scholarly journals Multimodal imaging for paracentral acute maculopathy; the diagnostic role of en face OCT

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hamid Riazi-Esfahani ◽  
Elias Khalili Pour ◽  
Kaveh Fadakar ◽  
Nazanin Ebrahimiadib ◽  
Fariba Ghassemi ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Case Series ◽  
Underlying Disease ◽  
Vascular Density ◽  
En Face Oct ◽  
En Face ◽  
Diagnostic Role ◽  
Capillary Plexus ◽  
Cilioretinal Artery

Abstract Background To describe the features of multimodal imaging and the diagnostic role of en face OCT in the paracentral acute middle maculopathy (PAMM) spectrum. Methods In this observational case series, 5 eyes of 5 patients with acute PAMM were identified. Demographic characteristics as well as data regarding the underlying disease, presenting visual acuity (VA) and ophthalmic examination results were recorded. All patients underwent multimodal imaging within 3 days after symptom onset. Results The mean age of patients was 52.2 (range, 33–67) years. Systemic comorbidities including diabetes mellitus and hypertension were identified in two patients. Except for one patient diagnosed with isolated PAMM, other patients had signs of retinal vascular disease such as a cilioretinal artery or branch retinal artery obstruction, non-ischemic central retinal vein occlusion, or a combination of these vascular disorders. The central vision was preserved in two cases; however, the remaining cases presented with profound VA reduction. Different patterns of PAMM including arterial, globular, and fern-like were observed in en face OCT at deep capillary plexus (DCP) level. En face OCT images could precisely delineate the margin of the PAMM area. Optical coherence tomography angiography (OCTA) showed decreased vascular density in DCP. Unresolved projection artifact by conventional OCTA software was observed in DCP and choriocapillaris slabs in all cases. Conclusion En face structural OCT in PAMM can delineate the area of ischemia and the degree of foveal involvement. Unresolved projection artifact by conventional OCTA software in the PAMM area can be seen in DCP and choriocapillaris layers.

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 Artifact Removed Quantitative Analysis Of Choriocapillaris Flow Voids

2021 ◽  
Author(s):  
M. Giray Ersoz ◽  
Mumin Hocaoglu ◽  
Isil Sayman Muslubas ◽  
Serra Arf ◽  
Erdost Yildiz ◽  
...  
Keyword(s):  
Optical Coherence Tomography Angiography ◽  
Autosomal Dominant ◽  
Pigment Epithelium ◽  
Subretinal Fluid ◽  
Outer Retina ◽  
En Face Oct ◽  
En Face ◽  
Capillary Plexus ◽  
Vitreous Opacities ◽  
Superficial Capillary Plexus

Abstract Purpose: To investigate choriocapillaris flow voids (FV) with a new optical coherence tomography angiography (OCTA) image processing strategy to exclude artifacts due to vitreous opacities, subretinal pigment epithelium (sub-RPE) fluid and deposits, and subretinal fluid (SRF) by thresholding the en-face OCT image of the outer retina.Methods: This retrospective study included 15 eyes with drusen and 15 eyes with SRF. Number (FVn), average area (FVav), and maximum area (FVmax) of FV and the percentage of the nonperfused choriocapillaris area (PNPCA) obtained using the proposed strategy were compared with those obtained by removing only artifacts due to superficial capillary plexus (SCP).Results: There were three eyes with autosomal dominant drusen and 12 eyes with drusen secondary to non-exudative AMD in the drusen group. SRF group included 15 eyes with active central serous chorioretinopathy. PNPCA, FVav, FVmax, and FVn obtained using the algorithm were significantly lower than those obtained by removing only SCP in both groups (all p< 0.05). The algorithm was able to remove 94.7% of artifacts secondary to vitreous opacities and all artifacts secondary to serous pigment epithelial detachments. Conclusion: Nonperfusion areas of choriocapillaris may be overestimated in eyes with RPE abnormalities and SRF. These areas can be removed using thresholded images of the outer retina en-face OCT scans.

scholarly journals Potential of Radiolabeled PSMA PET/CT or PET/MRI Diagnostic Procedures in Gliomas/Glioblastomas

2020 ◽  
Vol 13 (2) ◽  
pp. 94-98 ◽  
Author(s):  
Francesco Bertagna ◽  
Domenico Albano ◽  
Elisabetta Cerudelli ◽  
Maria Gazzilli ◽  
Raffaele Giubbini ◽  
...  
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Whole Body ◽  
Cochrane Library ◽  
Whole Body Imaging ◽  
Mri Imaging ◽  
Psma Pet ◽  
Pet Ct ◽  
Diagnostic Role

Background: Radiolabeled prostate-specific membrane antigen PSMA-based PET/CT or PET/MRI is a whole-body imaging technique currently performed for the detection of prostate cancer lesions. PSMA has been also demonstrated to be expressed by the neovasculature of many other solid tumors. Objective: The aim of this review is to evaluate the possible diagnostic role of radiolabeled PSMA PET/CT or PET/MRI in patients with gliomas and glioblastomas, by summarizing the available literature data. Methods: A comprehensive literature search of the PubMed/MEDLINE, Scopus, Embase and Cochrane library databases was conducted to find relevant published articles about the diagnostic performance of radiolabeled PSMA binding agents in PET/CT or PET/MRI imaging of patients with suspected gliomas or glioblastomas. Results: Seven case reports or case series and 3 studies enrolling more than 10 patients showed that gliomas and glioblastoma are PSMA-avid tumors. Conclusion: Radiolabeled PSMA imaging seems to be useful in analyzing glioma/glioblastoma. Further studies enrolling a wider population are needed to clarify the real clinical and diagnostic role of radiolabeled PSMA in this setting and its possible position in the diagnostic flow-chart.

scholarly journals OCT Angiography and En Face OCT Reflectance Aid in Monitoring Subclinical Inflammation in Serpiginous Choroidopathy

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Carl S. Wilkins ◽  
Jorge S. Andrade Romo ◽  
Toco Y. P. Chui ◽  
Richard B. Rosen ◽  
Stephanie Llop
Keyword(s):  
Disease Progression ◽  
Transition Zone ◽  
Multimodal Imaging ◽  
Primary Site ◽  
Subclinical Inflammation ◽  
Case Presentation ◽  
Normal Retina ◽  
Subclinical Disease ◽  
En Face Oct ◽  
En Face

Introduction. We present a case of serpiginous choroidopathy (SC) with novel OCTA and en face OCT reflectance findings which help identify subclinical disease progression. Case Presentation. En face OCT reflectance images demonstrated outer retinal tubules (ORT) at the serpiginous lesion margins of affected and unaffected retina on multimodal imaging. OCTA findings demonstrate variable dropout of choriocapillaris in “normal” retina beyond lesion borders which was not visible on standard imaging and which demonstrated a clear transition zone beyond the ORT. Discussion. This is the first report of choriocapillaris atrophy identified on OCTA not identified on traditional multimodal imaging in serpiginous choroidopathy. Damage to vasculature only visible with OCTA may help characterize the distribution of inflammation, aiding in monitoring of suppression not illustrated by traditional imaging and which may threaten the central macula. ORT in SC suggest death and reorganization of outer segments from dysfunction of the choriocapillaris and RPE, as well as serve to demarcate the area of chronic or old inflammation, supporting the hypothesis that the choriocapillaris is the primary site of inflammation in SC. Based on these findings, we recommend OCTA on all patients with serpiginous choroidopathy to monitor underlying state of inflammation and help determine immunosuppressive threshold.

Evaluation of pseudophakic cystoid macular edema using optical coherence tomography angiography

2017 ◽  
Vol 28 (2) ◽  
pp. 234-240 ◽  
Author(s):  
Rita Serra ◽  
Alexandre Sellam ◽  
Florence Coscas ◽  
Elsa Bruyère ◽  
André Sieiro ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Cystoid Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Face Image ◽  
Vascular Density ◽  
Optical Coherence ◽  
En Face ◽  
Capillary Plexus ◽  
Healthy Eyes ◽  
Sd Oct

Purpose: To compare the optical coherence tomography angiography (OCT-A) findings of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in eyes with pseudophakic cystoid macular edema (PCME) with those of fluorescein angiography (FA) and spectral-domain optical coherence tomography (SD-OCT) and to compare PCME vascular density values of the SCP and DCP with those of healthy eyes. Methods: In this retrospective observational study, 13 eyes (12 patients) with PCME underwent comprehensive ophthalmologic examinations including visual acuity, FA, SD-OCT, and OCT-A. The vascular density of the SCP and DCP were measured using AngioAnalytics software in all PCME eyes and compared with 46 healthy eyes of 25 subjects. Results: In patients with PCME, at the level of SCP, the mean vascular density in the whole en face image was 44.48 ± 3.61% while it was 50.27 ± 5.30% at the level of the DCP. In contrast, the vascular density in the whole en face image was 50.35 ± 3.22 at the level of SCP while it was 56.15 ± 3.28 at the level of DCP in 46 healthy eyes of 25 subjects. The vascular density of patients with PCME was significantly lower than in healthy subjects at the SCP (p<0.0001) and at the DCP (p<0.0001). Conclusion: We report the OCT-A appearance of PCME and vascular density map with values that can be easily interpreted for quantitative evaluation of retina perfusion status using OCT-A. This approach might be the first step in helping us fully understand the pathophysiologic mechanisms underlying PCME.

scholarly journals Multimodal Imaging Analysis in a Case with Congenital Fovea-Involving Retinal Macrovessel and Excellent Visual Acuity

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Vishal Shah ◽  
M. Ashwin Reddy ◽  
Vasilios P. Papastefanou
Keyword(s):  
Visual Acuity ◽  
Oct Angiography ◽  
Foveal Avascular Zone ◽  
Swept Source ◽  
En Face Oct ◽  
En Face ◽  
Avascular Zone ◽  
Capillary Plexus ◽  
Swept Source Oct ◽  
Swept Source Oct Angiography

Purpose. Congenital retinal macrovessels (CRM) represent rare aberrant vasculature of the retinal vessels that can supply or drain the macula. In this report, the optical coherence tomography angiography features of a congenital retinal macrovessel are discussed. Methods. The history and examination findings are presented alongside swept-source OCT angiography with corresponding B scan and en face OCT imaging. Patients. The case is a 12-year-old female patient with excellent best-corrected visual acuity in both eyes. Results. Swept-source OCT angiography demonstrated considerable loss of the foveal avascular zone at the levels of the superficial and deep capillary plexus. Discussion. In this case there was no detrimental effect on vision despite anatomical loss of the foveal avascular zone.

scholarly journals Multimodal imaging for the assessment of geographic atrophy in patients with ‘foveal’ and ‘no foveal’ sparing.

2020 ◽  
Author(s):  
Stamatina A. Kabanarou ◽  
Georgios Bontzos ◽  
Tina Xirou ◽  
Zoi Kapsala ◽  
Eleni Dimitriou ◽  
...  
Keyword(s):  
Multimodal Imaging ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Imaging Modalities ◽  
Separate Analysis ◽  
Imaging Protocol ◽  
Significant Difference ◽  
En Face Oct ◽  
En Face ◽  
Foveal Sparing

INTRODUCTION To evaluate the applicability of optical coherence tomography-angiography (OCT-A) for measuring geographic atrophy (GA) areas in age-related macular degeneration (AMD) patients with ‘foveal’ and ‘no foveal’ sparing disease and compare it to other imaging modalities. METHODS A multimodal imaging protocol was applied, using infrared imaging (IR), fundus autofluorescence (FAF), OCT-A and en-face OCT in 35 eyes of 23 AMD patients with GA. Patients were classified in two groups, with and without foveal sparing disease. GA area measurements for all imaging modalities were compared for each group separately. RESULTS The measured GA area was estimated 6.68 ± 3.18 mm2using IR; 6.99 ± 3.09 mm2 using FAF; 6.56 ± 3.11 mm2 using OCT-A and 6.65 ± 3.14 mm2using en-face OCT. There was no statistically significant difference in GA area between different modalities (p=0.977). When separate analysis was conducted for patients with ‘foveal’ and ‘no foveal’ sparing disease, although GA measurements in FAF imaging displayed higher numerical values compared to the other modalities, especially in patients with foveal sparing, no statistically significant difference in GA area was found between the different imaging modalities in either group (p=0.816 for foveal sparing; p=0.992 for no foveal sparing group). CONCLUSIONS OCT-A can be reliably used in the assessment of GA in AMD patients with and without foveal sparing disease. For both groups, measurements are comparable to IR, en-face OCT and FAF, despite the fact that the latter recorded larger area of GA, mainly in the foveal sparing cases.

scholarly journals The Diagnostic Role of Multimodal Imaging Techniques in Isolated Foveal Hypoplasia

2017 ◽  
Vol 47 (5) ◽  
pp. 306-308
Author(s):  
Figen Batıoğlu ◽  
Sibel Demirel ◽  
Emin Özmert ◽  
Betül Bayraktutar ◽  
Özge Yanık
Keyword(s):  
Multimodal Imaging ◽  
Imaging Techniques ◽  
Diagnostic Role ◽  
Foveal Hypoplasia

Multimodal imaging in subclinical best vitelliform macular dystrophy

2020 ◽  
pp. bjophthalmol-2020-317635
Author(s):  
Maurizio Battaglia Parodi ◽  
Alessandro Arrigo ◽  
Alessandro Calamuneri ◽  
Emanuela Aragona ◽  
Francesco Bandello
Keyword(s):  
Multimodal Imaging ◽  
Near Infrared ◽  
Case Series ◽  
Foveal Avascular Zone ◽  
Macular Dystrophy ◽  
Cross Sectional ◽  
Vitelliform Macular Dystrophy ◽  
Best Vitelliform Macular Dystrophy ◽  
Capillary Plexus ◽  
Growth Factor Production

BackgroundTo analyse multimodal imaging alterations in the subclinical form of best vitelliform macular dystrophy (BVMD).MethodsThe study was designed as an observational, cross-sectional case series. Eleven eyes of 7 subclinical patients with BVMD and 12 age-matched and sex-matched controls were included. Multimodal imaging included fundus blue-light autofluorescence, near-infrared autofluorescence (NIR-AF), structural optical coherence tomography (OCT) and OCT angiography (OCTA). The quantitative analysis included the calculation of the following parameters: vessel density (VD), vessel tortuosity (VT), vessel dispersion (Vdisp), vessel rarefaction (VR), foveal avascular zone (FAZ) area, reflectivity of the outer retinal bands and choriocapillaris porosity (CCP).ResultsMean best-corrected visual acuity was 0.0±0.0 LogMAR in both groups. The round central hypoautofluorescent alteration on NIR-AF corresponded to a significant reflectivity attenuation of the outer retinal bands on structural OCT (0.55±0.18 vs 0.75±0.08; p<0.001). VD, VT, VR and Vdisp were normal compared with controls (all p>0.05). The FAZ area turned out to be significantly restricted at the level of the deep capillary plexus in subclinical BVMD eyes (p<0.001). Furthermore, quantitative OCTA revealed a significant central increase of CCP, compared with controls (18.25±2.43 vs 4.58±1.36; p<0.001).ConclusionsThe subclinical stage of BVMD is characterised by significant alterations of the outer retinal bands and the choriocapillaris. Quantitative multimodal imaging assessment suggests that subclinical BVMD is affected by the functional impairment of the outer retinal structures, leading to an alteration in melanin and growth factor production.

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