Varicella zoster is known to be associated with vaso-occlusive pathologies, vasculitis, or optic neuritis, leading to profound visual loss. We report a case where a 13-year-old boy who initially presented to us with on and off diminution of vision in his right eye since 3 days and had normal ocular and OCT angiography findings followed up in 5 days with sudden painless diminution of vision in the same eye since one day this time revealing a pale macular region with rest of the retina being normal. Repeated OCT angiography showed loss of the capillary network around the perifoveal region suggesting cilioretinal artery occlusion.
A blunt trauma to a phthisical eye may elicit sympathetic ophthalmia. Non invasive imaging such as use of optical coherence tomography and angiography metrics of the retinal and choroidal vasculature can help monitor response to the treatment.
K E Y W O R D Sangiography, autoantigens, imaging, ocular wounds, optical coherence tomography and angiography, phthisis, sympathetic ophthalmia, uveitis 150 | KHATRI eT Al.How to cite this article: Khatri A, Timalsena S, Khatri BK, et al. A rare entity: Sympathetic ophthalmia presumably after blunt trauma to the phthisical eye and optical coherence tomography angiography metrics to monitor response to treatment. Clin Case Rep.
Introduction Diabetic maculopathy is a leading retinal cause of blindness. This study was conducted using optical coherence tomography angiography and noninvasive imaging modalities. Microaneurysms were evaluated for location, flow, and adjacent retinal tissue changes to establish knowledge of possible vision-threatening features. Methodology: This is a hospital-based, cross-sectional observational study. Eighteen patients with diabetic maculopathy were included in the study. Fundus photo, red-free filter image, infrared images with shadowgrams, optical coherence tomography cross sections, and optical coherence tomography angiography were analyzed. Mean, standard deviation, odds ratio, and 95% confidence interval were used for statistical analysis, and p-value of <0.05 was considered statistically significant where applicable. Results A total of 64 microaneurysms were evaluated. Forty-six (71.8%) microaneurysms were identifiable in all imaging modalities. In total, 53 (82.8%) were high-flow microaneurysms and 11 (17.2%) were low-flow microaneurysms. Thirty-eight of the high-flow microaneurysms (71.6% of the high-flow microaneurysms) were found in the deep capillary plexus, while only 15 (28.4% of the high-flow microaneurysms) were found in the superficial capillary plexus. Twenty-seven (71%) of the high-flow microaneurysms in deep capillary plexus were present in the areas of retinal thickening (odds ratio: 4.5, 95% confidence interval: 1.26–16.0, p = 0.02). A total of 11 microaneurysms were classified as low-flow microaneurysms and identified using fundus photo, red-free filter image, infrared images with shadowgrams, and optical coherence tomography—cross sections. They had a tendency to be present in the areas of decreased capillary plexus density (odds ratio: 25.6, 95% confidence interval: 5.09–128.7, p = 0.001). Conclusion Noninvasive imaging modalities combined with optical coherence tomography angiography can provide valuable information regarding microaneurysms. Certain features such as location and flow may help in predicting impending macular edema or ischemia.
Purpose
To report post typhoid fever neuroretinitis with Serous Retinal Detachment and choroidal involvement.
Observation
Patients with diminished vision post typhoid fever can present with neuroretinitis with serous retinal detachment.
Conclusion and importance
With help from noninvasive imaging such as optical coherence tomography angiography(OCTA) and Deep Range Imaging(DRI), we were able to conclude choroidal involvement – which has not been discussed in literatures yet.OCTA and choroidal thicknessboth served as agood indicators for monitoring the response of treatment in this case.
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