Multimodal imaging of two cases of retinal vein occlusion secondary to Waldenstrom macroglobulinemia

2021 ◽  
pp. 112067212199138
Author(s):  
Lidia Remolí Sargues ◽  
Javier Montero Hernández ◽  
Catalina Navarro Palop ◽  
Clara Monferrer Adsuara ◽  
Verónica Castro Navarro ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Vein Occlusion ◽  
Multimodal Imaging ◽  
Vision Loss ◽  
Optical Coherence ◽  
Waldenström Macroglobulinemia ◽  
Vein Occlusion ◽  
Waldenstrom Macroglobulinemia ◽  
Intravitreal Dexamethasone ◽  
Intraretinal Hemorrhages

Purpose: To report multimodal imaging characteristics of two cases of retinal vein occlusion (RVO) secondary to Waldenstrom macroglobulinemia (WM). Case report: Case 1: An 82-year-old woman presented with vision loss. She had a history of WM. Best-corrected visual acuity (BCVA) was 20/100 Snellen equivalent in the right eye (OD) and 20/63 in the left eye (OS). Fundoscopy showed bilateral hemorrhages in posterior pole and along superotemporal arcade. Fluorescein angiography illustrated no macular leakage. Optical coherence tomography (OCT) revealed macular edema (ME). Optical coherence tomography angiography (OCTA) demonstrated abnormalities in choriocapillaris. A diagnosis of bilateral branch RVO was made and ME was treated with intravitreal dexamethasone, achieving stability. Case 2: A 65-year-old man presented with venous dilation, tortuosity, and intraretinal hemorrhages. BCVA was 20/20 in both eyes (OU). OCT showed ME and hyperreflective dots in choroid. A diagnosis of bilateral central RVO was made. Laboratory evaluation and bone narrow biopsy confirmed a diagnosis of WM. After that, our patient consulted because of vision loss. BCVA was 20/400 in OU. Fundoscopy and OCT demonstrated a worsening of the intraretinal hemorrhages and the ME. OCTA showed damage of choriocapillaris. Thus, intravitreal dexamethasone and plasmapheresis was advised. Two months after, BCVA was 20/40 in the OD and 20/32 in the OS. Also, fundoscopy and OCT improved. Conclusion: Early treatment of WM is truly important, with the aim of achieving a decrease in IgM levels in order to avoid toxic effect over the RPE that results in refractory ME.

scholarly journals Comparison between Optical Coherence Tomography and Fundus Fluorescein Angiography in the Detection of Cystoid Macular Oedema in a Tertiary Eye Care Centre in Nagpur, Maharashtra

2021 ◽  
Vol 8 (40) ◽  
pp. 3459-3463
Author(s):  
Kavita Anand Dhabarde ◽  
Karuna Radhakishan Painjane ◽  
Ashok Hukumchand Madan
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Vein Occlusion ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Optical Coherence ◽  
Age Group ◽  
Care Centre ◽  
Eye Care ◽  
Fundus Fluorescein Angiography ◽  
Vein Occlusion

BACKGROUND Fundus fluorescin angiography (FFA) has been traditional gold standard for detection of cystoid macular oedema (CME) but nowadays optical coherence tomography (OCT) is used more often by to detect CME due to various conditions. Although FFA can assess CME qualitatively, OCT provides quantitative measurement of foveal thickness. The purpose of this study is to compare sensitivity of FFA and OCT for detection of CME and know the etiological distribution of CME and the ability of FFA and OCT in diagnosing CME in different aetiologies. METHODS A hospital based prospective observational diagnostic study was conducted in tertiary eye care centre in central India on 143 eyes of 103 patients. FFA and OCT findings in patients of CME diagnosed provisionally on fundus examination were studied. RESULTS Of total 103 patients studied, maximum patients 20 (19.42 %) were in age group of 55 - 59 years whereas minimum 6 (5.83 %) were in age group of 40 - 44 years. In 103 patients, 61 (59.22 %) were males and 42 (40.78 %) were females. Both eyes were involved in 41 (40.78 %) cases. Most common cause of CME was nonproliferative diabetic retinopathy (NPDR) 52 eyes (35.86 %), followed by branch retinal vein occlusion (BRVO) 32 eyes (22.06 %), then proliferative diabetic retinopathy (PDR) 14 eyes (9.6 %), central retinal vein occlusion (CRVO) 13 eyes (8.96 %). CME on OCT was seen in maximum of retinal vein occlusion patients - CRVO (84.61 %) and BRVO (84.37 %). Of 145 eyes, 114 (78.32 %) eyes had CME. CONCLUSIONS Most common cause of CME was NPDR followed by BRVO, PDR and CRVO. Sensitivity of OCT in comparison with FFA was 100 % with diagnostic accuracy of 81.38 %. Hence, one can use OCT as first modality investigation for diagnosis of CME. KEYWORDS Optical Coherence Tomography, Fundus Fluorescein Angiography, Cystoid Macular Oedema, NPDR

Fundus Fluorescein Angiography, Optical Coherence Tomography, and Optical Coherence Tomography Angiography Findings in Branch Retinal Vein Occlusion

2019 ◽  
pp. 83-87
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Optical Coherence Tomography Angiography ◽  
Serous Retinal Detachment ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography ◽  
Vein Occlusion ◽  
Capillary Plexus

Even though the diagnosis depends on clinical examination, in cases with branch retinal vein occlusion (BRVO), fundus fluorescein angiography (FFA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) provide unique data for follow-up, management and prognosis. In FFA, delay of laminar flow phase in the involved branch, hyperfluorescence due to leakage from the vessel wall in the late phases, hypofluorescence due to the blockage by hemorrhage, and soft exudates, and hyperfluorescence due to macular edema can be detected. In OCT, macular thickening, cystic spaces, serous retinal detachment, hyperreflective dots, disorganization of the outer retinal layers – particularly the photoreceptor inner and outer segments line and the external limiting membrane – can be seen. OCTA reveals non-perfusion, particularly in the deep capillary plexus.

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