Acquired choroidal osteoma

2019 ◽  
Vol 2 ◽  
pp. 2 ◽  
Author(s):  
Robert J. Purgert ◽  
Jose J. Echegaray ◽  
Scott Lauer ◽  
Arun D. Singh
Keyword(s):  
Multimodal Imaging ◽  
Fundus Photography ◽  
Normal Retina ◽  
Choroidal Osteoma

Choroidal osteoma is a choristomatous lesion postulated to be congenital in nature. Described herein is the case of a 16-year- old female presenting with a peripapillary lesion diagnosed as choroidal osteoma on multimodal imaging. Routine fundus photography 18 months before presentation demonstrated a normal retina and choroid without evidence of the lesion. Overall, this report provides evidence that choroidal osteoma may be acquired and not always congenital in origin.

scholarly journals Noninvasive multimodal imaging in diagnosing polypoidal choroidal vasculopathy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingyuan Yang ◽  
Mingzhen Yuan ◽  
Erqian Wang ◽  
Song Xia ◽  
Youxin Chen
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Multimodal Imaging ◽  
High Sensitivity ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Diagnostic Strategy ◽  
Imaging Features ◽  
Imaging Methods ◽  
Age Related ◽  
Choroidal Vasculopathy

Abstract Purpose To investigate the diagnostic accuracy of noninvasive multimodal imaging methods in diagnosing polypoidal choroidal vasculopathy (PCV) and distinguishing PCV from typical neovascular age-related macular degeneration (nvAMD). Methods Retrospective study. Imaging features of noninvasive multimodal imaging methods, including fundus photography (FP), B-scan optical coherence tomography (OCT), en face OCT, OCT angiography, and autofluorescence, of 103 eyes with PCV or typical nvAMD were reviewed. Diagnostic strategy was established based on imaging features and was validated in other 105 eyes with PCV or typical nvAMD. Results Features of subretinal orange nodule on FP, thumb-like PED on OCT, notched PED on OCT, bubble sign on OCT, and Bruch’s membrane depression under serosanguinous PED on OCT were more common. When the diagnostic strategy of using at least 2 of 5 features was performed, there is 0.88 sensitivity and 0.92 specificity for diagnosing PCV. The results of the validation test further confirmed the diagnostic strategy with 0.94 sensitivity and 0.93 specificity. Conclusions Noninvasive multimodal imaging, especially FP and B-scan OCT, provide high sensitivity and specificity for diagnosing PCV and distinguishing PCV from typical nvAMD, when at least 2 of 5 suggestive imaging features are present.

Multimodal imaging of chorioretinal folds induced by orbital vascular malformation in two cases

2020 ◽  
pp. 112067212095758
Author(s):  
Ahmet Kaan Gündüz ◽  
Carol L Shields ◽  
Şükran Bekdemir ◽  
Jerry A Shields
Keyword(s):  
Functional Status ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Late Phase ◽  
Vascular Tumor ◽  
Fundus Photography ◽  
Swept Source ◽  
Chorioretinal Folds

Purpose: To investigate the alterations in the retinal pigment epithelium (RPE) in the crest and trough portions of chorioretinal folds (CRFs) induced by an orbital vascular tumor. Methods: Review of multimodal imaging in two eyes of two patients with globe compression and CRFs from an orbital vascular tumor. Results: Fundus photography demonstrated obliquely extending CRFs with alternating hyperpigmented and hypopigmented linear alterations in both eyes. Fundus autofluorescence (AF) imaging showed obliquely oriented hypoAF lines, incompletely alternating with hyperAF lines. In Case 1, the hyperAF lines had interspersed hypoAF segments and Case 2 had peripapillary mottling of AF. Fluorescein angiography (FA) showed alternating hyper and hypofluorescent lines in the late phase in Case 1. Optical coherence tomography (OCT) documented relative thinning of RPE at the folded crests in Case 1 and preservation of RPE in Case 2. Swept-source OCT angiography (SS-OCTA) demonstrated oblique hyporeflective lines in the outer retina and choriocapillaris layers in Case 2. These findings suggest that the crest of a CRF represents thinned or rarified RPE with hypoAF, transmission hyperfluorescence (FA), partially attenuated RPE layer (OCT), and isoreflectivity (SS-OCTA) while the trough represents compressed RPE with irregular hyperAF, transmission hypofluorescence (FA), thickened RPE layer (OCT), and hyporeflectivity (SS-OCTA). Conclusion: The anatomic and functional status of the RPE in CRFs based on multimodal imaging reveals normal to attenuated RPE with hypofunctionality at the fold crest and compacted, thickened RPE at the trough with segmental functional impairment on AF imaging. Anatomic information regarding CRFs is evident on OCT, FA, and SS-OCTA while the functional status is depicted on AF.

Choroidal neovascular membranes secondary to intraocular tuberculosis misdiagnosed as neovascular age-related macular degeneration

2017 ◽  
Vol 28 (2) ◽  
pp. 216-224 ◽  
Author(s):  
Alessandro Invernizzi ◽  
Aniruddha Agarwal ◽  
Maura Di Nicola ◽  
Fabio Franzetti ◽  
Giovanni Staurenghi ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Choroidal Neovascularization ◽  
Multimodal Imaging ◽  
Age Related Macular Degeneration ◽  
Enhanced Depth Imaging ◽  
Fundus Photography ◽  
Imaging Features ◽  
Neovascular Amd ◽  
Age Related ◽  
Intraocular Tuberculosis

Purpose: Intraocular tuberculosis (IOTB) can be complicated by choroidal neovascularization (CNV). However, when the CNV development is not accompanied by clear signs of inflammation, the etiology can be missed, especially in countries nonendemic for tuberculosis. We describe the clinical and imaging features of CNVs presenting as the first sign of IOTB initially misdiagnosed as exudative age-related macular degeneration (AMD). Methods: A retrospective review of clinical and imaging data of patients initially misdiagnosed with neovascular AMD later diagnosed with inflammatory CNV secondary to IOTB at tertiary referral centers was conducted. Features of fundus photography, fluorescein angiography, indocyanine green angiography, and enhanced depth imaging optical coherence tomography were analyzed. Distinguishing features between neovascular AMD and IOTB-associated CNV were evaluated. Results: Five patients over 55 years of age, erroneously diagnosed with exudative AMD, were included in the study. Multimodal imaging analysis allowed identification of peculiar choroidal alterations such as choroidal granulomas or choroiditis suggestive for posterior uveitis. Systemic workup for granulomatous uveitis including immunologic investigations such as tuberculin skin test or QuantiFERON TB Gold® and radiologic investigations revealed tubercular etiology in all the cases, allowing correct diagnosis and management of the uveitis and related CNV. Conclusions: Choroidal neovascularization represents a rare and unusual presenting sign of IOTB that can be misleading especially when it occurs in the elderly living in countries with low prevalence of the disease. Multimodal imaging can be helpful and should be employed, especially in atypical cases of CNV, in order to avoid misdiagnosis and/or diagnostic delays.

scholarly journals Acute Zonal Occult Outer Retinopathy in a Patient Suffering from Epilepsy: Five-Year Follow-Up

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1276
Author(s):  
Izabella Karska-Basta ◽  
Bożena Romanowska-Dixon ◽  
Dorota Pojda-Wilczek ◽  
Alina Bakunowicz-Łazarczyk ◽  
Agnieszka Kubicka-Trząska ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Multimodal Imaging ◽  
Fundus Autofluorescence ◽  
Medical Intervention ◽  
Fundus Photography ◽  
Unknown Etiology ◽  
Visual Field Examination ◽  
Laboratory Findings

We report an unprecedented case of a young patient with epilepsy coexisting with acute zonal occult outer retinopathy (AZOOR), a rare white dot syndrome of unknown etiology, associated with damage to the large zones of the outer retina. Recently, it has been established that epileptic episodes contribute to an inflammatory response both in the brain and the retina. A 13-year-old male patient with epilepsy was referred by a neurologist for an ophthalmologic consultation due to a sudden deterioration of visual acuity in the left eye. The examination, with a key role of multimodal imaging including color fundus photography, fluorescein angiography, indocyanine green angiography (ICGA), fundus autofluorescence (FAF), swept-source optical coherence tomography (SS-OCT) with visual field assessment, and electroretinography indicated AZOOR as the underlying entity. Findings at the first admission included enlargement of the blind spot in visual field examination along a typical trizonal pattern, which was revealed by FAF, ICGA, and SS-OCT in the left eye. The right eye exhibited no abnormalities. Seminal follow-up revealed no changes in best corrected visual acuity, and multimodal imaging findings remain unaltered. Thus, no medical intervention is required. Our case and recent laboratory findings suggest a causative link between epilepsy and retinal disorders, although this issue requires further research.

scholarly journals A Multimodal Imaging–Based Deep Learning Model for Detecting Treatment-Requiring Retinal Vascular Diseases: Model Development and Validation Study

10.2196/28868 ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. e28868
Author(s):  
Eugene Yu-Chuan Kang ◽  
Ling Yeung ◽  
Yi-Lun Lee ◽  
Cheng-Hsiu Wu ◽  
Shu-Yen Peng ◽  
...  
Keyword(s):  
Deep Learning ◽  
Multimodal Imaging ◽  
Vascular Diseases ◽  
Learning Model ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Retinal Diseases ◽  
Ophthalmic Imaging ◽  
Retinal Fundus ◽  
Deep Learning Model

Background Retinal vascular diseases, including diabetic macular edema (DME), neovascular age-related macular degeneration (nAMD), myopic choroidal neovascularization (mCNV), and branch and central retinal vein occlusion (BRVO/CRVO), are considered vision-threatening eye diseases. However, accurate diagnosis depends on multimodal imaging and the expertise of retinal ophthalmologists. Objective The aim of this study was to develop a deep learning model to detect treatment-requiring retinal vascular diseases using multimodal imaging. Methods This retrospective study enrolled participants with multimodal ophthalmic imaging data from 3 hospitals in Taiwan from 2013 to 2019. Eye-related images were used, including those obtained through retinal fundus photography, optical coherence tomography (OCT), and fluorescein angiography with or without indocyanine green angiography (FA/ICGA). A deep learning model was constructed for detecting DME, nAMD, mCNV, BRVO, and CRVO and identifying treatment-requiring diseases. Model performance was evaluated and is presented as the area under the curve (AUC) for each receiver operating characteristic curve. Results A total of 2992 eyes of 2185 patients were studied, with 239, 1209, 1008, 211, 189, and 136 eyes in the control, DME, nAMD, mCNV, BRVO, and CRVO groups, respectively. Among them, 1898 eyes required treatment. The eyes were divided into training, validation, and testing groups in a 5:1:1 ratio. In total, 5117 retinal fundus photos, 9316 OCT images, and 20,922 FA/ICGA images were used. The AUCs for detecting mCNV, DME, nAMD, BRVO, and CRVO were 0.996, 0.995, 0.990, 0.959, and 0.988, respectively. The AUC for detecting treatment-requiring diseases was 0.969. From the heat maps, we observed that the model could identify retinal vascular diseases. Conclusions Our study developed a deep learning model to detect retinal diseases using multimodal ophthalmic imaging. Furthermore, the model demonstrated good performance in detecting treatment-requiring retinal diseases.

scholarly journals Multimodal Imaging in AIDS-Related Ocular Cryptococcosis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Maria Fernanda Flores Herrera ◽  
Nicolas Dauby ◽  
Evelyne Maillart ◽  
Agnes Libois ◽  
Alberto Papaleo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Indocyanine Green ◽  
Multimodal Imaging ◽  
Critical Role ◽  
Fundus Photography ◽  
Optical Coherence ◽  
Ocular Manifestations ◽  
Baseline Evaluation ◽  
Almost All

Purpose. To report multimodal imaging findings in two cases of AIDS-related cryptococcal chorioretinitis associated with uveitis and vasculitis. Methods. Findings on clinical examination, color fundus photography, fluorescein and indocyanine green angiographies, and optical coherence tomography. Patients. Both patients were diagnosed with Cryptococcus neoformans meningitis in the setting of untreated HIV infection with CD4+ T cell count < 100 / m m 3 . Ocular manifestations occurred during the course of the antifungal therapy for meningitis. Results. In both cases, fundus showed vitritis. Fluorescein angiography allowed the characterization of vasculitis lesions, and indocyanine green angiography indicated choroidal involvement. In combination with optical coherence tomography, ICG and FA allowed the assessment of treatment response. Conclusion. These two cases reveal the potential of C. neoformans to infect almost all ocular structures and the critical role of multimodal imaging in baseline evaluation and in the follow-up of patients.

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.

scholarly journals Bilateral Multifocal Choroidal Osteoma with Choroidal Neovascularization

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mousavi MirNaghi ◽  
Shoeibi Nasser ◽  
Hosseini SeyedehMaryam ◽  
Saadat Targhi Ali
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Multimodal Imaging ◽  
Rare Case ◽  
Clinical Characteristics ◽  
Intravitreal Bevacizumab ◽  
Imaging Findings ◽  
Choroidal Osteoma ◽  
The Right

Choroidal osteoma has been reported to be unilateral in approximately 80% of cases diagnosed with this condition. Herein we report the clinical characteristics and multimodal imaging findings in a rare case of bilateral multifocal choroidal osteoma. A 32-year-old female presented with decreased visual acuity (VA) in the right eye (20/100), though she had normal VA (20/20) in the left eye. Ophthalmoscopy and multimodal imaging investigation revealed bilateral multifocal choroidal osteoma complicated by choroidal neovascularization (CNV) in the right eye. Following three injections of intravitreal bevacizumab (IVB) for CNV in the right eye, VA improved to 20/40.

scholarly journals Multimodal imaging of a vascularized idiopathic epiretinal membrane

2020 ◽  
pp. 112067212098252
Author(s):  
Rodrigo Anguita ◽  
Hagar Khalid ◽  
Cristina Arpa ◽  
Janice Roth ◽  
Bishwanath Pal ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Detachment ◽  
Fluorescein Angiography ◽  
Epiretinal Membrane ◽  
Multimodal Imaging ◽  
Fundus Photography ◽  
Vascular Endothelial ◽  
Optical Coherence ◽  
Idiopathic Epiretinal Membrane ◽  
Endothelial Growth Factor

Purpose: To report a case of vascularized idiopathic epiretinal membrane including the multimodal imaging. Methods: Findings on clinical examination, color fundus photography, spectral-domain optical coherence tomography, optical coherence tomography angiography, and fluorescein angiography. Results: Sixty-three-year-old woman with a previous rhegmatogenous retinal detachment (RRD) who presented with an asymptomatic idiopathic neovascular complex below an epiretinal membrane. It was assessed with fluorescein angiography, OCT and OCT-A. The vascularized ERM was already present previously to the retinal detachment. Conclusion: Our case report describes an example of idiopathic epiretinal membrane complicated by neovascularization; we hypothesized hypertension could be one of the factors in this case, as it may lead to decreased retinal perfusion and upregulation in vascular endothelial growth factor (VEGF). Multimodal imaging can help in detecting neovascularized ERM.

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