Transfemoral cerebral angiography (TFCA) has been increasingly used as diagnostic method for the evaluation of cerebral vessels. Ophthalmologic complication after TFCA has rarely been reported, and most complications are associated with an intraoperative thrombo-embolic event. We reported a patient who developed a superior altitudinal visual field defect one day after diagnostic TFCA. The ophthalmic exam revealed a prominent inferior optic disc edema, and the fluorescein angiographic showed the non-perfusion of the corresponding inferior sectoral optic disc. Diffusion-weighted MRI on the day following cerebral angiography revealed multiple focal scattered acute infarctions. Even one month after steroid pulse therapy, the superior nasal field defect remained with minimal improvement. We believe this case was consistent with an acute anterior ischemic optic neuropathy (AION) due to thrombo-embolism after TFCA. Ophthalmic examinations and a visual field test should be performed before and immediately after the TFCA, particularly in the case with a high risk of thromboembolic events.

Purpose: To evaluate the peripapillary microvasculature changes in patients with epiretinal membrane (ERM) following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling using swept-source optical coherence tomography angiography (SS-OCTA). Method: Medical records and multimodal imaging data of 33 eyes after PPV for ERM were retrospectively reviewed. Peripapillary SS-OCTA images of 6×6 mm2 were recorded at baseline, 6 months and 1 year after PPV. A semi-automated method was used to analyzed SS-OCTA images, excluding the optic disc area, using the MATLAB software. The peripapillary vessel density (pVD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) was quantified in four quadrants (superior, inferior, nasal and temporal). Result: The mean pVD in SCP and DCP decreased at 6- and 12-months follow-up. In sectoral analysis, superior, inferior, and temporal quadrants pVD in SCP and DCP were significantly reduced at 1 year after vitrectomy (all p < 0.05). Meanwhile, inferior quadrants pVD in SCP and DCP showed the earliest significant reduction at 6-months (p = 0.022 and 0.048, respectively). A reduction of post-operative mean pVD in DCP was significantly greater in patients with diabetic retinopathy (p = 0.043). Conclusion: Postoperative pVD significantly decreased in ERM patients. The changes of pVD, especially in inferior sector, could be helpful to predict progression of retinal nerve fiber layer thinning followed by peripapillary microvascular alterations.

Purpose To evaluate the peripapillary microvasculature changes in patients with epiretinal membrane (ERM) following pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling using swept-source optical coherence tomography angiography (SS-OCTA). Method Medical records and multimodal imaging data of 33 eyes after PPV for ERM were retrospectively reviewed. Peripapillary SS-OCTA images of 6×6 mm2 were recorded at at pre- and post-operatively every 6 months for 1 year. A semi-automated method was used to analyzed SS-OCTA images, excluding the optic disc area, using the MATLAB software. The peripapillary vessel density (pVD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) was quantified in four quadrants (superior, inferior, nasal and temporal). Result The mean pVD in SCP and DCP decreased at 6- and 12-months follow-up. In sectoral analysis, superior, inferior, and temporal quadrants pVD in SCP and DCP were significantly reduced at 1 year after vitrectomy (all p < 0.05). Meanwhile, inferior quadrants pVD in SCP and DCP showed the earliest significant reduction at 6-months (p = 0.022 and 0.048, respectively). A reduction of post-operative mean pVD in DCP was significantly greater in patients with diabetic retinopathy (p = 0.043). Conclusion Peripapillary capillary density significantly decreased after surgical removal of ERM. Vitrectomy with ILM peeling can cause peripapillary microvascular damage starting in inferior sector.

Purpose: To investigate the baseline characteristics in patients with diabetic macular edema (DME) during 7 years according to the need for additional treatments after intravitreal ranibizumab (RBZ) loading injections. Methods:The medical records of 32 patients treated with intravitreal RBZ loading for DME during 7 years were reviewed. After three consecutive monthly RBZ injections, additional treatment was decided according to the patient's response to RBZ loading. Based on whether the patients received treatment with or without additional injections, including intravitreal anti-vascular endothelial factor (VEGF) or steroid injection, they were divided into the "No add (NA)" or "Add" groups, respectively.The baseline best-corrected visual acuity (BCVA), macular volume (MV), central subfoveal thickness (CST), and other clinical factors were analyzed, and their 7-year changes were compared between the two groups. Results:The BCVA of the NA group was better than that of the Add group at 2, 3, 5 and 7 years (2, 3 and 5-year; p < 0.01, respectively). Baseline MV was significantly smaller in the NA group than in the Add group (10.72 ± 0.88 vs. 11.98 ± 1.64 μm; p = 0.008). The DME duration before treatment in the NA group was significantly shorter than in the Add group (1.03 ± 0.98 vs. 1.91 ± 1.33 years; p = 0.042). The proportion of patients with serous retinal detachment (SRD) or cystic macular edema (CME) was significantly lower in the No add group than in the Add group (35.3% vs. 73.3%; p = 0.042). The NA group had smaller MV until 2 years than the Add group (1, 2-year; p = 0.002 and 0.006, respectively). Conclusions:The DME patients without additional treatments during 7 year after the initial loading treatment had shorter duration of DME and DRT morphologic type with lower MV at baseline, and better long-term visual prognosis.