Journal articles: 'Retinal nonperfusion area'

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Díez-Sotelo, Marta, Maximino Abraldes, and Francisco Gómez-Ulla. "Multimodality Imaging Approach for Combined Central Retinal Vein and Artery Occlusion: The Role of Optical Coherence Tomography Angiography." Case Reports in Ophthalmology 10, no. 3 (December 4, 2019): 415–23. http://dx.doi.org/10.1159/000504127.

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Combined central retinal artery and vein occlusion is an uncommon vascular pathology that can cause severe and permanent visual impairment. Optical coherence tomography angiography (OCTA) is a newly available, noninvasive imaging technique that can potentially improve understanding of the structural and vascular implications and prognosis of this infrequent pathology. The present report describes the principal clinical findings in a case of combined central retinal artery and vein occlusion, as detected by the different imaging modalities available in a tertiary referral hospital. OCTA wide-field montage images identified an extensive area of nonperfusion on the macula with involvement of the entire retina at nearly 360°. We observed the most severe nonperfusion in the deep capillary plexus, while perfusion of the choriocapillaris was unaffected. Meanwhile, fluorescein angiography (FA) findings revealed a delay in perfusion rate with marked nonperfusion areas in the peripheral retina at 360°. We identified that the wide-field OCTA montage permitted visualization of a similar or wider peripheral retinal area compared with FA. Therefore, OCTA is potentially useful for assessment of the global retinal nonperfusion status at baseline and during follow-up, with the added advantage of being a noninvasive technique.

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Scarinci, Fabio, Monica Varano, and Mariacristina Parravano. "Retinal Sensitivity Loss Correlates with Deep Capillary Plexus Impairment in Diabetic Macular Ischemia." Journal of Ophthalmology 2019 (October 13, 2019): 1–8. http://dx.doi.org/10.1155/2019/7589841.

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Purpose. To assess retinal sensitivity and retinal morphologic changes of capillary nonperfused areas in diabetic macular ischemia. Methods. Observational cross-sectional study. Patients were examined at IRCCS—Bietti Foundation, Rome, Italy. Fourteen consecutive diabetic eyes showing outer retinal changes on spectral domain optical coherence tomography B-scan were included. Ten eyes of ten diabetic patients with normal outer retinal structure on SD-OCT were included as controls. All eyes underwent optical coherence tomography angiography (OCTA) and MP1 microperimetry. To explore the outer retina findings and localized areas of capillary nonperfusion at the superficial and deep capillary plexus, we used the Spectralis HRA + OCTA (Heidelberg Engineering, Heidelberg, Germany). The B-scans as either normal or having outer retinal disruption and the enface images at the level of the superficial and/or deep capillary plexus were evaluated to identify areas of capillary nonperfusion. Results. Fourteen eyes of 12 consecutive type 2 diabetic patients with outer retinal disruption on SD-OCT showed that areas of capillary nonperfusion of the deep capillary plexus were colocalized to areas of reduced retinal sensitivity. Conclusions. On optical coherence tomography angiography, areas of capillary nonperfusion of deep capillary plexus due to macular ischemia are associated with photoreceptor structural abnormalities and retinal sensitivity loss on microperimetry. This highlights that the health status of deep capillary plexus and not only the choroid is important to the oxygen requirements of the photoreceptors in patients with diabetic macular ischemia. Also, the anatomical and functional consequences of these findings might help to explore the efficacy of new therapy into the macular area in clinical practice.

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Pomytkina, N. V., E. L. Sorokin, and Y. E. Pashentsev. "Optical coherence tomography angiography in the study of retinal blood flow in pregnant women with diabetes." Fyodorov journal of ophthalmic surgery, no. 1 (March 20, 2021): 30–38. http://dx.doi.org/10.25276/0235-4160-2021-1-30-38.

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Purpose. To study retinal blood flow in pregnant women with diabetes using optical coherence tomography angiography (OCTA). Material and methods. 60 pregnant women were examined: 24 women had type 1 and 2 diabetes (T1D and T2D) and 36 healthy women with physiological pregnancy consisted the control group. Pregnant women with diabetes were examined in three trimesters of pregnancy, the control group – in the third trimester. OCTA imaging was performed using the RTVue XR Avanti OCT 6×6 mm Angio Retina scan protocols (Optovue, USA). The vascular density (VD), vascular density in the fovea (VDF), and foveal avascular zone (FAZ) area in the superficial capillary plexus were studied. Results. In the third trimester, VDF in pregnant women with diabetes was significantly less than in the control group, in the absence of differences in VD and FAZ area. VD was significantly lower, and FAZ area was significantly higher in pregnant women with diabetic retinopathy (DR) than in pregnant women with diabetes without DR. There were no significant differences in the values of blood flow parameters in the groups of pregnant women with diabetes, regardless of underwent them the laser coagulation of the retina. At analyzing the values of VD, VDF, FAZ area in pregnant women with diabetes in different trimesters of pregnancy, statistically significant differences were not observed. In 11 pregnant women with DR areas of retinal nonperfusion were revealed, which in 6 patients tended to expand during pregnancy. In 2 patients with T1D without DR in the third trimester areas of nonperfusion were identified. Conclusion. Obtained data have practical importance for the diagnosis of DR manifestations during pregnancy. OCTA is a valuable diagnostic method that allows non-invasive diagnostics of the presence of areas of retinal nonperfusion in the absence of ophthalmoscopic signs of DR in pregnant women with diabetes, as well as assess the state of areas of retinal nonperfusion during pregnancy in patients with DR. Key words: optical coherence tomography angiography, diabetic retinopathy, pregnancy.

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Sędziak-Marcinek, Bogumiła, Sławomir Teper, Elżbieta Chełmecka, Adam Wylęgała, Mateusz Marcinek, Mateusz Bas, and Edward Wylęgała. "Diabetic Macular Edema Treatment with Bevacizumab Does Not Depend on the Retinal Nonperfusion Presence." Journal of Diabetes Research 2021 (February 26, 2021): 1–15. http://dx.doi.org/10.1155/2021/6620122.

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This study evaluated the relationship between the retinal nonperfusion area (NPA) presence and the effectiveness of bevacizumab treatment (IVB) in patients with diabetic macular edema (DME). It also tested the prognostic usefulness of ultra-wide-field fluorescein angiography (UWFFA) and OptosAdvance software for diabetic retinopathy monitoring. Eighty-nine patients with DME with a macular central subfield thickness CST ≥ 250 μ m , with ( N = 49 eyes) and without ( N = 49 eyes) retinal NPA, underwent nine bevacizumab injections over 12 months. NPA distribution, leakage area distribution, microaneurysm (MA) count, macular CST, diabetic retinopathy severity, and best-corrected visual acuity (BCVA) were assessed. The results show that bevacizumab reduced the macular CST from 420 to 280 μm ( p < 0.001 ) and improved BCVA ( p < 0.001 ) by about 10 ETDRS letters in both groups of patients. Additionally, the therapy reduced total retinal NPA from 29 (14-36) mm2 to 12 (4-18) mm2 (Me (Q1-Q3); p < 0.001 ) in patients with diagnosed nonperfusion. The effect of the therapy measured with vascular leakage, MA count, BCVArelative, and CSTrelative strongly depended on the zone of the retina and the NPA distribution. We conclude that the bevacizumab treatment had a positive effect on DME and BCVA in both study groups and on the size of retinal NPA in patients with retinal nonperfusion.

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Kim, Yoon Jeon, Joon Hyung Yeo, Gisung Son, Hyojoo Kang, Yu Sub Sung, Joo Yong Lee, June-Gone Kim, and Young Hee Yoon. "Efficacy of intravitreal AFlibercept injection For Improvement of retinal Nonperfusion In diabeTic retinopathY (AFFINITY study)." BMJ Open Diabetes Research & Care 8, no. 1 (October 2020): e001616. http://dx.doi.org/10.1136/bmjdrc-2020-001616.

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IntroductionTo evaluate the effects of intravitreal aflibercept injection on retinal nonperfusion in patients with diabetic retinopathy (DR) using ultrawide field (UWF) fluorescein angiography (FA).Research design and methodsThirty-eight eyes of 38 consecutive patients with DR and substantial retinal nonperfusion (nonperfusion index (NPI): nonperfused/total gradable area >0.2) without macular edema were included in this prospective case series. Monthly injections of 2 mg aflibercept were given for 6 months. UWF-fundus photography and UWF-FA images were acquired at baseline, 6 months, and 12 months and evaluated by 2 masked, independent graders for the extent of retinal nonperfusion and vascular leakage. Twenty untreated fellow eyes were analyzed as controls.ResultsInter-grader agreement was strong (r=0.875) for NPI measurements. NPI was 0.46±0.10 at baseline; NPI was decreased to 0.43±0.08 (p=0.015) after 6 monthly injections of aflibercept and then slightly increased to 0.44±0.09 (p=0.123) after 6 months of observation. Vascular leakage also significantly decreased by 21.0% at 6 months (p=0.010). Untreated fellow eyes did not show significant changes in NPI and vascular leakage during follow-up. Reduction in retinal nonperfusion was associated with severe nonproliferative diabetic retinopathy (NPDR) (vs PDR, OR 19.119, p=0.025) and higher leakage index (per 0.1, OR 15.152, p=0.020).ConclusionsIntensive aflibercept treatment was effective in reducing retinal capillary nonperfusion in patients with DR without macular edema. Severe NPDR and profound vascular leakage were significantly associated with retinal reperfusion after aflibercept treatment.Trial registration numberNCT03006081.

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Ra, Ho, Jae Hyun Park, Jin Uk Baek, and Jiwon Baek. "Relationships among Retinal Nonperfusion, Neovascularization, and Vascular Endothelial Growth Factor Levels in Quiescent Proliferative Diabetic Retinopathy." Journal of Clinical Medicine 9, no. 5 (May 13, 2020): 1462. http://dx.doi.org/10.3390/jcm9051462.

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Purpose: To investigate the relationships among the retinal nonperfusion (NP) area, neovascularization (NV) area, and aqueous humor vascular endothelial growth factor (VEGF) levels in quiescent proliferative diabetic retinopathy (PDR). Methods: Forty-seven eyes from 47 patients with treatment-naïve PDR that did not show macular edema or vitreous hemorrhage were enrolled. NP area, NV number, and NV area were quantitatively measured using ultra-widefield fluorescein angiography in an automated manner. Aqueous humor VEGF level was measured using a bead assay. Results: The NP areas of the total, posterior pole, peripheral retinae, and NV area positively correlated with each other (all p < 0.034). NV number correlated with total NP area, peripheral NP area, and NV area (all p ≤ 0.001). VEGF levels were significantly positively correlated with total, posterior polar, and peripheral NP areas and NV area (r = 0.575, 0.422, 0.558, and 0.362, respectively; all p ≤ 0.012). In eyes with NV in the disc area, the VEGF level was higher compare to eyes without NV in the disc area (208.89 ± 192.77 pg/mL vs. 103.34 ± 132.66, p = 0.010). A multiple linear regression model using NP area, NV area, and NVD demonstrated good prediction for VEGF level (R2 = 0.417, p < 0.001) and revealed a significant contribution of the peripheral NP area in predicting the VEGF level (β = 0.497, p = 0.002). Conclusions: Aqueous humor VEGF levels in quiescent PDR eyes were associated with NP and NV areas, which had positive correlations with each other. In addition, the NP area of the peripheral retina was the most important predictor of VEGF level.

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Pomytkina, N. V., E. L. Sorokin, and Y. E. Pashentsev. "Study retinal blood flow in pregnant women with diabetes mellitus and gestational diabetes mellitus." Modern technologies in ophtalmology, no. 3 (July 15, 2021): 344–48. http://dx.doi.org/10.25276/2312-4911-2021-3-344-348.

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Purpose. To study retinal blood flow in pregnant women with diabetes mellitus and gestational diabetes mellitus using optical coherence tomography angiography (OCTA). Material and methods. 203 pregnant women in the third trimester were examined: 24 – with type 1 and 2 diabetes mellitus (T1DM and T2DM), 143 – with gestational diabetes mellitus (GDM), and 36 apparently healthy women with physiological pregnancy, who consisted the control group. OCTA imaging was performed using the RTVue XR Avanti OCT 6 mm × 6 mm "Angio Retina" scan protocols (Optovue, USA). The whole image vessel density (wiVD), foveal vessel density (FVD), and foveal avascular zone (FAZ) area in the superficial capillary plexus were studied. Results. FVD in pregnant women with diabetes mellitus was significantly less than in pregnant women with GDM and in the control group, in this connection, it can be assume changes of the retinal microvascular regulation because of chronic disturbances of carbohydrate metabolism in such patients and due to microangiopathy development. FAZ area extension and wiVD diminution were revealed in patients with diabetic retinopathy (DR) compared to datas of the group of pregnant women with diabetes mellitus and absence of DR, in the absence of differences in FVD indexes. In 2 patients with T1D and the absence of ophthalmoscopic signs of DR, OCTA revealed areas of nonperfusion in the posterior pole of the eye. Conclusions. A significant FVD decrease in the superficial capillary plexus was revealed in pregnant women with diabetes mellitus, compared with pregnant women with GDM and healthy women with physiological pregnancy in the absence of significant difference in wiVD in the superficial capillary plexus and FAZ area. Patients with DR showed an expansion of FAZ area and decrease in wiVD in the superficial capillary plexus relative to the group of pregnant women with diabetes mellitus without DR. OCTA helps to identify areas of retinal nonperfusion in the posterior pole of the eye in pregnant women with diabetes in the absence of ophthalmoscopic signs of DR. Keywords: optical coherence tomography angiography, pregnancy, diabetic retinopathy, gestational diabetes, foveal avascular zone, retinal blood flow.

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Singer, Michael, Colin S. Tan, Darren Bell, and Srinivas R. Sadda. "AREA OF PERIPHERAL RETINAL NONPERFUSION AND TREATMENT RESPONSE IN BRANCH AND CENTRAL RETINAL VEIN OCCLUSION." Retina 34, no. 9 (September 2014): 1736–42. http://dx.doi.org/10.1097/iae.0000000000000148.

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Collins, Lauren F., Jessica G. Shantha, Peter L. Nesper, Anandi N. Sheth, Amani A. Fawzi, Steven Yeh, and Ighovwhera Ofotokun. "949. Use of Optical Coherence Tomography Angiography to Assess Microvascular Health Among Persons with HIV: Employing the Retina as a Convenient Window." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S507. http://dx.doi.org/10.1093/ofid/ofaa439.1135.

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Abstract Background Mechanisms underlying the rising burden of non-AIDS comorbidities (NACM) among persons with HIV (PWH) remain unclear. Microvasculopathy may link HIV-related chronic inflammation and premature multimorbidity, similar to diabetes and other conditions characterized by inflammatory end-organ damage. We used a novel retinovascular imaging tool, optical coherence tomography angiography (OCTA), to evaluate the retina as a convenient assessment of microvascular health among PWH. Methods Data from 4 PWH who underwent OCTA (Zeiss CIRRUSTM HD-OCT 5000) at the Emory Eye Center from 2018-2020 were analyzed. Demographics, HIV-specific indices and NACM were summarized at the time of OCTA. Images were reviewed qualitatively and metrics of microvascular health – the foveal avascular zone (FAZ) area and vessel density (VD) from the superficial capillary plexus (SCP) – were calculated by ImageJ. Results The median age was 39 years, 100% were male, 100% were black, 25% had ever smoked, and median body mass index was 25.4 kg/m2. Median time since HIV diagnosis was 19 years, all patients had a history of clinical AIDS, including 2 with prior cytomegalovirus retinitis. Median current CD4 count was 84 cells/mm3, 100% were prescribed antiretroviral therapy and 50% had HIV viral suppression. Prevalent NACM included (each n=1): hypertension, dyslipidemia, diabetes, chronic kidney disease and asthma. Qualitatively, all 7 of the eyes evaluated by OCTA had evidence of microvascular pathology: 2 eyes demonstrated diffuse capillary nonperfusion, while the remaining 5 eyes had focal areas of nonperfusion around the FAZ. Mean FAZ area was 0.31 (SD±0.10) mm2 and mean VD of the SCP was 43.9% (SD±10.9%). Retinovascular pathology identified by fundoscopy and OCTA is shown in the figure. Figure. Retinal imaging of a PWH with bilateral retinal vasculitis. Fundus photos of the right (A) and left (C) eyes show retinal vasculitis highlighted by the red arrows. OCTA of the right (B) and left (D) maculae (3X3 scan Zeiss AngioplexTM) show the FAZ areas outlined in yellow, both of irregular contour. OCTA of the left macula demonstrates areas of significant flow voids marked by the asterisks and the FAZ area is enlarged. Conclusion Among patients with longstanding HIV, OCTA identified microvascular abnormalities in all retinae examined. Retinovascular evaluation by OCTA is a feasible, non-invasive technique for assessing microvascular health and findings support additional study in a larger, more diverse group of PWH. Screening tools targeting microvasculopathy among PWH may aid in earlier detection of those at greatest risk of NACM and allow for aggressive risk-modification strategies. Disclosures All Authors: No reported disclosures

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Hida, Yoshifumi, Shinsuke Nakamura, Anri Nishinaka, Yuki Inoue, Masamitsu Shimazawa, and Hideaki Hara. "Effects of ripasudil, a ROCK inhibitor, on retinal edema and nonperfusion area in a retinal vein occlusion murine model." Journal of Pharmacological Sciences 137, no. 2 (June 2018): 129–36. http://dx.doi.org/10.1016/j.jphs.2018.06.010.

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Min, Ji Won, Hyung Duk Kim, Sang Yoon Park, Jun Hyuk Lee, Jae Hyun Park, Anna Lee, Ho Ra, and Jiwon Baek. "Relationship Between Retinal Capillary Nonperfusion Area and Renal Function in Patients With Type 2 Diabetes." Investigative Opthalmology & Visual Science 61, no. 14 (December 14, 2020): 14. http://dx.doi.org/10.1167/iovs.61.14.14.

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Huang, Jianfeng, Yingyi Lu, Xiaoya Gu, Bodi Zheng, and Tong Chen. "Correlation between the Nonperfusion Area on Ultra-Widefield Fluorescein Angiography and Nonflow Area on Optical Coherence Tomographic Angiography in Retinal Vein Occlusion." Journal of Ophthalmology 2021 (April 30, 2021): 1–6. http://dx.doi.org/10.1155/2021/5581319.

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Aims. To compare the relationship between the nonperfusion area (NPA) on ultra-widefield fluorescein angiography (UWFFA) and the nonflow area (NFA) on optical coherence tomographic angiography (OCTA) in retinal vein occlusion (RVO). Methods. Cross-sectional study. 46 eyes of 46 RVO patients who underwent UWFFA and OCTA. NPA and ischemic index (ISI) were quantified on UWWFA. NFA, vessel density (VD) of the superficial capillary plexus (SCP), the deep capillary plexus (DCP), and the size foveal avascular zone (FAZ) on 3 ∗ 3 mm OCTA were measured. The association of the NPA and ISI on UWWFA and the parameters on OCTA were analyzed. Spearman correlation was used for statistical testing. Results. The NPA and ISI on UWFFA were significantly correlated with the NFA on OCTA in RVO, and r values were 0.688 ( p < 0.01 ) and 0.680 ( p < 0.01 ), respectively. VD in the SCP of the temporal quadrant was negatively correlated with NPA and ISI, and r values were −0.346 ( p < 0.05 ) and −0.337 ( p < 0.05 ), respectively. VD in the DCP of the temporal quadrant was negatively correlated with the NPA, and the r value was −0.246 ( p < 0.05 ). No significant correlation was found between the NPA and ISI on UWFFA and VD of other quadrants in the SCP or DCP and the FAZ area on OCTA. Conclusion. NPA in the peripheral retina was correlated with NFA in macula. NFA detected by OCTA could be an indicator of the ischemic status in RVO.

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Ruppert, Misty, John Pyun, K. V. Chalam, and David Sierpina. "Multimodal Imaging Characteristics of ADRP in a Family with p.Thr58Arg Substituted RHO Mutation." Case Reports in Genetics 2020 (December 2, 2020): 1–9. http://dx.doi.org/10.1155/2020/8860863.

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Background. Autosomal dominant retinitis pigmentosa (adRP) is a rare cause of progressive visual impairment in young patients and is frequently a result of RHO gene mutations. p.Thr58Arg rhodopsin mutation leads to misfolding of rhodopsin, subsequent accumulation in the endoplasmic reticulum, and leads to consecutive atrophy of photoreceptor cells through apoptosis. Materials and Methods. We describe multimodal imaging findings in a 58-year-old female with adRP due to a c.173 C > G, p.Thr58Arg rhodopsin mutation (confirmed on genotyping), including ultra-wide-field fundus autofluorescence (UWF-FAF), color scanning laser ophthalmoscopy, structural optical coherence tomography (OCT), OCT-angiography (OCT-A), electroretinography (ERG), and visual field testing (HVF). Additionally, we compare the patient’s phenotypic findings to those of her offspring, who was also affected by adRP. Results. The 58-year-old female and her son with symptoms of nyctalopia and decreased vision showed macular pigmentary changes in a bull’s-eye pattern along with bone spicules in periphery with retinal atrophy. Genotyping confirmed p.Thr58Arg rhodopsin mutation. Wide area of dystrophic retina was noted on UWF-FAF, along with corresponding atrophy of photoreceptor layer on OCT. OCTA revealed complete nonperfusion of the superficial capillary plexus in areas of retinal dystrophy. ERG revealed increased latency and decreased amplitudes; HVF revealed constriction of visual fields consistent with retinal findings. Conclusions. Multimodal imaging is extremely helpful in delineating the extent of retinal dystrophy and comparable to ERG for monitoring of progress in retinitis pigmentosa. Photoreceptor layer thickness (measured with OCT) strongly correlated with ERG and can be used as a secondary surrogate for monitoring the disease progress.

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Matsuoka, Takanori, Kazunobu Asao, Noriyasu Hashida, and Kohji Nishida. "Chronic Retinal Necrosis Severely Complicated by Neovascular Glaucoma: A Case Report." Case Reports in Ophthalmology 8, no. 3 (October 26, 2017): 489–95. http://dx.doi.org/10.1159/000480724.

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Background: Chronic retinal necrosis (CRN) is a rare chronic granular necrotizing retinitis that was first described in 2013. CRN is characterized by intraocular inflammation accompanied by occlusive vasculitis, granular retinitis, and slowly progressing necrosis around the retina in a host with partial immune dysfunction. Cytomegalovirus (CMV) is reported to be a causative agent. There are several ocular complications such as retinal detachment and neovascular glaucoma; however, there has been no description of a clinical manifestation of neovascular glaucoma in CRN. We herein present a case of severe neovascular glaucoma in association with CRN. Case Presentation: An 80-year-old man was referred to our hospital with poor control of inflammation and intraocular pressure (IOP). The IOP in his left eye was 29 mm Hg. Anterior chamber cells (2+) and keratic precipitates were observed. In the peripheral retina, vitreous opacities and granular necrotizing retinitis were noticed. Fluorescein angiography revealed extensive retinal nonperfusion area from the macula lesion to the periphery. PCR analysis of aqueous humor showed the presence of CMV. A diagnosis of CRN was made soon afterwards. Antiviral drug and systemic corticosteroid were administered. The treatment temporally resolved the symptom; however, panretinal photocoagulation and intravitreal injection of bevacizumab were performed to treat iris neovascularization. During the follow-up, trabeculectomy was performed because of poor IOP control. At the final visit, severe uncontrolled neovascular glaucoma caused hyphema, and his left eye lost light perception. Conclusion: The prognosis of CRN is poor because of severe neovascular glaucoma and careful observation and active treatments are necessary.

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McAllister, Ian L., Mei H. Tan, Lynne A. Smithies, and Wan L. Wong. "The Effect of Central Retinal Venous Pressure in Patients with Central Retinal Vein Occlusion and a High Mean Area of Nonperfusion." Ophthalmology 121, no. 11 (November 2014): 2228–36. http://dx.doi.org/10.1016/j.ophtha.2014.05.031.

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Moriya, Takeshi, Ryosuke Ochi, Yukihiro Imagawa, Bumpei Sato, Seita Morishita, Masahiro Tonari, Masanori Fukumoto, et al. "A Case of Uveal Colobomas Showing Marked Left-Right Difference in Diabetic Retinopathy." Case Reports in Ophthalmology 7, no. 1 (March 24, 2016): 167–73. http://dx.doi.org/10.1159/000445248.

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Purpose: Congenital uveal colobomas, including inferior iris and choroidal colobomas, are associated with microcornea and microphthalmia and often show left-right differences (laterality). The purpose of this study was to report a case of choroidal coloboma associated with left-right differences in diabetic retinopathy (DR). Case: This study reports a 59-year-old male with bilateral iris and choroidal colobomas. The colobomatous area in the patient's right eye extended to the macula, and his right eye had been amblyopic since birth. The colobomatous area in his left eye was less extensive and did not involve the macula. Examination of the patient's left eye revealed multiple hemorrhages and hard exudates in the macula due to DR, but examination of his right eye showed almost no changes in DR, thus revealing a marked left-right difference. Optical coherence tomography showed more extensive retinal thinning in the patient's right eye than in his left eye. Fluorescein fundus angiography revealed a retinal nonperfusion area only in the left eye, and panretinal photocoagulation was subsequently performed. Conclusion: Our findings show that the reason for the left-right difference in DR was attributed to the more severe choroidal coloboma and retinal thinning in the patient's right eye compared to his left eye, thus reducing oxygen demand, as is also seen in eyes with severe myopia.

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Kobayashi, Takatoshi, Chihiro Katsumura, Hiromi Shoda, Nanae Takai, Sayako Takeda, Takako Okamoto, Koichi Maruyama, et al. "A Case of Syphilitic Uveitis in Which Vitreous Surgery Was Useful for the Diagnosis and Treatment." Case Reports in Ophthalmology 8, no. 1 (January 26, 2017): 55–60. http://dx.doi.org/10.1159/000455910.

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Purpose: To report a case of atypical syphilitic uveitis complicated with retinal vasculitis, proliferative retinopathy, and vitreous hemorrhage in which vitreous surgery was useful for the diagnosis and treatment. Case Report: A 38-year-old female was referred to our hospital after noticing visual disturbance in her right eye. Fundoscopy examination of that eye revealed retinal phlebitis accompanied by retinal hemorrhage and soft exudate, and remarkable exudative changes in the retinal vessels from the upper arcade to the macula region. After a blood examination, a serological test showed positive for syphilis; however, systemic findings were scarce. Syphilitic uveitis was suspected, so we administered treatment for syphilis, anticoagulant treatment for retinal vasculitis, steroids for intraocular inflammation, and photocoagulation for the retinal nonperfusion area. However, her visual acuity (VA) decreased to 30 cm/counting fingers due to vitreous hemorrhage resulting from fibrovascular membrane at the optic disc. Since the vitreous hemorrhage was insufficiently absorbed, vitreous surgery was performed to remove the hemorrhage and fibrovascular tissue. Following surgery, the uveitis and retinal vasculitis subsided, and her corrected VA improved to 0.3. Postoperative examination of a fixed quantity of collected vitreous fluid for syphilis showed a Treponema pallidum hemagglutination value of 5,120 times the normal amount, thus confirming the syphilitic uveitis diagnosis. Conclusions: Our findings show that when observing patients with obstructive retinal vasculitis of unknown causes, syphilitic uveitis should be considered as a differential diagnosis, and that vitreous surgery is useful for the diagnosis and treatment of atypical syphilitic uveitis which has progressed to proliferative retinopathy.

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Gozawa, Makoto, Yoshihiro Takamura, Seiji Miyake, Takehiro Matsumura, Masakazu Morioka, Yutaka Yamada, and Masaru Inatani. "Photocoagulation of the Retinal Nonperfusion Area Prevents the Expression of the Vascular Endothelial Growth Factor in an Animal Model." Investigative Opthalmology & Visual Science 58, no. 13 (November 1, 2017): 5646. http://dx.doi.org/10.1167/iovs.17-22739.

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Somkijrungroj, Thanapong, Sritatath Vongkulsiri, Wijak Kongwattananon, Peranut Chotcomwongse, Sasivarin Luangpitakchumpol, and Korrawan Jaisuekul. "Assessment of Vascular Change Using Swept-Source Optical Coherence Tomography Angiography: A New Theory Explains Central Visual Loss in Behcet’s Disease." Journal of Ophthalmology 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/2180723.

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Objective. To evaluate retinal vascular structural change in ocular Behcet’s using optical coherence tomography angiography (OCTA) and fluorescein angiography (FA). Methods. An analytic cross-sectional study of 37 eyes of 21 Behcet’s uveitic patients was performed. Foveal retinal thickness (FRT), perifoveal hypoperfusion areas in superficial capillary plexus (SCP), and deep capillary plexus (DCP) were measured with swept-source optical coherence tomography and OCTA. FA images were used for assessing the vascular features and correlation. Results. Twenty-one patients were enrolled (52.4% males). The average age at onset was 36.7 ± 12.93 years. The median of disease duration was 5 years (1–25). FRT was 118.1 ± 52.35 μm, which correlated with visual acuity (95% CI −60.47, −13.92). Using OCTA, the area of hypoperfusion in SCP (0.47 ± 0.17 mm2) was smaller than that in DCP (1.94 ± 3.87 mm2) (p<0.001). Superficial to deep capillary plexus nonperfusion (SCP : DCP) ratio was 0.57 ± 0.27 which had the positive coefficient correlation with visual acuity (95% CI −0.644, −0.015). Conclusions. OCTA is an alternative noninvasive method to monitor macular ischemia in Behcet. Behcet’s uveitis affects DCP more than SCP. Decreasing SCP : DCP ratio and decrease FRT correlates with poor visual acuity. Macular ischemia and DCP loss can be found early and can explain vision loss in Behcet.

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Kimura, Masayo, Miho Nozaki, Munenori Yoshida, and Yuichiro Ogura. "Wide-field optical coherence tomography angiography using extended field imaging technique to evaluate the nonperfusion area in retinal vein occlusion." Clinical Ophthalmology Volume 10 (July 2016): 1291–95. http://dx.doi.org/10.2147/opth.s108630.

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Nagasato, Daisuke, Hitoshi Tabuchi, Hiroki Masumoto, Hiroki Enno, Naofumi Ishitobi, Masahiro Kameoka, Masanori Niki, and Yoshinori Mitamura. "Automated detection of a nonperfusion area caused by retinal vein occlusion in optical coherence tomography angiography images using deep learning." PLOS ONE 14, no. 11 (November 7, 2019): e0223965. http://dx.doi.org/10.1371/journal.pone.0223965.

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Liu, Zheng-Feng, Xiao-Yan Zhang, Xue-Mei Pan, Rui-Xue Zhang, Hong-Sheng Bi, and Ying Wen. "Short-term effects of intravitreal Conbercept injection combined with laser photocoagulation on macular edema secondary to ischemic retinal vein occlusion." International Journal of Ophthalmology 14, no. 5 (May 18, 2021): 732–36. http://dx.doi.org/10.18240/ijo.2021.05.14.

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AIM: To observe changes in the best-corrected visual acuity (BCVA), central macular thickness (CMT), and central choroidal thickness (CCT) of patients with macular edema (ME) secondary to ischemic retinal vein occlusion (iRVO) following intravitreal Conbercept injection. METHODS: This retrospective study included 33 eyes from 33 patients who received intravitreal injections of Conbercept for ME secondary to iRVO. Treatments were performed on a 3+pro re nata (3+PRN) basis. All of the patients were examined by fundus fluorescein angiography and spectral domain optical coherence tomography at the first visit. Laser photocoagulation was performed in the nonperfusion area of the retina of all eyes after the first injection. BCVA, CMT, and CCT were observed before and after 6mo of treatment. The number of injections necessary to achieve improved vision was also noted. RESULTS: Following Conbercept treatment, the mean BCVA significantly improved from 0.81±0.39 at baseline to 0.41±0.25 and 0.43±0.29 logMAR in the third and sixth months, respectively (both P=0.000). The CMT of the patients at baseline was 556.75±98.57 μm; 304.78±68.53 and 306.85±76.77 μm 3 and 6mo after treatment, respectively (both P=0.000 vs baseline). The CCTs of the patients at baseline, 3 and 6mo after treatment were 304.63±57.83, 271.31±45.53, and 272.29±39.93 μm, respectively (P=0.026 and 0.035 vs baseline). No severe adverse event relevant to the therapy was noted, and the average number of injections delivered was 3.35. CONCLUSION: Intravitreal Conbercept injection combined with laser photocoagulation appears to be a safe and effective treatment for ME secondary to iRVO in the short-term.

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Egorov, A. V., O. V. Kolenko, V. V. Egorov, and G. P. Smoliakova. "Prospects modern pharmacotherapy in postoperative rehabilitation of patients after endovitreal surgery of rhegmatogenous retinal detachment." Fyodorov journal of ophthalmic surgery, no. 2 (July 15, 2021): 19–24. http://dx.doi.org/10.25276/0235-4160-2021-2-19-24.

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Purpose. To assess increasing the functional effectiveness of the results of endovitreal surgery in patients with rhegmatogenous retinal detachment (RRD) by using modern pharmacotherapy drug in the postoperative rehabilitation. Materials and methods. 108 people (108 eyes) with RRD. All patients underwent standard three-port vitrectomy, after which tamponade of the vitreous cavity with silicone oil with its removal 3 months after operation was performed. Patients were divided into 2 groups: the first – 60 people who received Cytoflavin on the background of standard therapy, and the second – 48 people with postoperative treatment only with standard therapy. Depending on the visual prognosis calculated before the operation, both groups were represented patients with satisfactory (A subgroup) and low (B subgroup) visual prognosis. Laser Doppler fluometry (LDF) was used to study chorioretinal microcirculation: microcirculation index and microcirculation efficiency index were recorded. Using OCT angiography (OCT-A), signs of macular ischemia were investigated: choroidal thickness, area nonperfusion of foveal avascular zone, density in the superficial capillary plexuses and density in the deep capillary plexuses in the macular area. Results. The inclusion of Cytoflavin in the postoperative rehabilitation of patients with RRD increases the possibility of a favorable functional outcome of the operation, affects the positive dynamics in the state of the capillary plexus in the macula. In the aggregate of patients of the 1st group, the increase in visual acuity was 2 times higher than in patients of the 2nd group 6 months after surgery. Also, in patients of the 1st group there was a more significant activation of chorioretinal blood flow according to LDF and OCT-A. Conclusion. The prescription of Cytoflavin in the postoperative treatment of patients underwent endovitreal surgery of RRD, regardless of the visual prognosis, increases the functional outcome of the operation. Improvement in visual functions in patients receiving Cytoflavin therapy is directly related to improved intraocular blood flow and macular perfusion. Keywords: rhegmatogenous retinal detachment, chorioretinal microcirculation, ocular hemodynamics, Laser Doppler fluometry, optical coherence tomography angiography, Cytoflavin.

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Khodzhaev, N. S., A. V. Sidorova, and M. A. Eliseeva. "Micropulse Transscleral Cyclophotocoagulation in the Combine Treatment of Neovascular Glaucoma." GlaucomaNews, no. 1 (January 20, 2020): 71–75. http://dx.doi.org/10.25276/2227-8281-1-71-75.

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Introduction. Neovascular glaucoma (NVG) is one of the most prognostically unfavorable forms of the glaucomatous process. The leading pathogenetic mechanism for the development of NVH is hypoxia of the inner layers of the retina, leading to the development of endothelial vascular growth factors (VEGF), which induce neovascular proliferation. In the presence of newly formed vessels in the corner of the anterior chamber, the use of traditional surgical methods for treating glaucoma is limited. That is why the search for a new pathogenetically oriented methods for the treatment of NVH is still acute issue in ophthalmology. Purpose. To evaluate the preliminary results of combined treatment, including intraocular introduction of anti-VEGF therapies (ranibizumab) and micropulse cyclophotocoagulation, in patients with secondary neovascular glaucoma. Materials and methods. The study included 15 patients (15 eyes) with secondary neovascular glaucoma. The value of intraocular pressure (IOP) before surgery ranged from 28 to 44 mm Hg. (average 36.3 ± 4.4 mm Hg), the number of hypotensive drops was 3.5 ± 0.5. The combine treat of patients including the intraocular administration of a VEGF inhibitor (ranibizumab) and through 7-14 days transscleral diode-laser cyclophotocoagulation in micropulse mode on the device «Cyclo G6 Glaucoma Laser System» (IRIDEX, USA) with a laser power of 2000 mW, an exposition of 160 s (80 s in each hemisphere) and a duty cycle of 31.3%. Results. All treatment procedures were performed without complications. By 6 months of follow-up, the average IOP level was 26.9 ± 3.3 mm Hg, the number of hypotensive drops was reduced to 2.7 ± 0.7 drugs. By 1 month of observation, a decrease in the number of newly formed vessels of the iris was achived in all patients. According to ultrasound biomicroscopy, the thickness of the ciliary body (CT) before treatment was on average 0.58 ± 0.14 mm. By 6 months of follow-up, no cases of postoperative atrophy of CT was diagnosed, the thickness of the CT was on average 0.53 ± 0.11 mm. According to the data of optical coherence tomography in the angiography mode, in all cases there was a positive dynamic in 1 month after combined treatment - a significant decrease in macular edema, the area of the retinal nonperfusion zone and the number of newly formed vessels. Conclusion. Combined treatment of patients with secondary neovascular glaucoma, including intraocular introduction of anti-VEGF therapies and micropulse cyclophotocoagulation, is an effective and safe method for reducing IOP.

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Madhusudhan, Savitha, and Nicholas Beare. "Wide-Field Fluorescein Angiography in Wet Age-Related Macular Degeneration." Scientific World Journal 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/536161.

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Purpose. The aim of our study was to investigate if peripheral retinal ischaemia contributed to the pathogenesis of neovascular AMD (NvAMD), using wide-field fluorescein angiography (WFFA).Methods. This prospective study included 30 consecutive patients with newly diagnosed NvAMD in the index eye. Wide-field colour fundus images and fluorescein angiograms were obtained using P200C optomap FA and analysed using a grid with three concentric circles of 50°, 100°, and 200° centred on the fovea to define zones Z1, Z2, and Z3.Results. Areas of peripheral retinal nonperfusion were seen in 2 (7%) eyes, peripheral vascular leakage in 5 (17%) eyes, and diffuse dye leakage close to the ora in 5 (17%) eyes. A total of one-third of the study eyes showed changes on WFFA in Z2 and Z3. On comparing index eyes to nonindex eyes in these patients, the presence of NvAMD was associated with peripheral FA changes (P=0.009, Fisher’s test).Conclusion. Frank peripheral retinal non-perfusion does not appear to be associated with NvAMD. In some patients with active NvAMD there is degradation of the peripheral blood-retina barrier. Smoking was also found to be associated with the above-mentioned abnormalities.

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Kaya, Mahmut, Taylan Ozturk, Ziya Ayhan, Nilufer Kocak, and Suleyman Kaynak. "Cilioretinal Artery Occlusion Combined with Central Retinal Vein Occlusion: What Is the Best Imaging Modality for the Follow-Up?" Case Reports in Ophthalmological Medicine 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/9032576.

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We report retinal structural changes of a 37-year-old man diagnosed with the concomitant occlusion of cilioretinal artery and central retinal vein. Comprehensive ophthalmological evaluation was performed, followed by spectral-domain optical coherence tomography (SD-OCT, Heidelberg), optical coherence tomography angiography (OCT angiography, Optovue Inc., Fremont, California, USA), fluorescein angiography, and color fundus photography. The use of OCT angiography and en face SD-OCT imaging as an adjunct test to map out correlative paracentral scotomas during follow-up allowed us to evaluate cilioretinal artery occlusion in the best way due to obtaining satisfactory images of the normal retinal vascular networks and areas of nonperfusion and congestion at various retinal levels.

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Jiramongkolchai, Kim, Tin Yan Alvin Liu, and J. Fernando Arevalo. "Peripheral Retinal Neovascularization with Vitreous Hemorrhage in HIV Retinopathy." Case Reports in Ophthalmology 8, no. 2 (June 16, 2017): 353–57. http://dx.doi.org/10.1159/000477161.

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We report a case of peripheral retinal neovascularization and vitreous hemorrhage in the setting of HIV retinopathy that can serve to extend the clinical spectrum of this condition. A 53-year-old African-American woman with AIDS was referred for decreased vision in the left eye and was found to have peripheral retinal neovascularization and vitreous hemorrhage. She had a workup that was negative for etiologies of retinal ischemia. Peripheral laser photocoagulation was used to treat areas of nonperfusion. To our knowledge, this is the first reported case of peripheral retinal neovascularization and vitreous hemorrhage in the setting of HIV retinopathy, and it can serve to extend the clinical spectrum of this condition.

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Kuehlewein, Laura, Lin An, Mary K. Durbin, and SriniVas R. Sadda. "Imaging Areas of Retinal Nonperfusion in Ischemic Branch Retinal Vein Occlusion With Swept-Source OCT Microangiography." Ophthalmic Surgery, Lasers and Imaging Retina 46, no. 2 (February 1, 2015): 249–52. http://dx.doi.org/10.3928/23258160-20150213-19.

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Wang, Hao, Yongye Chang, Fen Zhang, Rong Yang, Suxia Yan, Jieying Dong, Minglian Zhang, and Shaomin Peng. "Clinical Features of Combined Central Retinal Artery and Vein Occlusion." Journal of Ophthalmology 2019 (October 9, 2019): 1–7. http://dx.doi.org/10.1155/2019/7202731.

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Purpose. To describe the clinical features of combined central retinal artery and vein occlusion (CCRAVO). Methods. This retrospective study included 33 admitted patients (33 eyes) who had CCRAVO. Clinical data, such as age, gender, best-corrected visual acuity (BCVA), intraocular pressure (IOP), findings on fundus color photography and fundus fluorescein angiography (FFA), and information about follow-up, were collected and analyzed. Results. The age of the patients with CCRAVO ranged from 22 to 78 years, with a mean of 48.8 ± 14.1 years. At presentation, BCVA of the involved eyes ranged from no light perception (NLP) to 20/20. In addition, 45.5% (15/33) of the eyes had BCVA of finger counting (FC) or below, whereas 12.1% (4/33) had BCVA of 20/60 or above. The IOP was lower in the involved eyes than in the fellow eyes (15.0 ± 3.0 mmHg vs. 16.4 ± 2.3 mmHg, p=0.03). Ophthalmoscopic examination showed changes in both central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO), including retinal hemorrhage, retinal ischemic whitening, optic disc hyperemia and/or edema, venous dilation and tortuosity, cotton wool spot (CWS), and Roth’s spot. FFA showed prolonged arm-to-retina time (ART) and retinal arteriovenous passage time (RAP) (17.1 ± 4.9 s and 12.1 ± 8.8 s, respectively). Capillary nonperfusion (CNP) was seen in 21 eyes (63.6%), and in 14 (42.2%) of these, CNP was larger than 10 disc areas. At 2 to 3 weeks after presentation, BCVA improved in 23 eyes (71.9%) and further deteriorated in 5 eyes (15.6%). Retinal ischemic whitening improved in more than half of the eyes, whereas retinal hemorrhage increased in nearly half of the eyes. Follow-up ranged from 6 to 56 months. Seven patients were lost to follow-up. At final follow-up, six eyes had a visual acuity of 20/60 or greater, but 6 eyes had FC or worse. Four eyes developed neovascularization on follow-up. Conclusion. CCRAVO is a sight-threatening entity. Manifestations of CRAO and CRVO can be seen simultaneously in the early stage of disease, and CRVO may play a more important role in the development of CCRAVO.

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Mastropasqua, Rodolfo, Rossella D’Aloisio, Paulo Eduardo Stanga, and Richard Haynes. "Multiple Therapy Approach for Stage 3 Coats Disease: Long-Term Follow-Up." Journal of Ophthalmology 2020 (October 26, 2020): 1–5. http://dx.doi.org/10.1155/2020/8840630.

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Purpose. To assess long-term efficacy of a multiple therapy approach in the treatment and management of unilateral stage 3 Coats disease with exudative retinal detachment. Methods. 2 eyes of 2 young patients suffering from unilateral stage 3 Coats disease underwent a multiple therapy approach consisting of surgical drainage of exudative subretinal fluid + one simultaneous and up to one subsequent intravitreal injection of bevacizumab + multiple (up to 3) laser photocoagulation sessions of retinal nonperfusion areas and leaking Coats vasculature. Results. Complete reabsorption of SRF and retinal reattachment were observed in both cases over the follow-up. In no cases, we observed progression to phthisis bulbi. No bevacizumab-related complications were observed. Epiretinal membrane onset was detected in one eye at the end of follow-up. Conclusion. The management and treatment of this rare and degenerative disease in young subjects are still a challenge. The described technique is less invasive than conventional intraocular surgery and may be preferable to halt the devastating progression of the disease.

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Spaide, Richard F. "PROSPECTIVE STUDY OF PERIPHERAL PANRETINAL PHOTOCOAGULATION OF AREAS OF NONPERFUSION IN CENTRAL RETINAL VEIN OCCLUSION." Retina 33, no. 1 (January 2013): 56–62. http://dx.doi.org/10.1097/iae.0b013e3182641875.

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Toto, Lisa, Rossella D'Aloisio, Antonio Maria Chiarelli, Luca Di Antonio, Federica Evangelista, Giada D'Onofrio, Arcangelo Merla, Mariacristina Parravano, Guido Di Marzio, and Rodolfo Mastropasqua. "A Custom-Made Semiautomatic Analysis of Retinal Nonperfusion Areas After Dexamethasone for Diabetic Macular Edema." Translational Vision Science & Technology 9, no. 7 (June 11, 2020): 13. http://dx.doi.org/10.1167/tvst.9.7.13.

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Unoki, Noriyuki, Kazuaki Nishijima, Atsushi Sakamoto, Mihori Kita, Daisuke Watanabe, Masanori Hangai, Tetsushi Kimura, Naoaki Kawagoe, Masahumi Ohta, and Nagahisa Yoshimura. "Retinal Sensitivity Loss and Structural Disturbance in Areas of Capillary Nonperfusion of Eyes with Diabetic Retinopathy." American Journal of Ophthalmology 144, no. 5 (November 2007): 755–60. http://dx.doi.org/10.1016/j.ajo.2007.07.011.

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Spaide, Richard F. "PERIPHERAL AREAS OF NONPERFUSION IN TREATED CENTRAL RETINAL VEIN OCCLUSION AS IMAGED BY WIDE-FIELD FLUORESCEIN ANGIOGRAPHY." Retina 31, no. 5 (May 2011): 829–37. http://dx.doi.org/10.1097/iae.0b013e31820c841e.

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Terui, Takayuki, Mineo Kondo, Tadasu Sugita, Yasuki Ito, Nagako Kondo, Ichiro Ota, Kensaku Miyake, and Hiroko Terasaki. "CHANGES IN AREAS OF CAPILLARY NONPERFUSION AFTER INTRAVITREAL INJECTION OF BEVACIZUMAB IN EYES WITH BRANCH RETINAL VEIN OCCLUSION." Retina 31, no. 6 (June 2011): 1068–74. http://dx.doi.org/10.1097/iae.0b013e31820c83c2.

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Kaneko, Yuichiro, Muka Moriyama, Shuichiro Hirahara, Yuichiro Ogura, and Kyoko Ohno-Matsui. "Areas of Nonperfusion in Peripheral Retina of Eyes With Pathologic Myopia Detected by Ultra-Widefield Fluorescein Angiography." Investigative Opthalmology & Visual Science 55, no. 3 (March 10, 2014): 1432. http://dx.doi.org/10.1167/iovs.13-13706.

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Amato, Alessia, Francesco Nadin, Federico Borghesan, Maria Vittoria Cicinelli, Irini Chatziralli, Saena Sadiq, Rukhsana Mirza, and Francesco Bandello. "Widefield Optical Coherence Tomography Angiography in Diabetic Retinopathy." Journal of Diabetes Research 2020 (November 24, 2020): 1–10. http://dx.doi.org/10.1155/2020/8855709.

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Purpose. To summarize the role of widefield optical coherence tomography angiography (WF-OCTA) in diabetic retinopathy (DR), extending from the acquisition strategies to the main clinical findings. Methods. A PubMed-based search was carried out using the terms “Diabetic retinopathy”, “optical coherence tomography angiography”, “widefield imaging”, and “ultra-widefield imaging”. All studies published in English up to August 2020 were reviewed. Results. WF-OCTA can be obtained with different approaches, offering advantages over traditional imaging in the study of nonperfusion areas (NPAs) and neovascularization (NV). Quantitative estimates and topographic distribution of NPA and NV are useful for treatment monitoring and artificial intelligence-based approaches. Curvature, segmentation, and motion artifacts should be assessed when using WF-OCTA. Conclusions. WF-OCTA harbors interesting potential in DR because of its noninvasiveness and capability of objective metrics of retinal vasculature. Further studies will facilitate the migration from traditional imaging to WF-OCTA in both the research and clinical practice fields.

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KADOMOTO, SHIN, YUKI MURAOKA, AKIHITO UJI, RYOSUKE TAMIYA, YASUYUKI ORITANI, KENTARO KAWAI, SOTARO OOTO, TOMOAKI MURAKAMI, YUKO IIDA-MIWA, and AKITAKA TSUJIKAWA. "NONPERFUSION AREA QUANTIFICATION IN BRANCH RETINAL VEIN OCCLUSION." Retina Publish Ahead of Print (October 19, 2020). http://dx.doi.org/10.1097/iae.0000000000002999.

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Zina, Sourour, Imen Ksiaa, Chiraz Abdelhedi, Hager Ben Amor, Sonia Attia, Sana Khochtali, and Moncef Khairallah. "Multimodal imaging in IRVAN syndrome presenting with Branch Retinal Artery Occlusion." European Journal of Ophthalmology, October 23, 2020, 112067212096549. http://dx.doi.org/10.1177/1120672120965492.

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Purpose: To describe multimodal imaging ﬁndings in a patient with idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome presenting with branch retinal artery occlusion (BRAO). Case description: A 33-year-old woman presented with acute BRAO in the right eye. A diagnosis of underlying IRVAN syndrome was made based on the presence of arteriolar aneurysms on the optic disc and along major arterioles and faint retinal hard exudates in both eyes. Eight months later, best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. The hard exudates had increased, and there were extensive areas of peripheral retinal capillary nonperfusion without new vessels. Optical coherence tomography (OCT) showed a localized retinal thinning corresponding to the prior BRAO. Fundus autofluorescence showed nodulo-linear periarterial hypoautofluorescence. OCT angiography (OCTA) showed localized ischemic changes, mainly involving the deep capillary plexus, corresponding to the area of resolved BRAO. It also clearly delineated the optic disc aneurysms. The patient received bilateral scatter laser photocoagulation directed to areas of peripheral capillary nonperfusion. Over a 6-month follow-up period, visual acuity remained unchanged, and there was no evidence of disease progression. Conclusion: Multimodal imaging, including fundus autofluorescence, OCT, and OCTA can provide additional valuable information in the evaluation of IRVAN syndrome complicated with BRAO.

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Iida-Miwa, Yuko, Yuki Muraoka, Yuto Iida, Sotaro Ooto, Tomoaki Murakami, Kiyoshi Suzuma, and Akitaka Tsujikawa. "Branch Retinal Vein Occlusion: Treatment Outcomes According to the Retinal Nonperfusion Area, Clinical Subtype, and Crossing Pattern." Scientific Reports 9, no. 1 (April 25, 2019). http://dx.doi.org/10.1038/s41598-019-42982-5.

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Tang, Ziqi, Ximei Zhang, Guangqian Yang, Guanghua Zhang, Yubin Gong, Ke Zhao, Juan Xie, et al. "Automated segmentation of retinal nonperfusion area in fluorescein angiography in retinal vein occlusion using convolutional neural networks." Medical Physics, December 23, 2020. http://dx.doi.org/10.1002/mp.14640.

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Flores, Rita. "Analysis of Retinal Nonperfusion Area and Ganglion Cell Layer Thickness in Branch Retinal Vein Occlusion by OCT-Angiography." JOJ Ophthalmology 6, no. 4 (April 16, 2018). http://dx.doi.org/10.19080/jojo.2018.06.555693.

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Yang, Jingyuan, Bilei Zhang, Erqian Wang, Song Xia, and Youxin Chen. "Ultra-wide field swept-source optical coherence tomography angiography in patients with diabetes without clinically detectable retinopathy." BMC Ophthalmology 21, no. 1 (May 1, 2021). http://dx.doi.org/10.1186/s12886-021-01933-3.

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Abstract Background To investigate alterations in retinal microvasculature in eyes with preclinical diabetic retinopathy (DR) using ultra-wide field swept-source optical coherence tomography angiography (UWF SS OCTA). Methods Prospective cross-sectional study. Fifty-five eyes of 30 diabetic patients without clinical retinal signs were included. All subjects underwent OCTA examination with a 12 × 12 mm2 field of view of 5 visual fixations (1 central fixation and 4 peripheral fixations) to compose a UWF OCTA image. In the UWF images, the central area corresponded to the original central image obtained using central fixation, and the peripheral area was the remaining area. Lesions, including nonperfusion areas (NPAs), microvascular dilation and tortuosity, and neovascularization (NV), were recorded in different areas. Diabetes history was also recorded. Results Peripheral areas presented significantly more microvascular dilation and tortuosity than central areas (P = 0.024) and more NPAs than central areas, with borderline significance (P = 0.085). The number of lesion types was associated with HbA1c levels in the peripheral and overall areas (all P values < 0.001). Conclusions UWF SS OCTA is a promising imaging method for detecting vascular alterations in diabetic eyes without clinical signs to reveal retinal microvascular alterations. These alterations were correlated with systemic conditions.

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Choi, Kwang-Eon, Cheolmin Yun, Jaehyung Cha, and Seong-Woo Kim. "OCT angiography features associated with macular edema recurrence after intravitreal bevacizumab treatment in branch retinal vein occlusion." Scientific Reports 9, no. 1 (October 2, 2019). http://dx.doi.org/10.1038/s41598-019-50637-8.

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Abstract We aimed to evaluate the relationship between the capillary abnormalities including nonperfusion area (NPA) in optical coherence tomography angiography (OCTA) images and the recurrence of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) after intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF; bevacizumab). The records of 40 patients who underwent intravitreal bevacizumab injection for ME secondary to BRVO and had at least six months of follow-up were reviewed. Central retinal thickness (CRT; μm) and macular edema type were evaluated prior to treatment. After ME resolution, nonperfusion areas in the 1 mm (NPA1) and 1–3 mm (NPA3) zones on the Early Treatment Diabetic Retinopathy Study (ETDRS) circle within the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured using OCTA images. Furthermore, other microvascular abnormalities in the both SCP and DCP were compared between groups. ME recurred in 25 of 40 (62.5%) eyes. The NPA1 of the SCP and DCP (p = 0.002, 0.004, respectively), NPA3 of the SCP and DCP (p = 0.002, 0.008, respectively), and initial CRT (p = 0.022) differed significantly between eyes with and without ME recurrence. In multivariate logistic regression analyses, the NPA1 of the DCP (OR: 344.718; p = 0.029) and NPA3 of the SCP (OR: 4.072; p = 0.018) were significantly associated with ME recurrence. Other microvascular abnormalities were not significantly different between two groups. The central NPA and parafoveal NPA of the SCP in OCTA images correlated strongly with ME recurrence in BRVO patients after intravitreal anti-VEGF injection.

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UĞURLU, NAGİHAN, AYŞE GÜZİN TAŞLIPINAR UZEL, AHMET ŞENGÜN, FATMA YÜLEK, DEMET ÖZDAŞ, ABBAS ALİ TAM, REYHAN ERSOY, and BEKİR ÇAKIR. "Evaluation of the correlation between quantitative measurement of the foveal avascular zone and retinal vessel density and outer retinal disruptions in diabetic patients." TURKISH JOURNAL OF MEDICAL SCIENCES, March 28, 2019. http://dx.doi.org/10.3906/sag-1901-22.

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Aim: The aim of the current study was to evaluate the correlation between the integrity of the outer retinal layers on optical coherence tomography (OCT) and objective parameters of retinal microvascular perfusion on optical coherence tomography angiography (OCTA). Method: 105 eyes of 54 diabetic patients were included in to the study. Integrity of the outer retinal layers including the external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ) were assessed by spectral-domain optical coherence tomography (SD-OCT). The foveal avascular zone (FAZ) area and vessel density (VD) measurements in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in all the Early Treatment Diabetic Retinopathy Study (ETDRS) sectors were evaluated by OCTA. Association between the quantitative measurement of the foveal avascular zone and retinal vessel density measurements and outer retinal disruptions were evaluated. Results: FAZ area was correlated with outer retinal layer disruption at both in the superficial plexus (r = 0.244, 0.228, 0.212, p = 0.013, 0.02, 0.031 for the ELM, EZ and IZ respectively) and deep capillary plexus (r = 0.298, 0.234, 0.197, p = 0.002, 0.019, 0.048 for the ELM, EZ and IZ respectively). A significant relationship was also found between the VD measurements in the SCP and DCP in ETDRS sectors and the outer retinal layers disruption. Conclusion: The result of the current study shows a significant relationship between the quantitative OCTA parameters and the integrity of the outer retinal layers and. This finding reveals a correlation between retinal capillary nonperfusion and outer retinal disruption in eyes with diabetic retinopathy. Key Words: Outer retinal disruption, external limiting membrane, ellipsoid zone, interdigitation zone, foveal avascular zone, superficial capillary plexus, deep capillary plexus, optical coherence tomography angiography

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Kim, Kiyoung, Eung Suk Kim, and Seung-Young Yu. "Longitudinal changes in retinal microvasculature after panretinal photocoagulation in diabetic retinopathy using swept-source OCT angiography." Scientific Reports 11, no. 1 (January 8, 2021). http://dx.doi.org/10.1038/s41598-020-80697-0.

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AbstractThis study evaluated quantitative changes in microvascular parameters after panretinal photocoagulation (PRP) in diabetic retinopathy (DR), using swept-source OCT Angiography (SS-OCTA). A total of 27 treatment-naïve eyes were subjected to PRP and followed-up for > 12 months after the procedure. Foveal avascular zone (FAZ) area, macular perfusion density (PD), and vessel length density (VLD) were calculated on a 3 × 3 mm en face OCTA image and nonperfusion area (NPA) was obtained on a 12 × 12 mm en face OCTA image. One month after PRP, PD and VLD of superficial and deep capillary plexus decreased and subsequently, increased progressively across the next 12 months, with statistically significant differences (P = 0.015 and 0.02). Continuous decreasing trends in total NPA values was observed across 12 months after PRP (P = 0.125). A difference in PD of the superficial capillary plexus between baseline and 6 months post PRP, was significantly associated with the progression of DR, 12 months after PRP (OR 0.528; P = 0.025). We found significant longitudinal retinal microvascular changes after PRP in DR. Overall macular perfusion status was impaired and progressively recovered across the next 12 months, compared to the baseline. Additionally, the early treatment responses in PD can predict the long-term outcomes of PDR after PRP.

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Kim, Kiyoung, Eung Suk Kim, and Seung-Young Yu. "Longitudinal changes in retinal microvasculature after panretinal photocoagulation in diabetic retinopathy using swept-source OCT angiography." Scientific Reports 11, no. 1 (January 8, 2021). http://dx.doi.org/10.1038/s41598-020-80697-0.

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AbstractThis study evaluated quantitative changes in microvascular parameters after panretinal photocoagulation (PRP) in diabetic retinopathy (DR), using swept-source OCT Angiography (SS-OCTA). A total of 27 treatment-naïve eyes were subjected to PRP and followed-up for > 12 months after the procedure. Foveal avascular zone (FAZ) area, macular perfusion density (PD), and vessel length density (VLD) were calculated on a 3 × 3 mm en face OCTA image and nonperfusion area (NPA) was obtained on a 12 × 12 mm en face OCTA image. One month after PRP, PD and VLD of superficial and deep capillary plexus decreased and subsequently, increased progressively across the next 12 months, with statistically significant differences (P = 0.015 and 0.02). Continuous decreasing trends in total NPA values was observed across 12 months after PRP (P = 0.125). A difference in PD of the superficial capillary plexus between baseline and 6 months post PRP, was significantly associated with the progression of DR, 12 months after PRP (OR 0.528; P = 0.025). We found significant longitudinal retinal microvascular changes after PRP in DR. Overall macular perfusion status was impaired and progressively recovered across the next 12 months, compared to the baseline. Additionally, the early treatment responses in PD can predict the long-term outcomes of PDR after PRP.

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Nicholson, Luke, Clara Vazquez-Alfageme, Piyali Sen, Namritha V. Patrao, Tunde Peto, Yit Yang, Sobha Sivaprasad, and Philip G. Hykin. "The clinical relevance of ultra-widefield angiography findings in patients with central retinal vein occlusion and macular oedema receiving anti-VEGF therapy." Eye, May 25, 2021. http://dx.doi.org/10.1038/s41433-021-01553-7.

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Abstract Aims To report, using ultra-widefield angiography (UWFA) the area, distribution, and change in retinal capillary nonperfusion (RCNP) at baseline and 100 weeks in eyes with central retinal vein occlusion (CRVO) receiving anti-VEGF for macula oedema. Methods Prospective longitudinal multi-centre cohort study. Adults with CRVO treated with anti-VEGF therapy for macular oedema underwent UWFA at baseline and week-100. The area, distribution, and change in total, peripheral and posterior pole RCNP were determined. Results Of 153 eyes at baseline, mean area of RCNP was 34.3DA and 12 (7.8%) had ≥75DA RCNP. More than 10DA RCNP was present in the temporal periphery in 75.8% of eyes vs. 10.5% in the nasal periphery. At week-100, mean RCNP was 42.1DA with a median change from baseline of 3.3DA 95% CI [0.4, 7.3]; p < 0.01. Of 146 eyes with ≤10DA of posterior pole RCNP at baseline, 16/146 (11.0%) progressed to >10DA at week-100. These eyes had a median increase in total RCNP of 69.7DA [95% CI 27.2–85.4] vs 0DA [0.0–1.4]; p < 0.001 for those who did not, and two developed neovascular glaucoma. Larger baseline area of RCNP and history of glaucoma were risk factors for posterior pole RCNP developing. Conclusions With UWFA, significant baseline RCNP was identified in the majority of CRVO patients, notably in the temporal periphery, but large increases over 100 weeks were uncommon. Development of >10DA posterior pole RCNP is a marker for widespread RCNP and in such cases the risk of anterior segment neovascularisation is not abolished by concomitant anti-VEGF therapy.

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"Wide Field Imaging and Angiography." Güncel Retina Dergisi (Current Retina Journal), January 1, 2017, 32–37. http://dx.doi.org/10.37783/crj-0007.

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The recently developed wide-field imaging systems (WIS) enable 200 degrees imaging of retina by just one shot and angiographic and autofluorescence imaging of retinal periphery. In addition to facilitating the detection of retinal pathologies, WIS revealed the importance of lesions in retinal periphery and peripheral nonperfusion areas invisible by standard angiography. The novel finding of utmost importance for diabetic retinopathy (DR) patients was the 3 fold increased risk of progression assessed for peripheral DR lesions compared to that in the posterior pole. Detection of peripheral nonperfusion areas in DR or retinal vein occlusion cases with refractory macular edema altered the management approach. On the other hand by means of WIS new terms have been brought into the era like peripheral vascular leakage whose relevance and importance are unknown for retinal vascular diseases. In age-related macular degeneration, a disease known to affect the macula, WIS proved the effect on peripheral retina documented by both angiographies and also peripheral autofluorescence. In diseases known to affect peripheral retina like uveitis, degenerative myopia, etc. WIS further contributes to the detection of additional pathologies. WIS enabled documentation of retinal periphery and thus seems to change the treatment modality and probably clinical classification of unknown or treatment-refractory pathologies in retinal diseases where we mainly focused on macula always.

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Wei, Puying, Chenchen Liu, Yanzhen Zhang, and Liu Yang. "Evaluation of retinal sensitivity and microstructure in areas of capillary nonperfusion of eyes with branch retinal vein occlusion." BMC Ophthalmology 21, no. 1 (September 10, 2021). http://dx.doi.org/10.1186/s12886-021-02089-w.

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Abstract Background To evaluate macular microstructure alterations in the parafoveal nonperfusion areas of eyes with branch retinal vein occlusions (BRVO), and to investigate their impact on retinal sensitivity. Methods This was a cross-sectional study including thirteen BRVO patients with parafoveal capillary nonperfusion areas (NPA). Multiple modalities including microperimetry, optical coherence tomography angiography, and optical coherence tomography were performed to measure retinal sensitivity and thickness, and to identify the microstructure changes and perfusion status. Results The retinal sensitivity and thickness in the NPA were significantly lower than those in the perfusion areas (PA) (P = 0.001, P = 0.003). Microstructure changes, including disorganization of the retinal inner layers (DRIL), disruption of the outer retinal layers, and cysts were more frequently observed in NPA (P = 0.002, P = 0.018, P = 0.068). Within NPA, the retinal sensitivity of areas with DRIL, and outer retinal layers disruption was significantly lower than that of the areas without DRIL (P = 0.016), and with intact outer retinal layers (P < 0.001), respectively. 1dB increase in retinal sensitivity was correlated with 2.2 μm (95 % confidence interval, 1.71–2.7) increase of the thickness (P < 0.001). The retinal sensitivity was significantly lower at points with both DRIL and outer retinal layers disruption than at the points with DRIL or outer retina layers disruption alone (P = 0.001, P = 0.001). Conclusions Alterations in the macular microstructure are associated with ischemia, especially DRIL. DRIL and outer retinal layers disruption are imaging features that have important implications for local retinal sensitivity in the ischemic areas, and where the microstructure of both inner and outer retinal layers is disrupted the function is further destructed.

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Journal articles on the topic 'Retinal nonperfusion area'

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