Widefield OCT angiography and ultra-widefield multimodal imaging of Susac syndrome

2019 ◽  
Vol 30 (5) ◽  
pp. NP41-NP45
Author(s):  
Chiara Giuffrè ◽  
Elisabetta Miserocchi ◽  
Alessandro Marchese ◽  
Maria Vittoria Cicinelli ◽  
Elena Bruschi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Arterial Occlusion ◽  
Retinal Ischemia ◽  
Optical Coherence ◽  
Susac Syndrome ◽  
Corrected Visual Acuity ◽  
Large Vessels

The aim is to present the changes in ultra-widefield and widefield multimodal imaging, including optical coherence tomography angiography of a 33-year-old woman diagnosed with Susac syndrome, over 1 year of follow-up. Fundus examination and multimodal imaging revealed bilateral arterial occlusion of multiple vascular branches with retinal ischemia. Over 1 year follow-up, best-corrected visual acuity improved while retinal ischemia gradually resolved. Widefield optical coherence tomography angiography showed reperfusion of macular large vessels, but not of the small capillaries. Despite anatomical improvement, functional defects of the visual field persisted. In conclusion, widefield and ultra-widefield imaging provided high-resolution details of the central and peripheral damages in Susac syndrome.

Optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal ranibizumab

2018 ◽  
Vol 29 (2) ◽  
pp. 239-243
Author(s):  
Gilda Cennamo ◽  
Francesca Amoroso ◽  
Stefano Schiemer ◽  
Nunzio Velotti ◽  
Mariacristina Alfieri ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Pathologic Myopia ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To describe the optical coherence tomography angiography characteristics of myopic patients with choroidal neovascularization secondary to pathologic myopia during ranibizumab therapy. Methods: Nineteen patients were enrolled in this prospective study (13 females, 6 males, mean age 55.25 ± 9.63 years) for a total of 20 eyes examined (14 right eyes, 6 left eyes). Images were analyzed independently by two examiners. Results: Mean follow-up was 5.75 ± 1.88 months, with a mean intravitreal injections of 1.90 ± 0.44. Mean best-corrected visual acuity at baseline was 0.39 ± 0.18 logMAR versus 0.26 ± 0.16 logMAR 6 months after treatment. The neovascular area (Z = –2.091, p = 0.037) was significantly reduced after treatment, whereas vessel density was not (Z = –1.848, p = 0.065). Moreover, the best-corrected visual acuity was increased (Z = –3.055, p = 0.002). Neovascular area was significantly correlated with best-corrected visual acuity, at both baseline and follow-up (p < 0.05). Conclusion: Our data suggest that optical coherence tomography angiography is a reproducible non-invasive examination with which to monitor changes in the neovascular area in patients with pathologic myopia treated with ranibizumab.

Multimodal Imaging in a Patient with Traumatic Choroidal Ruptures

2017 ◽  
Vol 27 (6) ◽  
pp. e175-e178 ◽  
Author(s):  
Luisa Pierro ◽  
Chiara Giuffrè ◽  
Alessandro Rabiolo ◽  
Marco Gagliardi ◽  
Alessandro Arrigo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Ocular Trauma ◽  
Global Evaluation ◽  
Fundus Examination ◽  
Optical Coherence ◽  
Swept Source ◽  
Blunt Ocular Trauma

Purpose To describe the case and the follow-up of a traumatic choroidal rupture characterized by means of multimodal imaging including color fundus photographs, infrared reflectance, blue autofluorescence, swept-source optical coherence tomography, fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography angiography (OCT-A). Methods Case report. Results A 17-year-old boy was referred to our clinic complaining of reduction in visual acuity in the right eye (RE) after a blunt ocular trauma during a soccer match. Dilated fundus examination of RE showed 2 peripapillary choroidal ruptures located temporally and inferiorly to the optic disc. Among different imaging tools useful in the diagnosis and study of choroidal ruptures, particular attention must be paid to OCT-A, which showed the lesions as breaks in the choriocapillaris plexus with a hypointense appearance due to the lack of substance. Moreover, along the break it was possible to see the projection of the underlying choroidal vasculature, which appeared hyperintense. The retinal vascular plexa were spared. Conclusions All patients presenting with blunt ocular trauma should undergo fundus examination to exclude damage to the optic nerve, retina, and choroid, and need close follow-up to avoid the development of secondary complications such as choroidal neovascularization. Optical coherence tomography angiography might add relevant information in the global evaluation and follow-up of choroidal ruptures in a noninvasive fashion, and could replace other invasive modalities such as FA or ICGA.

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.

Dark and white lesions observed in central serous chorioretinopathy on optical coherence tomography angiography

2018 ◽  
Vol 28 (4) ◽  
pp. 446-453 ◽  
Author(s):  
Flore De Bats ◽  
Pierre-Loïc Cornut ◽  
Benjamin Wolff ◽  
Laurent Kodjikian ◽  
Martine Mauget-Faÿsse
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Serous Retinal Detachment ◽  
Descriptive Study ◽  
Dark Spot ◽  
Optical Coherence ◽  
Choroidal Neovascular Membrane

Purpose: To describe abnormal dark (hyposignal) and white (hypersignal) lesions observed on optical coherence tomography angiography in central serous chorioretinopathy. Methods: Prospective, multicenter, and descriptive study including patients with active or quiescent central serous chorioretinopathy. All patients had undergone a complete ophthalmic examination. Results: Abnormal dark lesions were detected as “dark spots” and “dark areas” on optical coherence tomography angiography. A “dark spot” could correspond to six different abnormalities: pigment epithelium detachment, subretinal deposit, “Lucency” within surrounding subretinal fibrin, choroidal cavitation, choroidal excavation, and choroidal fluid. A “dark area” could be related to a serous retinal detachment or choriocapillary compression. Abnormal white lesions were also detected: A “white spot” could correspond with the leaking point on fluorescein angiography or with hyper-reflective dots; A “white filamentous pattern” at the Brüch’s membrane level corresponded to abnormal choroidal neovascular vessels. Conclusion: A semiology is described using optical coherence tomography angiography in central serous chorioretinopathy as abnormal dark and white lesions. Multimodal imaging is mandatory in addition to optical coherence tomography angiography to diagnose non-neovascular retinal and choroidal central serous chorioretinopathy lesions. However, optical coherence tomography angiography alone is helpful in detecting choroidal neovascular membrane in central serous chorioretinopathy.

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 ◽  
Vol 20 (1) ◽  
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.

scholarly journals Optic coherence tomography angiography follow-up in a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome

2019 ◽  
Vol 30 (3) ◽  
pp. NP14-NP17 ◽  
Author(s):  
Juan Francisco Santamaría Álvarez ◽  
Anna Serret Camps ◽  
Javier Aguayo Alvarez ◽  
Olga García García
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Hemolytic Uremic Syndrome ◽  
Optical Coherence Tomography Angiography ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Optical Coherence ◽  
Corrected Visual Acuity ◽  
Capillary Plexus ◽  
Uremic Syndrome ◽  
Best Corrected Visual Acuity

Purpose: To report a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome and the changes seen in the optical coherence tomography angiography before and after treatment with eculizumab. Case description: A 22-year-old man with an unremarkable medical history presented with acute, bilateral blurred vision and headache of 1-week duration. Best corrected visual acuity of 20/50 and 20/40, respectively, in the patient’s right eye and left eye. Funduscopy revealed multiple cotton-wool spots associated with intrarretinal fluid. Swept source optical coherence tomography revealed multifocal retinal detachments with increased choroidal thickness. Optical coherence tomography angiography showed areas of ischemia in both capillary plexus. Due to concurrent symptoms and laboratory analysis, he was diagnosed with atypical hemolytic uremic syndrome and secondary Purtscher-like retinopathy; therefore, treatment with eculizumab was initiated. After 2 months revascularization of the previous ischemic areas was seen in the optical coherence tomography angiography that were correlated with best corrected visual acuity improvement. Conclusion: Our findings suggest that evaluation of the macular capillary plexus revascularization by optical coherence tomography angiography during the disease could help to predict an improvement of best corrected visual acuity in these patients and the measurement of choroidal thickness could give us information about the resolution of the pathologic process.

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