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Asensio-Sánchez VM. Unusual case of retinal arterial branch occlusion: possible variant of Sneddon syndrome. Arch Soc Esp Oftalmol (Engl Ed) 2024; 99:218-221. [PMID: 38401593 DOI: 10.1016/j.oftale.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/20/2024] [Indexed: 02/26/2024]
Abstract
Sneddon's syndrome (SS) manifests through multiple strokes and livedo reticularis. Livedoid vasculopathy (VL) is characterized by a long history of foot and leg ulceration and histopathology indicating a thrombotic process. Arterial retinal branch occlusion is described in a 52-year-old male with VL. He did not present noticeable laboratory abnormalities, such as antiphospholipid antibodies, or a history of strokes. Retinal artery occlusion accompanied by VL could be a variant of Sneddon's syndrome. Optical coherence tomography angiography revealed a reduction in the macula's vascular layers in the asymptomatic eye, indicating localized microvascular changes as an evolving marker in the pathogenesis of SS.
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Affiliation(s)
- V M Asensio-Sánchez
- Servicio de Oftalmología, Hospital Clínico Universitario, Valladolid, Spain.
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2
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Guemes-Villahoz N, Burgos-Blasco B, Fernández-Vigo JI, Morales-Fernández L, Perez-García P, García-Feijóo J, Martínez-de-la-Casa JM. Diagnostic ability of vessel density of the optic nerve head and macula versus structural parameters with optical coherence tomography in pseudoexfoliative glaucoma. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:680-686. [PMID: 37788756 DOI: 10.1016/j.oftale.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/02/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE To evaluate the diagnostic ability of the vessel density (VD) of the optic nerve head (ONH) and the macula on optical coherence tomography (OCT) angiography and the retinal nerve layer thickness (RNFL) thickness and the macular ganglion cell complex (GCC) thickness on OCT in patients with pseudoexfoliative glaucoma (PXG). METHODS Cross-sectional study including PXG patients and healthy controls. Demographic and clinical data were noted for all participants. Optical coherence tomography (OCT) and OCT angiography (OCTA) images of the ONH and macular area were obtained with the RS-3000 Advance OCT (Nidek Co., Gamagori, Japan). The RNFL and GCC thickness of different sectors was provided by the software. Macular VD of the superficial capillary plexus (SCP) and ONH VD of the radial peripapillary capillary plexus (RPCP) were registered. Groups were compared and area under the receiver operating characteristic (AUROC) curves were used to determine the power of discrimination of each parameter. RESULTS RNFL and GCC thickness and ONH and macular VD were significantly lower in PXG patients compared with healthy controls (all, p<0.05). The best discrimination parameter was the average RNFL thickness (AUROC: 0.928). ONH VD AUROC was better than that of macular VD (AUROC: 0.897 and 0.780, respectively). ONH VD AUROC was comparable to RNFL thickness (p<0.001). CONCLUSIONS The diagnostic ability of ONH vessel density in PXG appears comparable to that of the structural parameters, RNFL and GCC thickness, obtained with OCT, and may be a valuable tool in clinical practice.
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Affiliation(s)
- N Guemes-Villahoz
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de investigación sanitaria (IdiSCC), Madrid, Spain.
| | - B Burgos-Blasco
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de investigación sanitaria (IdiSCC), Madrid, Spain
| | - J I Fernández-Vigo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de investigación sanitaria (IdiSCC), Madrid, Spain
| | - L Morales-Fernández
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de investigación sanitaria (IdiSCC), Madrid, Spain
| | - P Perez-García
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de investigación sanitaria (IdiSCC), Madrid, Spain
| | - J García-Feijóo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de investigación sanitaria (IdiSCC), Madrid, Spain
| | - J M Martínez-de-la-Casa
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de investigación sanitaria (IdiSCC), Madrid, Spain
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de Los Santos C, Herreras JM, Cocho L. Detecting progression of acute zonal occult outer retinopathy (AZOOR) with optical coherence tomography angiography: A case report. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:595-600. [PMID: 37364680 DOI: 10.1016/j.oftale.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
CLINICAL CASE A 48-year-old woman with persistent superotemporal scotomas and photopsias for 2 months, and depigmented zones in the retina of both eyes with a trizonal pattern on multimodal imaging. Brain magnetic resonance imaging, positron emission tomography, antiretinal antibodies, immunological, infectious and tumor markers tests were negative, thus acute zonal occult outer retinopathy was diagnosed. Patient was treated with adalimumab. Nevertheless, 19 months later symptoms increased, and progression was detected on optic coherence tomography angiography, as well as in Humphrey visual field test and electroretinogram, thus, mycophenolate mofetil was added showing improvement and stabilization of the disease in a 4-year follow-up. DISCUSSION Optic coherence tomography angiography may be a potential tool to monitor progression and response to treatment in addition to other imaging modalities in acute zonal occult outer retinopathy, and the combination of adalimumab and mycophenolate may be useful in recurrent disease.
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Affiliation(s)
- C de Los Santos
- IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain.
| | - J M Herreras
- IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain; Departamento de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - L Cocho
- IOBA (Instituto de Oftalmobiología Aplicada), Universidad de Valladolid, Valladolid, Spain; Departamento de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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4
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Duch Hurtado M, Vidal Oliver L, Marín Lambies C, Salom Alonso D. Microvascular quantitative metrics in retinitis pigmentosa using optical coherence tomography angiography. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:270-275. [PMID: 37031736 DOI: 10.1016/j.oftale.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/12/2023] [Indexed: 04/11/2023]
Abstract
AIMS To describe the changes in vessel density (VD) using optical coherence tomography angiography (OCTA) of the different sectors in the macular area between retinitis pigmentosa (RP) patients and controls. METHODS Observational case-control study. We initially included 22 patients with RP and 21 controls. We obtained 6 × 6 OCTA images of the macular area using Angio-OCT SS-DRI-Triton 1.22 (Topcon, Japan), together with visual acuity, biomicroscopy, visual field and optical coherence tomography examination. We compared the VD values in both groups for both superficial (SVP) and deep vascular plexus (DVP). Correlation between VD and macular thickness was also calculated. RESULTS The mean visual field index (VFI) in the RP group was 26.11% (+/- 17.29). VD was significantly lower in the RP group compared with healthy controls in all sectors of the DVP (Superior 43.48+/-3.79 vs 48.86+/-2.62, p < 0.0001; Nasal 40,52+/- 4.30 vs 46,01+/- 3.23, p = 0.0002; Inferior 42.76+/-5.26 vs 50.10+/- 3.36, p < 0.0001; Temporal 40.42+/- 4.46 vs 46.09+/-2.91, p = 0.0001) and in all but nasal sector in the SVP (Superior 39.86+/-4.46 vs 46.47+/- 2.61, p < 0.0001; Nasal 40.35+/- 4.56 vs 44.09+/-2.87, p = 0.0067; Inferior 40.74+/- 4.61 vs 46.58+/-3.26, p = 0.0002; Temporal 39.98+/-5.07 vs 44.78+/-3.28, p = 0.0024). Correlation between VD and macular thickness was positive and significant (RP: r = 0.59, p = 0.043; controls r = 0.51, p = 0.018). CONCLUSIONS Patients with advanced forms of RP have less vessel density in the macular area than healthy subjects. These differences are present in all four quadrants in the DVP and three in the SVP.
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Affiliation(s)
- M Duch Hurtado
- Servicio de Atención Primaria, Centro de Salud Pego, Alicante, Spain
| | - L Vidal Oliver
- Servicio de Oftalmología, Hospital Clínico Universitario Valencia, Valencia, Spain.
| | - C Marín Lambies
- Servicio de Oftalmología, Hospital de Manises, Manises, Valencia, Spain
| | - D Salom Alonso
- Servicio de Oftalmología, Hospital de Manises, Manises, Valencia, Spain
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Salazar-Quiñones L, Peña-Urbina P, Fernández-Vigo JI, Pérez-Quiñones Y, Molero-Senosiain M, Mendez-Hernandez C, Martínez-de-la-Casa JM, García-Feijóo J. Reproducibility of peripapillary, optic nerve head and macular vessel density by OCT-A according to glaucoma severity staging. Arch Soc Esp Oftalmol (Engl Ed) 2023:S2173-5794(23)00045-2. [PMID: 37023850 DOI: 10.1016/j.oftale.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To assess the reproducibility of peripapillary, optic nerve head (ONH-PP) and macular vessel density (VD) by Spectral Domain optical coherence tomography angiography (SD OCT-A) in glaucoma patients and healthy subjects. METHODS Cross-sectional study assessing 63 eyes of 63 subjects, including 33 glaucoma patients and 30 healthy subjects. Glaucoma was classified in mild, moderate, or advanced. Two consecutive scans were acquired by Spectralis Module OCT-A (Heidelberg, Germany), and provided images of the superficial vascular complex (SVC), nerve fiber layer vascular plexus (NFLVP), superficial vascular plexus (SVP); deep vascular complex (DVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP). VD (%) was calculated by AngioTool. Intraclass correlation coefficients (ICCs) and coefficients of variation (CV) were calculated. RESULTS Among ONH-PP VD, better ICC presented advanced (0.83-0.97) and moderate glaucoma (0.86-0.96) compared with mild glaucoma (0.64-0.86). For the macular VD reproducibility, ICC results for superficial retinal layers were better for mild glaucoma (0.94-0.96) followed by moderated (0.88-0.93) and advanced glaucoma (0.85-0.91), and for deeper retinal layers ICC was better for moderate glaucoma (0.96-0.95) followed by advanced (0.80-0.86) and mild glaucoma (0.74-0.91). CVs ranged from 2.2%% to 10.94%. Among healthy subjects, ICCs for the ONH-PP VD measurements (0.91-0.99) and for the macular VD measurements (0.93-0.97) were excellent in all layers, with CVs from 1.65% to 10.33%. CONCLUSIONS SD OCT-A used to quantify macular and ONH-PP VD showed excellent and good reproducibility in most layers of the retina, both in healthy subjects and in glaucoma patients regardless of the severity of the disease.
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Affiliation(s)
- L Salazar-Quiñones
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, OFTARED, Madrid, Spain.
| | - P Peña-Urbina
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, OFTARED, Madrid, Spain
| | - J I Fernández-Vigo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, OFTARED, Madrid, Spain
| | - Y Pérez-Quiñones
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, OFTARED, Madrid, Spain; Escuela de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - M Molero-Senosiain
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, OFTARED, Madrid, Spain
| | - C Mendez-Hernandez
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, OFTARED, Madrid, Spain
| | - J M Martínez-de-la-Casa
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, OFTARED, Madrid, Spain; Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Madrid, Spain
| | - J García-Feijóo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, OFTARED, Madrid, Spain; Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Madrid, Spain
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Diafas A, Dastiridou A, Samouilidou M, Tzamalis A, Mataftsi A, Tsinopoulos I, Kozobolis V, Ziakas N. The effect of acetazolamide on the retinal and choroidal vasculature of the macula and the optic disc using OCT angiography. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:125-131. [PMID: 36738925 DOI: 10.1016/j.oftale.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/30/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND OBJECTIVES To investigate the effect of acetazolamide (AZ) on the retinal and choroidal ocular microvasculature in the macula and radial peripapillary capillaries (RPC) of the optic disc with OCT Angiography (OCTA). MATERIALS AND METHODS Nine-month observational cross-sectional study. Forty-five eyes from 45 healthy participants who underwent cataract surgery were recruited. Macular retina and choriocapillaris vessel density (VD) and RPC VD in the optic disc area were compared before and 60min after 250mg acetazolamide per os. Intraocular pressure (IOP) and systemic blood pressure (BP) were also measured before each scan. RESULTS Mean age was 73.1±6.9 years. VDs in the superficial (SCP) and deep (DCP) capillary plexus of the retina and the choriocapillaris (CC) in the macular area showed no significant change (P>.5, for all parameters). VD in the RPC showed no significant change with AZ (P>.5, for all parameters). Foveal and parafoveal thickness increased from 248.98 (±23.89) to 250.33 (±23.74) and from 311.62 (±16.53) to 311.98 (±16.38) (P<.001 and P=.046), respectively. IOP decreased from 13.2 (±3.0) mmHg to 11.8 (±3.2) mmHg (P<.001), while systolic and diastolic BP decreased from 144.8 (±21.8) to 137.7 (±19.0) and from 80.0 (±12.7) to 76.2 (±11.7) (P=.021 and P=.030), respectively. CONCLUSIONS OCTA imaging did not reveal any significant changes in the VD of the optic disc or the retinal and choroidal VD in the macula with oral AZ one hour after its administration in otherwise healthy participants who underwent cataract surgery.
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Affiliation(s)
- A Diafas
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece; St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
| | - A Dastiridou
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - M Samouilidou
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - A Tzamalis
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - A Mataftsi
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - I Tsinopoulos
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
| | - V Kozobolis
- Instituto Oftalmológico de Tracia, Universidad Demócrito de Tracia, Alexandroupoli, Greece
| | - N Ziakas
- 2(nd) Departamento de Oftalmología, Universidad Aristóteles de Tesalónica, Facultad de Medicina, Hospital General Papageorgiou, Tesalónica, Greece
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Gutierrez-Benitez L, Palomino Y, Casas N, Asaad M. Automated measurement of the foveal avascular zone in healthy eyes on Heidelberg spectralis optical coherence tomography angiography. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:432-442. [PMID: 35680537 DOI: 10.1016/j.oftale.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/30/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To develop and evaluate an automated method to measure the foveal avascular zone (FAZ) area in healthy eyes on Heidelberg Spectralis Optical Coherence Tomography Angiography (HS-OCTA). This method is referred to as the modified Kanno-Saitama macro (mKSM) which is an evolution of the Kanno-Saitama macro (KSM) approach. METHODS This cross-sectional study included 29 eyes of 25 healthy volunteers who underwent HS-OCTA at the macular area twice at the same time. Regardless of the quality of the images, all of them were included. Macular data on the superficial vascular plexus, intermediate capillary plexus (ICP) and deep capillary plexus were processed by mKSM. The FAZ area was measured twice automatically using the mKSM and KSM and twice manually by two independent examiners. RESULTS From 174 images, KSM could not measure correctly 31% while mKSM could successfully measure all of them. Intrascan intraclass coefficient ranged from 0,948 to 0,993 for manual measurements and was 1 for mKSM method. Despite that the difference between human examiners is smaller than between human examiners and mKSM according to Bland-Altman plots, the scatterplots show a strong correlation between human and automatic measurements. The best results are obtained in ICP. CONCLUSIONS With mKSM, the automated determination of the FAZ area in HS-OCTA is feasible and less human-dependent. It solves the inability of KSM to measure the FAZ area in suboptimal quality images which are frequent in daily clinical practice. Therefore, the mKSM processing could contribute to our understanding of the three vascular plexuses.
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Affiliation(s)
- L Gutierrez-Benitez
- Departamento de Oftalmología, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.
| | - Y Palomino
- Departamento de Oftalmología, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
| | - N Casas
- Universidad Politécnica de Catalunya, Barcelona, Spain
| | - M Asaad
- Departamento de Oftalmología, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
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Garza-Garza LA, Ruiz-Lozano RE, Ancona-Lezama D, González-Godinez S, Garza-León M. Multimodal imaging assessment of a "micro" optic disk melanocytoma: A case report. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:663-667. [PMID: 34844688 DOI: 10.1016/j.oftale.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/01/2020] [Indexed: 06/13/2023]
Abstract
An optic disk melanocytoma is a benign pigmented neoplasm of the optic disk measuring 2.00 mm of diameter in average. Smaller optic disk melanocytomas are rare and have not been studied with multiple imaging studies. A case of a "micro" optic disk melanocytoma measuring 0.71 mm in diameter was studied by multiple imaging modalities, including fundus autofluorescence, ultrasound, visual fields, optical coherence tomography (OCT) and OCT angiography. While clinical appreciation and fundus autofluorescence reveal changes compatible with previously reported cases, OCT, OCT angiography and ultrasound reveal specific changes that could be useful for follow up.
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Affiliation(s)
- L A Garza-Garza
- Institute of Ophthalmology and Visual Science, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, Mexico
| | - R E Ruiz-Lozano
- Institute of Ophthalmology and Visual Science, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, Mexico
| | - D Ancona-Lezama
- Institute of Ophthalmology and Visual Science, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, Mexico
| | - S González-Godinez
- Institute of Ophthalmology and Visual Science, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, Mexico
| | - M Garza-León
- Department of Clinical Sciences, Division of Health Sciences, University of Monterrey, San Pedro Gaza García, Nuevo León, Mexico; Destellos de Luz Non-profit Foundation, San Pedro Gaza García, Nuevo León, Mexico.
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9
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Hervás A, García-Delpech S, Udaondo P. Analysis of the perfusion of the optic nerve using angio-OCT in glaucoma. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:214-218. [PMID: 32675037 DOI: 10.1016/j.oftal.2020.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/28/2020] [Accepted: 05/07/2020] [Indexed: 06/11/2023]
Abstract
The introduction of optical coherence tomography angiography (OCT-A) has generated interest in evaluating vascular dysfunctions in the optic nerve head for the diagnosis and monitoring of glaucoma. The purpose of this study is to compare perfusion of the optic disc between normal subjects and subjects with glaucoma using OCT-A in order to detect changes in perfusion of the optic disc. Using the OCT-A AngioVue® system, an examination was performed on 40 eyes of 40 patients (20 with glaucoma and 20 healthy controls). Total radial peripapillary flow density (4.5×4.5mm) was measured at different levels of segmentation. The study demonstrated that the peripapillary vascular flow of OCT-A and exploration of the optic nerve head was better in the normal eyes compared to glaucoma patients. This review provides a comprehensive summary of the most important current and potential applications of OCT-A in glaucoma.
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Affiliation(s)
- A Hervás
- Hospital Universitario y Politécnico La Fe, Valencia, España, AIKEN, Valencia, España.
| | - S García-Delpech
- Hospital Universitario y Politécnico La Fe, Valencia, España, AIKEN, Valencia, España
| | - P Udaondo
- Hospital Universitario y Politécnico La Fe, Valencia, España, AIKEN, Valencia, España
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Monares-Zepeda G, Montano M, Bonilla LA, Chew-Bonilla A, Lima-Gómez V. Vessel/perfusion density in two optical coherence tomographic angiography protocols: Interchangeable? GAC MED MEX 2021; 157:160-166. [PMID: 34270531 DOI: 10.24875/gmm.20000471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Different optical coherence tomography angiography (OCTA) scanning protocols evaluate the macula. Objective To compare the determination coefficients (R2) between vessel and perfusion densities of two OCTA scanning protocols in order to determine if their metrics could be interchanged. Method Cross-sectional, prospective, comparative, observational, study between two OCTA scanning protocols (Angioplex, Zeiss) in healthy subjects. The R2 between central, inner, and full densities (3 x 3 mm protocol) and between central, inner, outer and full densities (6 x 6 mm protocol) was identified, both for vessel and perfusion densities. Results Seventy-eight eyes were evaluated; subjects' median age was 23 years. There were high R2 between inner and full densities with the 3 x 3 mm protocol (0.96), between outer and full densities with the 6 x 6 mm protocol (0.96), and between central vessel and perfusion densities (≥ 0.96); R2 between central vessel and perfusion densities of different protocols was ≤ 0.71. Conclusions Vessel and perfusion densities have high determination coefficients within a scanning protocol, but not between protocols, given that each one preferentially measures different macular areas. Metrics from different protocols should not be interchanged for follow up.
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Affiliation(s)
- Gerardo Monares-Zepeda
- Retina Department, Clínica de Microcirugía Ocular Avanzada "Dr. Enrique Monares García", Toluca, State of Mexico
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Garza-Garza LA, Ruiz-Lozano RE, Ancona-Lezama D, González-Godinez S, Garza-León M. Multimodal imaging assessment of a "micro" optic disk melanocytoma: A case report. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:S0365-6691(20)30447-0. [PMID: 33495052 DOI: 10.1016/j.oftal.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/01/2020] [Indexed: 06/12/2023]
Abstract
An optic disk melanocytoma is a benign pigmented neoplasm of the optic disk measuring 2.00mm of diameter in average. Smaller optic disk melanocytomas are rare and have not been studied with multiple imaging studies. A case of a "micro" optic disk melanocytoma measuring 0.71mm in diameter was studied by multiple imaging modalities, including fundus autofluorescence, ultrasound, visual fields, optical coherence tomography (OCT) and OCT angiography. While clinical appreciation and fundus autofluorescence reveal changes compatible with previously reported cases, OCT, OCT angiography and ultrasound reveal specific changes that could be useful for follow up.
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Affiliation(s)
- L A Garza-Garza
- Institute of Ophthalmology and Visual Science, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, México
| | - R E Ruiz-Lozano
- Institute of Ophthalmology and Visual Science, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, México
| | - D Ancona-Lezama
- Institute of Ophthalmology and Visual Science, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, México
| | - S González-Godinez
- Institute of Ophthalmology and Visual Science, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey, México
| | - M Garza-León
- Department of Clinical Sciences, Division of Health Sciences, University of Monterrey, San Pedro Gaza García, Nuevo León, México; Destellos de Luz Non-profit Foundation, San Pedro Gaza García, Nuevo León, México.
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Moll-Udina A, Hernanz I, Dotti M, Llorenç V, Adán A. Multimodal imaging in acute idiopathic blind spot enlargement syndrome. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:449-52. [PMID: 34340786 DOI: 10.1016/j.oftale.2020.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/09/2020] [Indexed: 11/21/2022]
Abstract
Two cases are reported of acute idiopathic blind spot enlargement syndrome (AIBSE) that presented with peripapillary white spots in the fundus. AIBSE belongs to the acute zonal occult outer retinopathy (AZOOR) complex. Conditions of this AZOOR complex may overlap. Typically, in AIBSE, a peripapillary hyperautofluorescence is seen in the autofluorescence. En-face OCT angiography at the ellipsoid level showed hyper-reflective spots around the optic disk in both cases. One case showed a reversible enlargement of the blind spot in visual field. AZOOR complex is an inflammatory disorder that affects the outer retina, and can now be confirmed with structural optical coherence tomography. In the cases presented, there was a reversible severe loss of the outer retina.
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Abstract
Two cases are reported of acute idiopathic blind spot enlargement syndrome (AIBSE) that presented with peripapillary white spots in the fundus. AIBSE belongs to the acute zonal occult outer retinopathy (AZOOR) complex. Conditions of this AZOOR complex may overlap. Typically, in AIBSE, a peripapillary hyperautofluorescence is seen in the autofluorescence. En-face OCT angiography at the ellipsoid level showed hyper-reflective spots around the optic disk in both cases. One case showed a reversible enlargement of the blind spot in visual field. AZOOR complex is an inflammatory disorder that affects the outer retina, and can now be confirmed with structural optical coherence tomography. In the cases presented, there was a reversible severe loss of the outer retina.
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14
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Kudsieh B, Sánchez-Dehesa Sáez M, Flores Moreno I, Ruiz Moreno JM. Ocular hypertension as a cause of cilioretinal artery obstruction in the young patient, about a case. Arch Soc Esp Oftalmol (Engl Ed) 2020; 95:188-191. [PMID: 32143845 DOI: 10.1016/j.oftal.2020.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/21/2020] [Accepted: 01/23/2020] [Indexed: 06/10/2023]
Abstract
A 16-year-old patient seen in the Emergency Department due to loss of visual acuity (VA) in the left eye (LE), and oppressive headache of 1 day onset. The patient was on treatment with topical corticosteroids for viral conjunctivitis. The VA was 1.00 in the right eye and 0.05 in LE. The intraocular pressure was 42mmHg in both eyes. In the LE, the funduscopy revealed retinal ischaemic oedema in the papillomacular bundle. The optical coherence tomography angiography (OCT-A) showed an obstruction of the cilioretinal artery. The systemic study was normal, the cardiac and supra-aortic trunks ultrasound was normal, with ocular hypertension secondary to corticosteroids being the only causative agent identified. This case shows that in the event of an obstruction of the cilioretinal artery, a systemic study should be performed in order to identify possible embolic phenomena. Ocular hypertension is one of the possible causes that may be responsible for this condition.
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Affiliation(s)
- B Kudsieh
- Departamento de Oftalmología, Hospital Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España; Centro Internacional de Oftalmología Avanzada, Madrid, España.
| | - M Sánchez-Dehesa Sáez
- Departamento de Oftalmología, Hospital Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - I Flores Moreno
- Departamento de Oftalmología, Hospital Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España; Centro Internacional de Oftalmología Avanzada, Madrid, España
| | - J M Ruiz Moreno
- Departamento de Oftalmología, Hospital Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España; Departamento de Oftalmología, Universidad de Castilla-La Mancha, Albacete, España
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15
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Espinosa-Barberi G, Alba Linero C, Llorens Bellés V, Adán Civera A. Multimodal imaging and treatment of Purtscher-like retinopathy. Arch Soc Esp Oftalmol (Engl Ed) 2019; 94:45-49. [PMID: 30274765 DOI: 10.1016/j.oftal.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/14/2018] [Accepted: 07/17/2018] [Indexed: 06/08/2023]
Abstract
A 52-year-old patient with multiple cardiovascular risk factors referred for unilateral, acute, and painless visual loss. In the fundoscopic image there was significant papillary inflammation with tortuosity at this level and haemorrhages. Ophthalmological examination showed papillary inflammation, macular oedema, and involvement in retinal inner layers. The control fluorescein angiography and optical coherence tomography angiography showed areas of central and peripheral ischaemia. Given the clinical findings and background of the patient, the diagnosis of Purtscher-like retinopathy was reached and treatment with intravitreal dexamethasone was decided. Purtscher-like retinopathy is a rare entity that occurs in patients with multiple systemic pathologies, but without a traumatic background, which differentiates it from Purstcher's retinopathy. The diagnosis and early intervention are important in the prognosis. There are no therapeutic protocols, but good results have been obtained with intravitreal therapy with dexamethasone.
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Affiliation(s)
- G Espinosa-Barberi
- Servicio de Oftalmología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas, España; Escuela de Doctorado y Postgrado, Universidad de Las Palmas de Gran Canaria, Las Palmas, España.
| | - C Alba Linero
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, Barcelona, España
| | - V Llorens Bellés
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, Barcelona, España
| | - A Adán Civera
- Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, Barcelona, España
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Torrecillas-Picazo R, Cerdà-Ibáñez M, Almor Palacios I, Hervás Hernandis JM, Ramón-Cosín R, Ruiz Del Rio N, Duch-Samper A. Analysis and follow-up of type 1 choroidal neovascularisation with optical coherence tomography-angiography after antiangiogenic treatment. ACTA ACUST UNITED AC 2017; 92:265-272. [PMID: 28189273 DOI: 10.1016/j.oftal.2016.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 12/01/2016] [Accepted: 12/04/2016] [Indexed: 11/29/2022]
Abstract
AIM To describe the characteristics of type 1 choroidal neovascularisation (CNV) in age-related macular degeneration (ARMD) using two different optical coherence tomography angiography (OCT-A) devices sequentially during a standard protocol of three intravitreal injections of an anti-vascular endothelial growth factor (anti-VEGF). METHODS The study included 6 eyes with naïve neovascular ARMD. Macular OCT-A images were acquired using AngioPlex Cirrus HD-OCT 5000 (Carl Zeiss Meditec, Inc., Dublin, USA) and DRI OCT Triton SS-OCT Angio (Topcon, Medical Systems, Inc. Oakland, NJ, USA). The macular OCT-A scan covered an area of 3×3mm. Distinct morphological patterns and quantifiable features of the neovascular membranes were studied on en face projection images, which were taken at different stages of the follow-up. RESULTS Treatment response could be estimated using the OCT-A criteria of CNV activity. Higher activity scores before treatment resulted in a greater decrease in the membrane area. The estimated net decline in area ranged from 83.5% to 1.4%. The OCT-A performed one-week after treatment revealed the greatest area reductions. CONCLUSIONS OCT-A provides new possibilities for the non-invasive assessment of features of neovascular networks and CNV structural morphology. Newly described activity criteria can also guide therapeutic decisions, and help in evaluating responses. Quantitative and qualitative information can be provided with this technique. However, further software development and future investigation are essential to define the role of this tool on a daily basis.
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Affiliation(s)
- R Torrecillas-Picazo
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
| | - M Cerdà-Ibáñez
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - I Almor Palacios
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - J M Hervás Hernandis
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - R Ramón-Cosín
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - N Ruiz Del Rio
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - A Duch-Samper
- Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España
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Molina-Sócola FE, López-Herrero F, Medina-Tapia A, Rueda-Rueda T, Contreras-Díaz M, Sánchez-Vicente JL. Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis. ACTA ACUST UNITED AC 2016; 92:490-494. [PMID: 27956326 DOI: 10.1016/j.oftal.2016.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/16/2016] [Accepted: 10/17/2016] [Indexed: 12/01/2022]
Abstract
CASE REPORT A 36 year-old male with a recent HIV diagnosis, presented with loss of vision of his left eye. Ophthalmoscopy revealed a unilateral yellowish placoid lesion in the macula. After fluorescein angiography, optical coherence tomography, optical coherence tomography angiography, syphilis serology, and cerebrospinal fluid results, he was diagnosed with neurosyphilis and syphilitic posterior placoid chorioretinitis. DISCUSSION Acute syphilitic posterior placoid chorioretinitis is a rare ocular manifestation of syphilis. All patients with characteristic clinical and angiographic findings of acute syphilitic posterior placoid chorioretinitis should be tested for a neurosyphilis and human immunodeficiency virus co-infection. Early treatment with intravenous penicillin is usually effective with good visual results.
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Affiliation(s)
- F E Molina-Sócola
- Servicio de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - F López-Herrero
- Servicio de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - A Medina-Tapia
- Servicio de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - T Rueda-Rueda
- Servicio de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - M Contreras-Díaz
- Servicio de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J L Sánchez-Vicente
- Servicio de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, España
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