No difference in age, sex-distribution, best-corrected visual acuity, CFT was registered between the two groups. OCTA data analysis showed in RA-patients a statistically significant reduction in the VD in the mean global area, inner ring, especially in the superior quadrant of the SCP. A trend of VD reduction was also registered in temporal, nasal, and inferior quadrants, respectively, although it did not reach a statistically significant value. Assessment of VD of DCP and FAZ area did not evidence any difference among the groups. Conclusions: OCTA allows to highlight the vascular remodeling of the retinal microcirculation in RA-patients, even in early stages of the disease, demonstrating a reduction of VD. Outcomes of the current investigation can provide new insight in the pathogenetic mechanism of RA and extend the potential applications of this diagnostic tool.

scholarly journals Sequential bilateral Behçet’s neuroretinitis associated with prepapillary vitreous exudate: case report

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Imen Ksiaa ◽  
Safa Ben Aoun ◽  
Sourour Zina ◽  
Dhouha Nefzi ◽  
Sana Khochtali ◽  
...  
Keyword(s):  
Case Report ◽  
Single Case ◽  
Signal Loss ◽  
Fiber Layer ◽  
Swept Source ◽  
Single Case Report ◽  
Shadowing Effect ◽  
Eye Involvement ◽  
The Right ◽  
Inflammatory Changes

Abstract Objective To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and methods A single case report documented with multimodal imaging. Results A 37-year-old man developed neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but 1 year later a similar neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. Swept source (SS) OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCT angiography (OCTA) demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects. Conclusion Sequential bilateral neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.

scholarly journals Relationship between retinal capillary vessel density of OCT angiography and intraocular pressure in pig

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mihyun Choi ◽  
Seong-Woo Kim ◽  
Somin Ahn ◽  
Thi Que Anh Vu ◽  
Cheolmin Yun ◽  
...  
Keyword(s):  
Capillary Density ◽  
Vessel Density ◽  
Retinal Blood Flow ◽  
Vascular Plexus ◽  
Retinal Capillary ◽  
Capillary Plexus ◽  
Ocular Pressure ◽  
Retinal Artery ◽  
The Mean ◽  
Iop Elevation

AbstractThe purpose of this study was to evaluate density change in the retinal capillary plexus during intra ocular pressure (IOP) elevation in vitrectomized pigs’ eyes using optical coherence tomography angiography (OCTA). Eight eyes of eight micro pigs received vitrectomy and the IOP was controlled from 15 mmHg (baseline) to 105 mmHg in 15 mmHg increments using a vented-gas forced-infusion system, and then decreased back to normal IOP (recovery state). The spectral-domain OCTA device was set to scan an area of 8.8 × 4.4 mm (30° × 15°) above the optic nerve head for each IOP. The relative vessel density (rVAD) compared to baseline was determined for the total retinal blood flow (RBF) which included major retinal artery and venous vessels, radial peripapillary capillaries (RPCs), superficial (SVP), intermediate (IVP), and deep vascular plexus (DVP). The mean rVAD was 0.890 in RBF, 0.826 in RPCs, 0.817 in SVP, 0.819 in IVP, and 0.794 in DVP at 30 mmHg. While the rVAD of RBF and RPCs decreased to 0.504 and 0.541 at 45 mmHg, the SVP, IVP, and DVP decreased to 0.433, 0.359, and 0.345, respectively. When IOP was normalized, the rVAD was recovered in all layers and the VAD of RBF, IVP, and DVP were higher than baseline (P = 0.040, 0.019, and 0.019, respectively). Retinal capillary density deterioration in each layer was found from 30 mmHg using an OCTA system which showed excellent depth-resolved segmentation of retinal capillary layers even at higher IOPs. Reduction in VAD showed full recovery after IOP normalization.

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