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Microvascular Capillary Plexus Findings of Commotio Retinae on Optical Coherence Tomography Angiography
摘要： Optical coherence tomography (OCT) and histopathology features of commotio retinae (CR) have been established, but alterations of the microvascular macular capillary plexus on OCT angiography (OCTA) has not been previously studied. We present a 46-year-old man who sustained a tennis ball injury to the right eye with visual acuity reduction to 20/30 and grey-white deep macular discoloration, suggestive of CR. Spectral-domain OCT (SD-OCT) showed increased reflectivity and thickness of the ellipsoid zone (junction of photoreceptor inner and outer segments). OCTA revealed no apparent microvascular alterations (right versus left eye) in the foveal avascular zone superficial (0.42 vs. 0.43 mm2) and deep (0.45 vs. 0.44 mm2), superficial foveal capillary density (34.1 vs. 32.6%), and superficial parafoveal capillary density (55.2 vs. 52.2%). Deep macular capillary plexus and choriocapillaris were qualitatively comparable between the two eyes. At 2 months’ follow-up, SD-OCT had normalized. CR is characterized by disruption of the ellipsoid zone without detectable alteration of the capillary plexuses.
关键词： Optical coherence tomography angiography,Commotio retinae,Berlin’s edema,Spectral-domain optical coherence tomography,Traumatic maculopathy
更新于2025-09-23 15:23:52
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Multimodal imaging and treatment of Purtscher-like retinopathy
摘要： 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 hemorrhages. Ophthalmological examination showed papillary inflammation, macular edema, and involvement in retinal inner layers. The control fluorescein angiography and optical coherence tomography angiography showed areas of central and peripheral ischemia. 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.
关键词： Purtscher flecken,Purtscher-like retinopathy,Purtscher retinopathy,Optical coherence tomography angiography,Optical coherence tomography
更新于2025-09-23 15:23:52
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Retinal vascular density evaluated by optical coherence tomography angiography in macular telangiectasia type 2
摘要： Purpose To evaluate the retinal and choroidal vascular changes through optical coherence tomography angiography (OCTA) in patients with macular telangiectasia type 2 (MacTel 2). Methods Our study included 20 patients (40 eyes) with MacTel 2, and age-matched and sex-matched 18 subjects (36 eyes) in the control group. Fundus color photographs, fundus autofluorescence, fundus fluorescein angiography, spectral-domain optical coherence tomography and OCTA were performed. Foveal vascular density and parafoveal vascular density (PFVD), and foveal retinal thickness and parafoveal retinal thickness, choroidal thickness (CT) and retinal ganglion cell–inner plexiform layer (GCIPL) were compared between MacTel 2 patients and normal age-matched controls. Results The retinal whole vascular density and PFVD of the deep plexus were significantly lower in patients with MacTel 2 than that of the control group (56.93% vs. 58.54%, p = 0.003; and 60.38% vs. 61.66%, p = 0.045). The foveal avascular zone (FAZ) of the deep plexus was significantly enlarged in patients with MacTel 2 than that of the control group (0.44 vs. 0.36, p = 0.009). There was a positive and statistically significant correlation between the FAZ of the superficial and deep plexus and CT in patients with MacTel 2. There was a positive and statistically significant correlation between retinal whole, parafoveal temporal quadrant vascular density of the superficial and deep plexus and GCIPL thickness in patients with MacTel 2. Conclusions Our study demonstrated that important retinal vascular density and FAZ changes in MacTel 2 occur in the deep capillary plexus of the retina.
关键词： Macular telangiectasia type 2,Vascular density,Choroidal thickness,Retinal ganglion cell–inner plexiform layer,Optical coherence tomography angiography
更新于2025-09-23 15:23:52
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Vascular and structural alterations of the choroid evaluated by optical coherence tomography angiography and optical coherence tomography after half-fluence photodynamic therapy in chronic central serous chorioretinopathy
摘要： Purpose To concurrently evaluate the effect of half-fluence photodynamic therapy (hf PDT) on choriocapillaris (CC) perfusion and choroidal structure in chronic central serous chorioretinopathy (CSC). Methods This prospective study included 48 eyes of 41 patients with chronic CSC. Enhanced depth imaging optical coherence tomography and optical coherence tomography angiography (OCTA) images were analyzed. Choroidal area (CA), luminal area (LA), and stromal area (SA) were computed using Image J software. Results One month after hf-PDT, total CA decreased to 1.312 mm2 from 1.490 mm2 (p < 0.001), LA decreased to 0.981 mm2 from 1.097 mm2 (p < 0.001), and SA decreased to 0.331 mm2 from 0.393 mm2 (p < 0.001). In OCTA, the CC flow in the eyes with CSC (17.75 mm2) was statistically significantly lower than the fellow eyes (18.93 mm2) at the baseline visit (p < 0.001). After hf-PDT, the flow in the choriocapillaris statistically significantly increased to 18.81 mm2 at the first month (p = 0.02). Conclusions OCTA proves that after hf-PDT a significant increase in CC perfusion occurred at first month. The decrease of the luminal areas in enhanced depth imaging optical coherence tomography is mainly due to a decrease in large-caliber vessels, which indicates that hf-PDT has an effect on larger choroidal vessels and spares CC flow.
关键词： Chronic central serous chorioretinopathy,Optical coherence tomography angiography,Half-fluence photodynamic therapy,Choriocapillaris perfusion
更新于2025-09-23 15:23:52
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Quantitative measurement of vascular density and flow using optical coherence tomography angiography (OCTA) in patients with central retinal vein occlusion: Can OCTA help in distinguishing ischemic from non-ischemic type?
摘要： Background: To evaluate microvascular changes and quantitative parameters in patients with central retinal vein occlusion (CRVO) by using optical coherence tomography angiography (OCTA) and finding difference between presumably ischemic and non ischemic CRVO. Methods: Patients with CRVO (31) and healthy control (20) were enrolled in this observational case control study. The OCTA was done for each patient and control subject. In macular area 2 images were taken for each eye (3 × 3 mm and 8 × 8 mm). The images were analyzed at three capillary plexuses (superficial and deep retinal capillary layers and choriocapillaris layer). Results: Thirty-one patients with CRVO (mean age 60.00 ± 13.72 years) and 20 healthy age/gender matched subjects (mean age 54.10 ± 12.33 years) were enrolled in this study (p = 0.095). The mean visual acuity of patients was 0.47 ± 0.54 LogMAR. Eyes with CRVO as compared with fellow eyes and control group showed significant reduction of flow in superficial (1.171 ± 0.262 vs. 1.362 ± 0.285 vs. 1.453 ± 0.105) and deep capillary plexus (1.042 ± 0.402 vs. 1.331 ± 0.315 vs. 1.526 ± 0.123) and choriocapillaris (1.206 ± 0.543 vs. 1.841 ± 0.308 vs. 1.966 ± 0.05) and vascular density in superficial (45.92 ± 4.2 vs. 50.99 ± 4.35 vs. 52.85 ± 2.99) and deep (48.03 ± 4.71 vs. 55.86 ± 3.81 vs. 58.2 ± 2.65) capillary plexuses. Some parameters (flow of both retinal capillary plexuses and parafoveal vascular density in deep plexus) showed significantly reduction in fellow eyes than control group. The parameters including flow [superficial (1.014 ± 0.264 vs. 1.279 ± 0.19) and deep (0.873 ± 0.442 vs. 1.152 ± 0.32) capillary plexuses and choriocapillaris (0.79 ± 0.327 vs. 1.424 ± 0.51)] and vascular density [superficial (44.24 ± 2.13 vs. 46.58 ± 4.13) and deep (45.28 ± 3.5 vs. 49.32 ± 3.94) capillary plexuses] were lower significantly in ischemic type than non ischemic CRVO. The most damaged parameter was flow in deep capillary plexus. The model with smallest Akaike information criterion and Bayesian information criterion was chosen as the best model. For easier calculation, we also calculated the reduced model. By choosing the threshold of 12.6, the formula [3.9 × F1S + 0.8 × F3S] can diagnose the presumably ischemic CRVO from non ischemic type with AUC of 0.84, sensitivity of 100% and specificity of 69%. (F1S: flow in the central 1 mm-radius-circle of superficial plexus and F3S: flow in the central 3 mm-radius-circle of superficial plexus). Conclusion and relevance: In CRVO patients, the OCTA can accurately evaluate changes in microvascular structures. It may help in differentiation ischemic CRVO from non-ischemic CRVO.
关键词： Ischemic,Non-ischemic,Central retinal vein occlusion,Optical coherence tomography angiography
更新于2025-09-23 15:23:52
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Optical Coherence Tomography Angiography of Optic Disc and Macula Vessel Density in Glaucoma and Healthy Eyes
摘要： Aim: To study the microvascular density of the macular and optic nerve head in healthy and glaucoma subjects using optical coherence tomography angiography. Methodology: We performed a cross-sectional cohort study on healthy subjects and patients with glaucoma. The AngioVue Enhanced Microvascular Imaging System was used to capture the optic nerve head and macula images during one visit. En face segment images of the macular and optic disc were studied in layers. Microvascular density of the optic nerve head and macula were quanti?ed by the number of pixels measured by a novel in-house developed software. Areas under the receiver operating characteristic curves (AUROC) were used to determine the accuracy of differentiating between glaucoma and healthy subjects. Results: A total of 24 (32 eyes) glaucoma subjects (57.5 ± 9.5-y old) and 29 (58 eyes) age-matched controls (51.17 ± 13.5-y old) were recruited. Optic disc and macula scans were performed showing a greater mean vessel density (VD) in healthy compared with glaucoma subjects. The control group had higher VD than the glaucoma group at the en face segmented layers of the optic disc (optic nerve head: 0.209 ± 0.05 vs. 0.110 ± 0.048, P < 0.001; vitreoretinal interface: 0.086 ± 0.045 vs. 0.052 ± 0.034, P = 0.001; radial peripapillary capillary: 0.146 ± 0.040 vs. 0.053 ± 0.036, P < 0.001; and choroid: 0.228 ± 0.074 vs. 0.165 ± 0.062, P < 0.001). Similarly, the VD at the macula was also greater in controls than glaucoma patients (super?cial retina capillary plexus: 0.115 ± 0.016 vs. 0.088 ± 0.027, P < 0.001; deep retina capillary plexus: 0.233 ± 0.027 vs. 0.136 ± 0.073, P < 0.001; outer retinal capillary plexus: 0.190 ± 0.057 vs. 0.136 ± 0.105, P = 0.036; and choriocapillaris: 0.225 ± 0.053 vs. 0.153 ± 0.068, P < 0.001. The AUROC was highest for optic disc radial peripapillary capillary (0.96), followed by nerve head (0.92) and optic disc choroid (0.76). At the macula, the AUROC was highest for deep retina (0.86), followed by choroid (0.84), super?cial retina (0.81), and outer retina (0.72). Conclusions: Microvascular density of the optic disc and macula in glaucoma patients was reduced compared with healthy controls. VD of both optic disc and macula had a high diagnostic ability in differentiating healthy and glaucoma eyes.
关键词： optical coherence tomography angiography,glaucoma,microvascular density
更新于2025-09-23 15:23:52
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Comparative Study of Optical Coherence Tomography Angiography and Phase-Resolved Doppler Optical Coherence Tomography for Measurement of Retinal Blood Vessels Caliber
摘要： Purpose: To compare the accuracy of Doppler optical coherence tomography (DOCT) and OCT angiography (OCTA) for measuring retinal blood vessel caliber at different flow rates. Methods: A research-grade 1060-nm OCT system with 3.5-lm axial resolution in retinal tissue and 92,000 A scan/s image acquisition rate was used in this study. DOCT and OCTA measurements were acquired both from a flow phantom and in vivo from retinal blood vessels in six male Brown Norway rats. The total retinal blood flow (TRBF) was modified from baseline to 70% and 20% of baseline by reducing the ocular perfusion pressure (OPP). The retinal blood vessel caliber (RBVC) was measured from OCTA and DOCT images. The caliber measurements were conducted by two separate graders using a custom MATLAB-based image processing algorithm. Results: The RBVC measured with OCTA and DOCT for normal blood flow rates were not significantly different (56.69 6 12.17 and 57.17 6 9.46 lm, P ? 0.27, respectively). However, significant differences were detected when TRBF was reduced to 70% (55.69 6 11.56 vs. 50.62 6 8.85 lm, P , 0.01) and 20% (50.29 6 9.29 vs. 44.88 6 7.13 lm, P , 0.01) of baseline. Conclusions: Reduced TRBF resulted in inaccuracy of the RBVC measurements with DOCT in both the phantom and animal study. This result suggests that OCTA is a more accurate tool for RBVC evaluation when applied to retinal diseases associated with reduced TRBF, such as glaucoma and diabetic retinopathy. Translational Relevance: Results from this study are directly applicable to clinical studies of retinal blood flow measured with OCTA and DOCT.
关键词： optical coherence tomography angiography,ocular perfusion pressure,retinal imaging,doppler optical coherence tomography
更新于2025-09-23 15:22:29
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Choroidal imaging biomarkers
摘要： The choroid is the vascular coat of the eye,and its role has been studied in multiple chorioretinal disorders. The recent advancements in choroidal imaging techniques including enhanced depth imaging optical coherence tomography (EDI-OCT), swept source (SS-OCT), enface OCT and OCT angiography have facilitated an in-depth analysis of choroid. The gradual shift from manual to automated segmentation and binarization methods have led to precise and reproducible measurements of choroidal parameters. These qualitative and quantitative parameters, called choroidal imaging biomarkers, have evolved over the past decade from a simple linear subfoveal choroidal thickness to more complex 3 dimensional (3-D) choroidal reconstruction thus widening the spectrum encompassing multiple parameters. These biomarkers have provided a better understanding of the pathogenesis, are helpful in diagnostic dilemmas, and in future may also help to devise treatment options. The lack of normative data, absence of standardized parameters and limitations of the imaging techniques, however, have led to ambiguity and difficulty in the interpretation of these variables. We attempt to address these lacunae in the literature and provide a basic understanding of the choroid in both health and disease using these choroidal biomarkers.
关键词： Optical coherence tomography angiography (OCTA),En-face OCT,Swept source optical coherence tomography (SS-OCT),Choroidal thickness,Choroidal vascularity index (CVI),Choroidal imaging biomarkers,Choroidal volume
更新于2025-09-23 15:21:21
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The Validity of Optical Coherence Tomography Angiography as a Screening Test for the Early Detection of Retinal Changes in Patients with Hydroxychloroquine Therapy
摘要： Purpose: The aim of this study was to quantitatively compare both the vessel density of macular capillary plexuses and the foveal avascular zone (FAZ) areas of patients receiving hydroxychloroquine (HCQ) therapy for more than 5 years while using age- and sex- matched controls. Methods: The patients undergoing HCQ who were screened for toxic effects were evaluated. The FAZ parameters included the area, perimeter, and the acircularity index. The foveal density and vessel density values of both the superficial (SCP) and deep capillary plexuses (DCP) were measured using optical coherence tomography angiography (OCTA). Results: This study included 80 eyes of 40 subjects: 20 subjects in the HCQ group and 20 subjects in the control group. The FAZ perimeter and the FAZ area in the SCP and full retinal vasculature were significantly larger in the HCQ group than in the control group (P < 0.05 for all). Additionally, the vessel density of fovea in the SCP and DCP was significantly lower in the HCQ group than in the control group (P < 0.05 for all). Conclusions: OCTA provides objective documentation about FAZ and vessel density features in patients using long-term HCQ therapy before toxicity begins, and it can be used as a screening tool for detecting early changes in the macula.
关键词： optical coherence tomography angiography,Chloroquine,foveal avascular zone,vessel density,hydroxychloroquine
更新于2025-09-23 15:21:21
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Efficacy of navigated focal laser photocoagulation in diabetic macular edema planned with en face optical coherence tomography versus fluorescein angiography
摘要： Aim To analyze the efficacy of navigated focal laser photocoagulation (FLP) of microaneurysms in diabetic macular edema (DME) planned using en face optical coherence tomography (OCT) as against fluorescein angiography (FA). Methods Twenty-six eyes of 21 DME patients (12 males, 9 females, 69.5 ± 12.3 years) with mean BCVA of 0.52 ± 0.44 LogMAR were included. En face OCT images of deep capillary plexus slab and FA images were used to plan FLP targeting of leaky microaneurysms. The primary outcome measures were central retinal thickness (CRT) and macular volume. The secondary outcome measure was best-corrected visual acuity (BCVA). Results The difference in the change of CRT and macular volume between en face OCT and FA-planned FLP after 1 month and at the end of follow-up was not statistically significant (p > 0.05), except for a higher CRT reduction in the en face OCT-planning group (p = 0.007) at the end of mean follow-up of 2.6 ± 0.9 months. There was no difference in BCVA change between the two planning options (p = 0.42). Conclusion En face OCT is a non-inferior alternative for FA in the planning of navigated FLP of microaneurysms in DME.
关键词： Navigated laser,Optical coherence tomography,Diabetic macular edema,Focal laser photocoagulation,Optical coherence tomography angiography,Fluorescein angiography,Microaneurysms
更新于2025-09-23 15:19:57