A 65-year-old man with diabetes and a history of fever of unknown origin 2 weeks earlier complained of sudden decreased vision in the left eye. The patient was diagnosed with bilateral West Nile virus (WNV) chorioretinitis associated with occlusive retinal vasculitis in the left eye. Swept-source optical coherence tomography angiography (SS-OCTA) of the left eye showed extensive, well-delineated, hypointense non-perfusion areas and perifoveal capillary arcade disruption in the superficial capillary plexus, as well as larger non-perfusion areas, capillary rarefaction, and diffuse capillary network attenuation and disorganization in the deep capillary plexus. OCTA may be a valuable tool for noninvasively assessing ...

BACKGROUND AND OBJECTIVE: To compare patterns of choroidal hypoperfusion in white dot syndromes (WDS) using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Consecutive patients with WDS were imaged with either the Zeiss AngioPlex OCT Angiography (Carl Zeiss AG, Oberkochen, Germany) or the AngioVue OCT Angiography (Optovue, Fremont, CA) from February to November 2016. Four patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE), birdshot chorioretinopathy (BCR), presumed ocular histoplasmosis syndrome (POHS), and multiple evanescent white dot syndrome (MEWDS) were selected. This study was approved by the institutional review board at Massachusetts Eye and Ear. RESULTS: Unique patterns of choroidal ...

Glaucoma management has undergone significant advancements in recent years. New minimally invasive surgical options have become available, filling in the gap between medical management and major surgeries such as trabeculectomy and tubes. On the diagnostic side, OCT technology has allowed a better understanding of the pathophysiology of glaucoma and more accurate monitoring of the effects of treatment, and has broadened the view to new imaging markers for progression. Glaucoma has opened up as a subspecialty to share areas of interest with other subspecialties and even other branches of medicine. “The life of a glaucoma specialist has become a lot busier ...

Optical coherence tomography angiography (OCTA) is a noninvasive, rapid imaging technique that generates angiographic images without intravenous dye injections. Cross-sectional studies have described the presence of asymptomatic choroidal neovascularization (CNV) in patients with intermediate age-related macular degeneration (AMD). This case report describes the OCT features on longitudinal follow-up of a patient who started with unilateral asymptomatic CNV and eventually developed symptomatic exudative AMD.

BACKGROUND AND OBJECTIVE: The quantification of the density of macular vascular networks and blood flow areas in the foveal and parafoveal area in healthy subjects using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Cross-sectional, prospective study in an institutional setting at the Retina Services of Farabi Eye Hospital. One hundred twelve normal volunteers with no known ocular or systemic disease were included, including patient numbers (one or both eyes), selection procedures, inclusion/exclusion criteria, randomization procedure, and masking. En face angiogram OCTA was performed on a 3 mm × 3 mm region centered on the macula. Automated thresholding and measuring ...

The authors present the case of a 59-year-old woman in treatment with interferon alfa-2b for stage IV melanoma and widespread metastases who presented with interferon-associated retinopathy. An ocular examination revealed multiple retinal cotton-wool spots and hard exudates. Interferon treatment was suspended. The patient was followed up for 5 months following the baseline visit by means of en face optical coherence tomography (OCT), spectral-domain OCT, and OCT angiography. Multimodal imaging was useful in the follow-up of this condition, permitting the characterization of all the lesions hallmarking the interferon-retinopathy and showing that this illness was related to a reduction of the retinal ...

Descriptive study of two patients affected by Susac's syndrome (SuS) focusing on the chronic retinal tissue damage assessed by optical coherence tomography (OCT) and OCT angiography (OCTA). To the authors' knowledge, this is the first case series reporting OCTA in SuS. OCTA imaging revealed secondary hypoxia due to branch retinal artery occlusion of the deep capillary plexus, with additional involvement of the superficial capillary network in one case. OCTA is a noninvasive and quick diagnostic tool for detecting hypoxic retinal damage in SuS. With further development of OCTA, as wide-field imaging, a better understanding of the retinal and choroidal ...

Venous loops are relatively rare manifestations of diabetic retinopathy. The authors describe a case characterized by the development of a venous loop during a 3-year period. Optical coherence tomography angiography (OCTA) revealed a hyperintense signal from the lesion, attesting an ordinary flow into the venous loop. OCTA also showed an area of capillary loss in proximity of the lesion, which is in agreement with the proposed pathogenesis for venous loops, developed to bypass an area of retinal vessels occlusion.

BACKGROUND AND OBJECTIVE: To compare capillary density (CD) changes assessed by optical coherence tomography angiography (OCTA) during diabetic retinopathy (DR) progression using three previously published methods: binarization, skeletonization, and automated flow density (AFD). PATIENTS AND METHODS: Retrospective study of 98 eyes of 74 patients with diabetes and 18 control eyes imaged using OCTA. The macular CD at each stage of DR was assessed using the three methods and were compared to control eyes. RESULTS: AFD was the only method that detected differences between controls and severe nonproliferative DR eyes. The three methods showed a significant difference in CD between controls ...

BACKGROUND AND OBJECTIVE: To assess the utility of swept-source optical coherence tomography (SS-OCT) in visualizing macular hole (MH) closure through gas-filled eyes on postoperative day (POD) 1 using a dual scanning protocol. PATIENTS AND METHODS: We examined 30 consecutive patients with full-thickness MH who underwent standard vitrectomy with SF6 (25%) gas tamponade between July 2015 and April 2016. SS-OCT imaging was performed using horizontal raster and 16-line radial scans with manual delicate focusing to evaluate MH closure status. RESULTS: On POD1, optically clear images with visualization of all retinal layers at the fovea were obtained in 80% of eyes, of ...

PURPOSE: To report a case of lenticule adherent to the anterior cap during small incision lenticule extraction (SMILE) and its subsequent management aided by anterior segment optical coherence tomography (AS-OCT). METHODS: Case report. RESULTS: A 24-year-old woman presented with high myopia of −8.00 −0.50 @ 180° in the right eye and −8.00 −0.25 @ 180° in the left eye and underwent SMILE. In the right eye, difficulty was experienced in separating the lenticule from adjacent stroma. AS-OCT examination confirmed the presence of the lenticule adherent to the anterior stromal cap with the plane of dissection visible posterior to ...

Optical coherence tomography (OCT) angiography is an important new imaging modality that is already being used by ophthalmologists in retina centers worldwide. It uses motion as intrinsic contrast, thus obviating the need to inject any intravenous dye. It uses infrared light that is invisible to the patient, and only requires few seconds per scan. This makes it both easier to use and much better tolerated by patients than traditional dye-based fluorescein angiography (FA) and indocyanine green (ICG) angiography. Inside Optical Coherence Tomography Angiography of the Eye Drs. David Huang, Bruno Lumbroso, Yali Jia, and Nadia Waheed include detailed information on ...

The role of optical coherence tomography (OCT) in characterizing normal and pathologic retinal architecture is still evolving. Numerous groups have tried to use OCT findings of retinal features as a surrogate for visual acuity in macular edema, but no traditional measure consistently accounts for visual outcomes. Retina specialists are still trying to process the data in the literature regarding this topic, as no good review currently exists. Dilraj S. Grewal, MD, and Glenn J. Jaffe, MD, provide us with an overview of the literature and focus on the role of disorganization of the retinal inner layers (DRIL) as an OCT ...

Optic disc melanocytoma (ODM) is a pigmented tumor with malignant potential characterized clinically as a dark brown to black lesion with feathery margins. The authors report a case of ODM and describe the utility of optical coherence tomography angiography (OCTA) in detecting superficial tumor vascularization. This case report demonstrated the ability of OCTA to reveal the fine abnormal retinal vasculature on the surface of the lesion, a characteristic of ODM, which has been previously correlated with tumor growth.

BACKGROUND AND OBJECTIVE: To evaluate the choriocapillaris using optical coherence tomographic angiography (OCTA) after half-dose verteporfin photodynamic therapy (hd-PDT) for chronic central serous chorioretinopathy (CSC). PATIENTS AND METHODS: We studied six eyes (six patients) with chronic CSC treated by hd-PDT. OCTA was performed before, 1 week after, and 1 month after hd-PDT. The area of flow abnormality at the choriocapillaris level within the PDT spot after hd-PDT was compared with that before hd-PDT. RESULTS: Serous retinal detachment was diminished in all eyes, with three achieving complete resolution at 1 month. On OCTA, all eyes showed irregular choriocapillaris flow before hd-PDT ...

PURPOSE: To describe the use of intraoperative optical coherence tomography (OCT) vault measurement in 5 cases of posterior chamber phakic intraocular lens (IOL) implantation. METHODS: This case series included 5 eyes in 3 consecutive patients undergoing phakic IOL implantation. RTVue OCT (Optovue, Inc., Fremont, CA) was used to obtain intraoperative vault measurements after pupil constriction. Visante OCT (Carl Zeiss Meditec, Jena, Germany) was used to obtain postoperative vault measurements. RESULTS: Intraoperative vault measurements ranged from 228 to 1,060 µ m. There were no postoperative complications. Postoperative OCT vault measurements ranged from 230 to 670 µ m. CONCLUSIONS: Intraoperative OCT can be ...

BACKGROUND AND OBJECTIVE: To determine the ultra-wide-field fundus autofluorescence (UWFFAF) and optical coherence tomography (OCT) features of syphilitic outer retinopathy (SOR). PATIENTS AND METHODS: Retrospective chart review. RESULTS: Three patients with SOR were investigated. Treatment with parenteral penicillin led to improvement of outer retinopathy, visual acuity, and symptoms. UWFFAF showed speckled hyperautofluorescence, hypoautofluorescence, and normal autofluorescence, similar to what has been described as a trizonal pattern in acute zonal occult outer retinopathy (AZOOR) in the chronic case of SOR, but with hyperautofluorescent areas in the two acute cases. OCT showed disruption of the photoreceptor outer segment ellipsoid zone and external ...

This is a report of microvascular changes seen on fluorescein angiography (FA) and optical coherence tomography angiography (OCTA) in a 47-year-old man with macular telangiectasia Type 1 (MacTel1) after a 7-year bevacizumab (Avastin; Genentech, South San Francisco, CA) treatment course. OCTA allowed for clear visualization of most telangiectasias and aneurysms in the deep capillary plexus, with only few microvascular dilatations in the superficial plexus. In addition, areas of capillary dropout in the superficial and deep vascular plexa located near telangiectasias were documented on OCTA. Serial FA demonstrated reduced number of aneurysms and telangiectasias at the 7-year mark compared to baseline.

BACKGROUND AND OBJECTIVE: To evaluate the feasibility and utility of a novel microscope-integrated intraoperative optical coherence tomography (OCT) system. PATIENTS AND METHODS: The DISCOVER study is an investigational device study evaluating microscope-integrated intraoperative OCT systems for ophthalmic surgery. This report focuses on subjects imaged with the EnFocus prototype system (Leica Microsystems/Bioptigen, Morrisville, NC). OCT was performed at surgeon-directed milestones. Surgeons completed a questionnaire after each case to evaluate the impact of OCT on intraoperative management. RESULTS: Fifty eyes underwent imaging with the EnFocus system. Successful imaging was obtained in 46 of 50 eyes (92%). In eight cases (16%), surgical ...

BACKGROUND AND OBJECTIVE: To evaluate subfoveal choroidal vascularity in eyes with myopia in comparison to age-matched healthy subjects. PATIENTS AND METHODS: Retrospective analysis of single foveal enhanced depth imaging optical coherence tomography (EDI-OCT) scans of 30 eyes with myopia (axial length greater than 25 mm). Subfoveal choroidal vascularity was evaluated by calculating vessel-area-to-stromal-area ratio using a previously validated automated algorithm. RESULTS: The subfoveal stromal area was significantly smaller in myopes (0.95 mm 3 ± 0.22 mm 3 ) compared to controls (1.33 mm 3 ± 0.23 mm 3 ; P < .0001). However, there was no significant difference in vascular area ...

“Macular degeneration is the most common and maybe the most complex choroidal retinal degeneration. It started to be understood in the 1960s, but it’s not that long ago that the sequence of the development of drusen and atrophy has been understood, in part,” Eric J. Sigler, MD, a retinal specialist, said here at SECO .

Optic nerve and macular optical coherence tomography can be helpful in distinguishing between glaucoma and glaucoma masqueraders, according to researchers. Researchers reported a case series of 4 patients and their spectral-domain OCT findings with retinal disease or nonglaucomatous optic neuropathy, who presented with suspected or previously diagnosed normal-tension glaucoma. The first patient was found to have marked diffuse retinal nerve fiber layer (RNFL) and macular thinning on OCT due to cancer-associated retinopathy, researchers wrote. The 76-year-old woman was referred after cataract surgery failed to relieve her symptoms of progressive vision loss. The second patient showed deep focal inferotemporal RNFL loss ...

BACKGROUND AND OBJECTIVE: To report a distinct optical coherence tomography (OCT) appearance of macular combined hamartoma of retina and retinal pigment epithelium (CHRRPE). \ PATIENTS AND METHODS: This is a retrospective case series of four eyes of four patients with macular CHRRPE who were assessed with the help of color fundus photographs, swept-source OCT (SS-OCT), and fundus fluorescein angiography wherever required. RESULTS: All four patients presented with decreased visual acuity. SS-OCT in all patients showed adherent epiretinal membrane (ERM) and localized thickening of underlying retina. An omega-shaped disorganization of inner retinal layers was seen bounded posteriorly by the outer plexiform layer ...