Optical coherence tomography angiography characterization of acute and late stage Purtscher retinopathy

2018 ◽  
Vol 28 (4) ◽  
pp. NP1-NP6 ◽  
Author(s):  
Pedro Gil ◽  
Miguel Raimundo ◽  
João P Marques ◽  
João Póvoa ◽  
Rufino Silva
Keyword(s):  
Optical Coherence Tomography ◽  
Late Stage ◽  
Optical Coherence Tomography Angiography ◽  
Road Traffic ◽  
Optical Coherence ◽  
Cotton Wool ◽  
Fiber Layer ◽  
Cotton Wool Spots ◽  
Purtscher Retinopathy

Purpose: To report a case of Purtscher retinopathy imaged with optical coherence tomography angiography. Methods: Case-report. Left eye fundoscopic examination in a 21-year old male after a road traffic accident with chest compression revealed multiple peri-papillary cotton-wool spots and intra- and pre-retinal hemorrhages. A diagnosis of Purtscher retinopathy was assumed. Results: In both the superficial and deep retinal plexuses, acute stage optical coherence tomography angiography identified multiple irregular areas of capillary non-perfusion that extended beyond the clinically visible peri-papillary cotton-wool spots. At 5-month follow-up, despite the clearing of visible cotton-wool spots, there were still permanent areas of irregular capillary non-perfusion and inner retina atrophy. These sequelae, along with a decrease in the peri-papillary retinal nerve fiber layer thickness, were consistent with a suboptimal visual outcome and a dense inferior arcuate scotoma. Conclusion: Baseline and follow-up optical coherence tomography angiography was able to detect, quantify, and map focal microvascular abnormalities at the level of the superficial and deep inner retinal vascular plexuses. These lesions were consistent with late stage structural and functional sequelae, conferring them prognostic value.

scholarly journals Persistent Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia at 6-Months Follow-Up Assessed by Optical Coherence Tomography Angiography

Biomedicines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 502
Author(s):  
Valentina Bilbao-Malavé ◽  
Jorge González-Zamora ◽  
Manuel Saenz de Viteri ◽  
Miriam de la Puente ◽  
Elsa Gándara ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Hospital Discharge ◽  
Optical Coherence Tomography Angiography ◽  
Control Group ◽  
Vascular Density ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Cotton Wool Spots

The purpose of this study was to evaluate the long-term evolution of retinal changes in COVID-19 patients with bilateral pneumonia. A total of 17 COVID-19 patients underwent retinal imaging 6 months after hospital discharge with structural optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). The parafoveal retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) were significantly thinner in COVID-19 patients at 6 months compared to 0 months (p = <0.001 in both cases). In the optic nerve analysis, a significantly thinner RNFL was observed (p = 0.006) but persisted significantly thickened, compared to controls (p = 0.02). The vascular density (VD) at 6 months persisted significantly decreased when compared to the control group, and no significant differences were found with the 0 months evaluation; in addition, when analyzed separately, women showed a worsening in the VD. Moreover, a significantly greater foveal area zone (FAZ) (p = 0.003) was observed in COVID-19 patients at 6 months, compared to 0 months. The cotton wool spots (CWSs) observed at baseline were no longer present at 6 months, except for one patient that developed new ones. This study demonstrates that some of the previously known microvascular alterations resulting from COVID-19, persist over time and are still evident 6 months after hospital discharge in patients who have suffered from bilateral pneumonia.

scholarly journals Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography Angiography

Biomedicines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 247
Author(s):  
Jorge González-Zamora ◽  
Valentina Bilbao-Malavé ◽  
Elsa Gándara ◽  
Anna Casablanca-Piñera ◽  
Claudia Boquera-Ventosa ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Foveal Avascular Zone ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Cotton Wool Spots ◽  
Avascular Zone ◽  
Capillary Plexus ◽  
Microvascular Alterations ◽  
Changes Over Time

The purpose of this study was to evaluate the presence of retinal and microvascular alterations in COVID-19 patients with bilateral pneumonia due to SARS-COV-2 that required hospital admission and compare this with a cohort of age- and sex-matched controls. COVID-19 bilateral pneumonia patients underwent retinal imaging 14 days after hospital discharge with structural optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) measurements. Vessel density (VD) and foveal avascular zone (FAZ) area were evaluated in the superficial, deep capillary plexus (SCP, DCP), and choriocapillaris (CC). After exclusion criteria, only one eye per patient was selected, and 50 eyes (25 patients and 25 controls) were included in the analysis. COVID-19 patients presented significantly thinner ganglion cell layer (GCL) (p = 0.003) and thicker retinal nerve fiber layer (RNFL) compared to controls (p = 0.048), and this RNFL thickening was greater in COVID-19 cases with cotton wool spots (CWS), when compared with patients without CWS (p = 0.032). In both SCP and DCP, COVID-19 patients presented lower VD in the foveal region (p < 0.001) and a greater FAZ area than controls (p = 0.007). These findings suggest that thrombotic and inflammatory phenomena could be happening in the retina of COVID-19 patients. Further research is warranted to analyze the longitudinal evolution of these changes over time as well as their correlation with disease severity.

scholarly journals Investigation of Macular Choroidal Thickness and Blood Flow Change by Optical Coherence Tomography Angiography After Posterior Scleral Reinforcement

2021 ◽  
Vol 8 ◽  
Author(s):  
Zheng Zhang ◽  
Yue Qi ◽  
Wenbin Wei ◽  
Zi-Bing Jin ◽  
Wen Wang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Optical Coherence Tomography ◽  
High Myopia ◽  
Choroidal Thickness ◽  
Optical Coherence Tomography Angiography ◽  
Pathologic Myopia ◽  
Optical Coherence ◽  
Short Period ◽  
Posterior Scleral Reinforcement

Purpose: This work aimed to study the effect of posterior scleral reinforcement (PSR) on choroidal thickness (CT) and blood flow.Methods: This study included 25 eyes of 24 patients with high myopia ( ≤ -6.0 dioptres or axial length ≥ 26.0 mm) who underwent PSR surgery. All patients completed the 1-month follow-up visit. Myopic macular degeneration (MMD) was graded according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification based on color fundus photographs. Swept-source optical coherence tomography angiography (SSOCTA) was performed to investigate CT, choroidal perfusion area (CPA), and choriocapillaris perfusion area (CCPA) change following PSR surgery.Results: The distribution of MMD categories was 9 (36.0%) in category 1, 10 (40.0%) in category 2, and 6 (24.0%) in category 3 or 4. MMD severity was strongly correlated with CT (all P &lt; 0.01) and CPA (all P &lt; 0.04). Postoperative CT at each sector increased significantly at 1 week's follow-up, compared to preoperative measures (all P &lt; 0.05). Postoperative CPA at subfoveal, superior, inferior, and nasal sectors also increased significantly 1 week after PSR surgery (all P &lt; 0.05). Moreover, the increased CT, CPA, and CCPA remain after PSR surgery at 1 month's follow-up, but the difference was not statistically significant.Conclusions: We demonstrated that the CT and choroidal blood flow increased significantly in patients with high myopia who underwent PSR surgery in a short period of time. In addition, the CT and CPA were independently associated with MMD. However, whether the transient improvement of the choroidal circulation could prevent long-term progression of high myopia warrants further study in the future.

scholarly journals Characterizing Flow and Structure of Diabetic Retinal Neovascularization after Intravitreal Anti-VEGF Using Optical Coherence Tomography Angiography: A Pilot Study

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Christof Haensli ◽  
Katrin Fasler ◽  
Daniel Barthelmes ◽  
Sandrine A. Zweifel
Keyword(s):  
Optical Coherence Tomography ◽  
Initial Treatment ◽  
Measurement Method ◽  
Optical Coherence Tomography Angiography ◽  
Case Series ◽  
Retinal Neovascularization ◽  
Flow Density ◽  
Optical Coherence ◽  
En Face

Background/Aims. This study evaluates changes of flow and structure of diabetic retinal neovascularization (NV) treated with intravitreal antivascular endothelial growth factor (VEGF) agents using optical coherence tomography angiography (OCTA). With OCTA, retinal blood vessels are visualized at high resolution to separately look at flow and structure information without the need for dye injection. We introduce a new measurement method including and combining information of flow and structure. Methods. Retrospective observational case series. Patients with proliferative diabetic retinopathy (PDR) were treated with intravitreal antiVEGF injections. Retinal NV were repeatedly imaged using swept-source OCTA (Zeiss PlexElite 9000) at baseline, after initial treatment block with 3-4 monthly injections, and during a follow-up period of up to 51 weeks. Change of size and flow density of the structural and angio area of NV was assessed. Results. Nine NV in eight eyes of five patients were analyzed with a median follow-up time of 45 weeks. After the initial treatment block, en face structural area regressed, 18.7% ± 39.0% (95% CI 44.2–6.8%, p = 0.26 ), and en face angio area regressed, 51.9% ± 29.5% (95% CI 32.6 to 71.2%, p = 0.007 ). Flow density within the en face structural area decreased by 33% ± 19.2% (95% CI 20.5–45.5%, p = 0.0077 ). Flow density within the en face angio area decreased by mean 17.9% ± 25.2% (95% CI 1.4–34.4%, p = 0.066 ). In two fellow eyes, NV recurrence could be observed before the onset of vitreous bleeding in one. Conclusion. Our study introduces a new quantitative measurement for NV in PDR, combining structure and flow measurement. The structure area remained after treatment, while its flow density and angio area regressed. We propose this measurement method as a more physiological and possibly more comparable metrics.

scholarly journals Assessment of choriocapillary blood flow changes in response to half-dose photodynamic therapy in chronic central serous chorioretinopathy using optical coherence tomography angiography

2020 ◽  
Author(s):  
Juejun Liu ◽  
Changzheng Chen ◽  
Lu Li ◽  
Yishuang Xu ◽  
Zuohuizi Yi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Optical Coherence Tomography ◽  
Photodynamic Therapy ◽  
Central Serous Chorioretinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Chronic Central Serous Chorioretinopathy ◽  
Half Dose ◽  
Flow Changes

Abstract Background: Optical coherence tomography angiography (OCTA) is a newly developed imaging quantitative technique for analysis of choriocapillaris (CC) flow changes, thereby exploring the pathological mechanism of chronic central serous chorioretinopathy (CCSC) and the therapeutic effects of photodynamic therapy (PDT). In this study, we sought to quantify the blood flow changes in CC of CCSC patients receiving half-dose PDT using OCTA.Methods: A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled in this study. The proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA was assessed in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, the CC patterns in response to PDT at early stage and the subsequent morphologic changes were qualitatively documented using OCTA.Results: For affected eyes, FSV at 6-m follow-up was significantly lower than that at 1-m follow-up (p=0.036). When compared to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p<0.05 for all), and FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p<0.05 for all). Three CC patterns of early response to PDT were identified, including signs of recovery with more even flow signals, transient appearance of worse ischemia and secondary neovascularization within CC level.Conclusion: Abnormal CC flow attenuation remains in completely resolved eyes of CCSC patients treated with half-dose PDT.

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