OCT-angiography in optic disk pit after inverted ILM flap: A case report.

BACKGROUND: To describe OCT-angiography features in a case of an optic disk pit (ODP) which underwent a pars plana vitrectomy with inverted ILM flap for macular detachment. CASE PRESENTATION: A 12 years old child with an ODP responsible for a macular detachment underwent 23G vitrectomy in the subacute phase of the disease with an inverted ILM flap used as a plug over the lateral dehiscence of the pit. Among the various retinal imaging examinations performed in the post-operative period, the OCT-angiography showed very interesting features characterized by a capillary drop-out in correspondence of the superficial and deep capillary plexus, a fine texture of the choroid capillary layer and star-shaped folds in correspondence of both the outer retina and the choroid capillary layer. OCT-A performed 24 months after surgery showed a normalization of the macular perfusion which correlated with a full recovery of the visual acuity of the young child. CONCLUSIONS: OCT-A is an useful tool to monitor the subretinal fluid reabsorption after ILM inverted flap surgery for ODP-maculopathy and correlates with visual function. OCT-A may be useful in the follow-up of this rare condition as well as its response to therapeutic strategies.

Optical coherence tomography angiography of central serous chorioretinopathy: quantitative evaluation of the vascular pattern and capillary flow density.

BACKGROUND: This study aimed to evaluate the vascular pattern and capillary flow density (CFD) map on optical coherence tomography angiography (OCTA) images of patients affected by central serous chorioretinopathy (CSC). METHODS: In this retrospective cohort study, OCTA (AngioVue RTVue XR Avanti, Optovue) 3 × 3 mm macula scans of both eyes of patients with CSC were taken at baseline; the images were segmented and compared with OCTA scans of fellow eyes without CSC as well as age-matched healthy subjects. OCTA images were processed by quantitative textural analysis (ImageJ software) to provide an objective grading of choroidal capillary alterations. The texture of OCTA images was examined by the autocorrelation method. RESULTS: In eyes with CSC (40 eyes), we found six different morphological patterns of the choriocapillaris layer vasculature (CCL), likely corresponding to different grades of OCT choroidal hyporeflectivity and OCTA reduction of the decorrelation signal. Moreover, the OCTA capillary flow density map revealed capillary depletion in the superficial capillary plexus (p value = 0.0023), in the deep vascular network (p value = < 0.0001), and in the CCL (p value = 0.0001). Such findings were not observed in healthy subjects (13 eyes). CONCLUSIONS: OCTA in CSC is a useful tool that allows the identification of the clinical type of CSC by means of specific CCL patterns. Moreover, CFD depletion is observed in association with the inner retinal layers, pointing to an involvement of the inner blood retinal barrier in CSC. According to our results, it is plausible that the patterns observed herein may correlate to the different clinical subtypes of the disease.

Visual outcome and poor prognostic factors in acute retinal necrosis syndrome.

OBJECTIVE: To evaluate the impact of selected clinical parameters on the mid-/long-term visual outcome of patients with acute retinal necrosis (ARN) DESIGN: A retrospective cohort study SETTING: Two University Hospitals (Parma, Italy; Lausanne, Switzerland). PARTICIPANTS: Thirty-nine non-HIV patients (39 eyes) with ARN, as confirmed by polymerase chain reaction on intraocular samples. The following potential predictors were tested using linear regression models: age, sex, etiology, best-corrected visual acuity (BCVA) on admission, delay between ARN symptom onset and treatment initiation, and surgery (performed or not). MAIN OUTCOME: BCVA at the final follow up RESULTS: Thirty-nine of 39 non-HIV patients (22 men and 17 women; mean age, 50 years) diagnosed with ARN were enrolled in the study. Etiologies were: varicella-zoster virus in 25 eyes (64%), herpes simplex viruses in the remaining 14 eyes. The average follow-up duration was 19 ± 13 months. All patients had undergone systemic antivirals; surgery was performed in 16 eyes. The mean delay between onset of visual symptoms and antiviral treatment initiation was 15 ± 31 days (range, 1-180 days). The mean BCVA at baseline was 0.83 ± 0.75 logMAR, while the mean final BCVA was 0.75 ± 0.81 logMAR. Both initial BCVA and treatment delay (TD) were significantly correlated with the final BCVA (p < 0.05). CONCLUSIONS: Initial BCVA and TD seem to be significant predictors of mid-/long-term visual outcome in non-HIV patients affected by ARN.