Indocyanine green angiography imaging findings in artery occlusions

2021 ◽  
pp. 112067212110378
Author(s):  
Ramesh Venkatesh ◽  
Nikitha Gurram Reddy ◽  
Vishma Prabhu ◽  
Pukhraj Rishi ◽  
Arpitha Pereira ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Multimodal Imaging ◽  
Indocyanine Green Angiography ◽  
Retinal Vessel ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Imaging Features ◽  
Retinal Artery ◽  
Choroidal Perfusion ◽  
Rouleaux Formation

Purpose: To describe the multimodal imaging features including indocyanine green angiography (ICGA) in cases diagnosed clinically as central retinal artery occlusion (CRAO) at its different disease stages. Methods: In this retrospective observational study, patients diagnosed clinically as CRAO or hemi-CRAO were included. All patients underwent multimodal imaging with optical coherence tomography (OCT), fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were studied. Analysis of ICGA images in different stages of artery occlusions and its correlation with accompanying FFA and OCT images was done. Results: Eight such studies in five patients were available for analysis. The most important observation noted on ICGA was the presence of hypercyanescent spots seen during the acute stages of the disease in four of the five cases. The spots were accompanied by retinal vessel staining on FFA in the corresponding region. As the disease showed signs of resolution, the hypercyanescent spots on ICGA and retinal vessel staining on FFA disappeared. The hypercyanescent spots seen on the ICGA were noted due to the red blood cell aggregation or ‘rouleaux’ formation. In addition, choroidal perfusion abnormalities were noted on ICGA in all five cases in the acute stage. Conclusion: Choroidal perfusion changes can be identified in acute phase of retinal artery occlusion. Rouleaux formation in the retinal circulation occurs due to the slowing of the blood flow following artery occlusion. These are seen as hypercyanescent spots in the late phase on ICGA.

scholarly journals The use of multimodal imaging in the evaluation of a patient with central retinal artery occlusion in the setting of asteroid hyalosis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Timothy M. Janetos ◽  
Olga German ◽  
Rukhsana Mirza
Keyword(s):  
Multimodal Imaging ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Timely Diagnosis ◽  
Cardiovascular Morbidity And Mortality ◽  
Asteroid Hyalosis ◽  
Retinal Artery

Abstract Background A central retinal artery occlusion (CRAO) is an ophthalmic emergency due to its strong association with cerebrovascular and cardiovascular morbidity and mortality. A timely diagnosis is necessary but difficult in the setting of dense asteroid hyalosis, as typical fundoscopic findings can be obscured. We present a case where multimodal imaging in an eye with an obscured fundus could lead to timely diagnosis and management of CRAO in a patient with acute vision loss. Case presentation A 94-year-old Caucasian woman with a history of exudative macular degeneration presented to the retina clinic with acute vision loss in one eye over the course of an afternoon. The patient had dense asteroid hyalosis, and a direct retinal exam was not possible. Multimodal imaging suggested a CRAO diagnosis. The patient received digital ocular massage directly prior to undergoing fluorescein angiography (FANG), which confirmed the diagnosis. The patient was transported from clinic to the emergency room for an emergency stroke workup, which revealed a spontaneous echo in the left atrial appendage, and the patient was started on antiplatelet therapy. When she presented for follow-up within a week, the patient noted that her vision had improved at the time of digital ocular massage and continued to improve thereafter. Her FANG showed marked reperfusion of the retina, and she subsequently has completely regained her baseline visual acuity. Conclusions Multimodal imaging is useful in evaluating visual loss in patients with acute vision loss. In addition, ocular massage is a simple, low-risk intervention that may have benefit in the treatment of acute CRAO. Patients who present to ophthalmologists with an acute CRAO need an emergency referral for evaluation of cerebrovascular and cardiovascular comorbidities.

scholarly journals Multimodal Images of Acute Central Retinal Artery Occlusion

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Parth Shah ◽  
Stephen G. Schwartz ◽  
Harry W. Flynn
Keyword(s):  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Retinal Ischemia ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Imaging Studies ◽  
Retinal Artery ◽  
Multimodal Images

Two illustrative cases of acute central retinal artery occlusion (CRAO) are presented with multimodal imaging, including fluorescein angiography (FA) and commercially available optical coherence tomography angiography (OCT-A). In both patients, retinal ischemia was imaged well using both FA and OCT-A, and the two imaging studies provided comparable pictures. OCT-A provides useful information for the diagnosis and management of patients with acute CRAO, without the need for dye injection.

scholarly journals Purtscher-like Retinopathy Associated with High Altitude Travel

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000022
Author(s):  
Luke Y. Chang ◽  
Cindy W. Mi ◽  
Lily Im ◽  
Marena Patronas
Keyword(s):  
High Altitude ◽  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Vessel ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Cotton Wool Spots ◽  
Retinal Artery ◽  
Funduscopic Examination ◽  
Plexiform Layers

Purpose To report a case of Purtscher-like retinopathy associated with travel at high altitude. Methods Case report. Results A 67-year-old man presented 2 weeks after acute vision loss in his left eye that occurred while he was hiking in the mountains of South America. Funduscopic examination revealed multiple cotton-wool spots and discrete areas of retinal whitening. Fluorescein angiography demonstrated areas of choroidal fluorescence blocked by retinal whitening, delayed arteriovenous transit time, and late capillary leakage. Spectral-domain optical coherence tomography showed hyperreflectivity in the inner plexiform, inner nuclear, and outer plexiform layers localized to the areas of retinal whitening. These findings were believed to be most consistent with Purtscher flecken, and the patient was diagnosed with Purtscher-like retinopathy. Conclusions Purtscher-like retinopathy may be linked to travel at high altitude through retinal vessel dilation and constriction leading to retinal vasospasm and precapillary arteriole occlusion. This proposed mechanism of pathogenesis suggests that Purtscher-like retinopathy may represent a partial central retinal artery occlusion.

scholarly journals Analysis of Multimodal Imaging Characteristics of Transient Central Retinal Artery Occlusion

2021 ◽  
Author(s):  
Weiting An ◽  
Qi Zhao ◽  
Jindong Han
Keyword(s):  
Multimodal Imaging ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Posterior Pole ◽  
Cotton Wool ◽  
Cotton Wool Spot ◽  
Imaging Characteristics ◽  
Capillary Plexus ◽  
Retinal Artery

Abstract Background To observe and analyze the multimodal imaging characteristics of transient central retinal artery occlusion (T-CRAO). Methods Retrospective observational study. Eight patients (8 eyes) diagnosed as T-CRAO in Tianjin Medical University Eye Hospital were included in this study. There were 6 males (6 eyes) and 2 females (2 eyes) with an average age of 63.8 years (38-78years). The clinical manifestation was acute vision loss. All patients underwent best corrected visual acuity (BCVA), slit lamp microscope, color fundus photography (CFP), fundus fluorescein angiography (FFA), optical coherence tomography (OCT) and OCT angiography (OCTA). The clinical data and multimodal imaging characteristics of patients were analyzed. Results There were 4 eyes with BCVA from 0.05 to 0.1 and 4 eyes from 0.1 to 0.3. CFP demonstrated multiple patchy “cotton-wool spot”-like lesions in posterior pole, without typical cherry-red spot. FFA manifested as sluggish filling of arteries, filling front, and delayed filling of vein. The filling was completed within 5 to 10 seconds. The “cotton-wool spot”-like lesions showed low fluorescence in early stage. Some lesions filled gradually; others still showed low fluorescence in late stage. OCT showed inner layer and local nerve fiber layer of retina was thickened. The reflexes of lesions were enhanced intermittently, especially the “hump-like” change of inner nuclear layer (INL). OCTA revealed the vascular density (VD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) of retina was decreased, the shape of the arcade was damaged, and the foveal avascular zone (FAZ) area was enlarged. En-face image showed isolated patchy hyperreflective lesions at SCP and fused patchy hyperreflective lesions at DCP.Conclusions CFP demonstrated multiple patchy “cotton-wool spot”-like lesions in posterior pole; OCTA revealed decreased VD of SCP and DCP. After treatment, the “cotton-wool spot”-like lesions gradually vanished, and the VD partially recovered.

scholarly journals Complications of Intra-Arterial tPA for Iatrogenic Branch Retinal Artery Occlusion: A Case Report through Multimodal Imaging and Literature Review

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 963
Author(s):  
Katherine Dalzotto ◽  
Paige Richards ◽  
Tyler D. Boulter ◽  
Marilyn Kay ◽  
Mihai Mititelu
Keyword(s):  
Visual Field ◽  
Multimodal Imaging ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Fundus Photography ◽  
Automated Perimetry ◽  
Branch Retinal Artery Occlusion ◽  
Retinal Artery ◽  
Sd Oct

Background and Objectives: To document, through multimodal imaging, the post-procedural clinical course and visual outcome of a patient who received intra-arterial tissue plasminogen activator (tPA) for acute iatrogenic branch retinal artery occlusion (BRAO), and to review the literature and guidelines regarding the use of tPA for retinal arterial occlusions. Methods: A 28-year-old female patient who sustained an iatrogenic BRAO and subsequently received intra-arterial tPA was followed through her post-interventional course of 3 months with serial exams and multimodal imaging, including color fundus photography, visual field testing, spectral domain optical coherence tomography (SD-OCT), and OCT angiography (OCT-A). Results: A patient with history of left internal cerebral artery (ICA) aneurysm and baseline visual acuity (VA) of 20/20 developed an acutely symptomatic BRAO after undergoing a neuroendovascular procedure and was acutely treated with tPA through the left ophthalmic artery. At two weeks follow-up, a central posterior pole hemorrhage was noted although VA was preserved. A superior altitudinal defect was shown on automated perimetry. VA dropped to 20/50 at 7 weeks follow-up and hyperreflective material deep to the attachment between the posterior hyaloid and the internal limiting membrane (ILM) consistent with hemorrhage was noted on SD-OCT. At 11 weeks follow-up, VA returned to 20/20, SD-OCT revealed a membrane bridging the foveal depression, OCT-A showed decreased vascularity in the inferior macula, and the visual field defect was stable by automated perimetry. Conclusions: Intraocular hemorrhage is a possible complication of intra-arterial tPA administration for BRAO, and a careful analysis of risks, benefits, and goals of this procedure must be considered by both provider and patient before such intervention.

Multimodal imaging in IRVAN syndrome presenting with Branch Retinal Artery Occlusion

2020 ◽  
pp. 112067212096549
Author(s):  
Sourour Zina ◽  
Imen Ksiaa ◽  
Chiraz Abdelhedi ◽  
Hager Ben Amor ◽  
Sonia Attia ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Disc ◽  
Multimodal Imaging ◽  
Fundus Autofluorescence ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Hard Exudates ◽  
Retinal Artery ◽  
The Right

Purpose: To describe multimodal imaging findings in a patient with idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome presenting with branch retinal artery occlusion (BRAO). Case description: A 33-year-old woman presented with acute BRAO in the right eye. A diagnosis of underlying IRVAN syndrome was made based on the presence of arteriolar aneurysms on the optic disc and along major arterioles and faint retinal hard exudates in both eyes. Eight months later, best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. The hard exudates had increased, and there were extensive areas of peripheral retinal capillary nonperfusion without new vessels. Optical coherence tomography (OCT) showed a localized retinal thinning corresponding to the prior BRAO. Fundus autofluorescence showed nodulo-linear periarterial hypoautofluorescence. OCT angiography (OCTA) showed localized ischemic changes, mainly involving the deep capillary plexus, corresponding to the area of resolved BRAO. It also clearly delineated the optic disc aneurysms. The patient received bilateral scatter laser photocoagulation directed to areas of peripheral capillary nonperfusion. Over a 6-month follow-up period, visual acuity remained unchanged, and there was no evidence of disease progression. Conclusion: Multimodal imaging, including fundus autofluorescence, OCT, and OCTA can provide additional valuable information in the evaluation of IRVAN syndrome complicated with BRAO.

Sign in / Sign up

Export Citation Format

Share Document