Lattice Degeneration Imaging with Optical Coherence Tomography Angiography

Abstract

Purpose: To describe a series of cases of lattice degeneration of the retina imaged with optical coherence tomography angiography (OCTA). Methods: Four eyes of four patients were included and evaluated with green reflectance using a confocal scanning laser ophthalmoscopy and OCTA. In each case, the microcirculation of the retina and choriocapillaris within the lesion, as well as choroidal thickness beneath the lesion, were assessed. Results: OCTA showed regional loss of retinal perfusion and rarefication of the choriocapillaris network within the lesion and the presence of venous collectors in the choroid beneath the lesion. The choroid was substantially thinner beneath the lesion compared to the adjacent normal region. Cross-sectional OCT scans showed retinal thinning, vitreal adhesion, atrophic holes, and subretinal fluid within the lesions. Conclusion: Lattice degeneration is characterized by significant local changes in retinal and choroidal microcirculation which may play an important role in the pathophysiology of lattice degeneration.

Combined application of B-scan ultrasonography and eye-steering ultrawide field imaging to improve the detection of retinal tears before cataract surgery

“…We found that combining B-scan US and eye-steering UWFI may be always preferred regardless of the number, type, and location of retinal tears. For atrophic holes, UWFI also showed comparable sensitivity to the gold standard, probably because atrophic holes are often accompanied by retinal degeneration 21,22 that provides a valuable clue in UWFI. Although B-scan US performed worse for the relatively flat atrophic type, it showed comparable sensitivity to the gold standard for horseshoe tears, probably because these tears always present abnormal echoes at the vitreoretinal interface, which can be easily noticed by ultrasonography.…”

Spotlight on Lattice Degeneration Imaging Techniques

“…At the same time, large white vessels are still perfused by means of OCTA. 25 This fact, as well as the scattered pattern of vessel loss around the lesion, suggests that vascular changes could have secondary character since even on high-resolution images no regularity in the distribution of retinal non-perfusion is observed ( Figure 6 ). Due to the loss of RPE, visualization of the choriocapillaris is enhanced within the LD region.…”

“…OCTA produces readable images in a significant proportion of LD eyes, mostly in those with midperiphery lesions. 25 , 32 Although this helps in evaluation of some details of anatomical relationships within the lesion, the clinical significance of this imaging is less important than structural OCT, due to the complexity OCTA in retinal periphery.…”

“…OCTA reveals rarefication of the choriocapillaris meshwork and at the same time the presence of choroidal venous collectors beneath lesions. 25 , 32 There is a possibility that due to their relatively large area, LD lesions may coincidentally include choroidal venous collectors. However, this would also suggest that lesions follow the choriocapillaris vascular pattern rather than the retinal one.…”

Peripheral Lattice Degeneration Imaging with Ultra-Widefield Swept-Source Optical Coherence Tomography

“…Some studies have visualized and analyzed anatomic changes of lattice degeneration and adjacent vitreous using spectral domain optical coherence tomography (SD-OCT) and OCT angiography. However, these devices can only capture central retina, peripheral lattice degeneration could not be characterized [ 3 , 10 – 13 ]. Ultra-widefield (UWF) swept-source OCT (SS-OCT) system is a novel device that combines UWF scanning laser opthalmoscope (SLO) with a navigated SS-OCT (Silverstone, Nikon Healthcare Japan Inc).…”