RESUMO
BACKGROUND: Susac's syndrome (SuS) is an uncommon disease characterized by retinal microangiopathy that may be assessed more accurately with optical coherence tomography angiography (OCTA), a new imaging technique which provides a retinal microvasculature map. The purpose of this case report is to describe the multimodal imaging findings of SuS correlating OCTA with functional tests. CASE PRESENTATION: Retrospective review of one case with clinical and imaging evidence of SuS. Color fundus photograph, fluorescein angiography (FA), OCTA, microperimetry (MP) and visual field (VF) tests were analyzed at the time of presentation and at 1- and 6-month visit following initiation of treatment. The study patient underwent standard treatment for SuS. The patient age was 31 year-old and the baseline visual acuity was 20/60 and 20/20 in the right and left eyes, respectively. At presentation, FA showed branch retinal arterial occlusion within the macular area of the right eye and vascular leakage in the periphery of the left eye. OCTA demonstrated areas of superficial and deep retinal vascular plexuses hypoperfusion in both eyes. The OCTA segmentations in the outer retina and choriocapillaris were normal. The low VF and MP sensitivity signals precisely corresponded to the topography of decreased vascular perfusion seen on the OCTA density map in both eyes. Six months after specific SuS therapy, retinal vascular perfusion showed partial improvement in both eyes. CONCLUSION: OCTA may demonstrate superficial and deep retinal vascular non-perfusion without choriocapillary vasculature changes in SuS. This anatomical information given by OCTA corresponded to points of low sensitivity on functional tests represented by VF and MP.
RESUMO
BACKGROUND AND OBJECTIVE: To compare the architecture of single plane self-sealing clear corneal incision (SP-CCI) and shallow grooved self-sealing clear corneal incision (SG-CCI) after cataract surgery using Fourier-domain optical coherence tomography (FD-OCT). PATIENTS AND METHODS: An FD-OCT system with a corneal adaptor module was used to image the corneal incisions in radial sections in 44 eyes. A line scan pattern was used to measure the corneal incision, positioning the caliper mark perpendicular to the limbus. Measurements were performed immediately after cataract surgery and at postoperative days 1, 7, and 30. Incisions were analyzed regarding length, location, angle, architecture, and anatomic imperfections. RESULTS: All incisions were located superiorly (temporal, 24 eyes; nasal, 20 eyes). The mean SG-CCI length (20 eyes) was 1.79 ± 0.31 mm (range: 0.93-2.64 mm) and the mean incision angle was 37 ± 7 degrees (range: 24-34 degrees). The mean SP-CCI length (22 eyes) was 1.64 ± 0.22 mm (range: 1.25-2.36 mm) and the mean incision angle was 38.5 ± 5 degrees (range: 27-52 degrees) (P < .05). Anatomic imperfections were observed at postoperative day 1 in 19 eyes for SP-CCI and 14 eyes for SG-CCI. No patient presented endophthalmitis during 30 days of follow-up. CONCLUSION: Epithelial imperfection at the corneal incision site was observed in more than 36% of the wounds (36% in SP-CCI and 45% in SG-CCI) at postoperative day 1 with spontaneous resolution. SG-CCI had the greatest length and lowest angle of corneal incision. Reduced incision length and inappropriate construction may determine risk factors for wound architectural imperfections. Further studies including more patients with an architectural analysis of clear corneal incisions are needed to confirm these preliminary results.
