The Spectrum of Superficial and Deep Capillary Ischemia in Retinal Artery Occlusion

Yu, Shizhu; Pang, Claudine E.; Gong, Yuanyuan; Freund, K. Bailey; Yannuzzi, Lawrence A.; Rahimy, Ehsan; Lujan, Brandon J.; Tabandeh, Homayoun; Cooney, Michael J.; Sarraf, David

doi:10.1016/j.ajo.2014.09.027

Cited by 177 publications

(133 citation statements)

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“…27 Other studies have reported that in paracentral acute middle maculopathy, a subtype of retinal artery occlusion, capillary plexuses in the SINL and DINL are obstructed, and subsequently the OCT reflectivity increases in the middle portion of the sensory retina. 15,16 Taken together, we hypothesized that spots with inverted OCT reflectivity was associated with a novel laminar ischemia in GCL and NFL.…”

Section: Discussionmentioning

confidence: 90%

“…[12][13][14] Recent publications have reported that obstruction of the deep capillary layers including the SINL and DINL induces deep capillary ischemia and a concomitant increase in OCT reflectivity in the middle layers alone, referred to as paracentral acute middle maculopathy. 15,16 Compared to these findings, the kinds of clinical findings that represent laminar ischemia in GCL remain unclear.…”

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confidence: 99%

“…For example, the reflectivity levels were iovs.arvojournals.org j ISSN: 1552-5783 increased in the middle retinal layers in eyes with paracentral acute middle maculopathy, and DME eyes have cystoid spaces with the various reflectivity levels. 15,16,25 However, OCT reflectivity of the diabetic lesions in the NFL and GCL remains ill-defined.…”

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confidence: 99%

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Characterization of Inner Retinal Spots With Inverted Reflectivity on En Face Optical Coherence Tomography in Diabetic Retinopathy

Yoza

Murakami

Uji

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Yoza R, Murakami T, Uji A, et al. Characterization of inner retinal spots with inverted reflectivity on en face optical coherence tomography in diabetic retinopathy. Invest Ophthalmol Vis Sci. 2016;57:186257: -187057: . DOI:10.1167 PURPOSE. The purpose of this study was to characterize inner retinal spots with inverted reflectivity on en face images of swept-source optical coherence tomography (SS-OCT) in diabetic retinopathy (DR). METHODS.We retrospectively reviewed seventy-five eyes of 75 patients with DR (15 eyes with individual grades of DR severity). We obtained three-dimensional images (6 3 6 mm) centered on the fovea, followed by the generation of en face images. We investigated the morphologic characteristics of spots with inverted reflectivity, which had lower reflectivity than the surrounding areas in the nerve fiber layer (NFL) and higher reflectivity in the ganglion cell layer (GCL).RESULTS. Thirty-seven of 45 eyes (82.2%) with moderate nonproliferative diabetic retinopathy (NPDR) or more severe grades were accompanied with well-defined spots with inverted reflectivity, whereas 30 eyes with no apparent retinopathy or mild NPDR had no such lesions. These spots had various shapes in the NFL and GCL on en face OCT images; the mean area was 0.126 6 0.052 mm 2 at the NFL level. In all 75 eyes, 153 of 184 spots (83.2%) were localized in the NFL and GCL, whereas 31 spots (16.8%) extended to retinal layers deeper than the GCL. One-hundred sixty-nine spots (91.8%) were not visible on color fundus photographs, and 15 spots (8.2%) were accompanied by whitish-yellow lesions in the corresponding areas. In 45 eyes for which fluorescein angiography images were obtained, mild hypofluorescence was seen in 156 spots (84.8%) and focal nonperfused areas in 17 spots (9.2%).CONCLUSIONS. En face images of SS-OCT showed spots with inverted reflectivity in the NFL and GCL in DR.

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Characterization of Inner Retinal Spots With Inverted Reflectivity on En Face Optical Coherence Tomography in Diabetic Retinopathy

Yoza

Murakami

Uji

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…The same hypothesis has been further supported by a recent study showing that PAMM lesions may occur in angiographically silent retinal artery occlusion. 6 FA is currently the gold standard to image retinal ischemia. This imaging modality allows visualization of the SCP in excellent detail, however, the intermediate and DCP are not seen.…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography angiography in paracentral acute middle maculopathy secondary to central retinal vein occlusion

Casalino

Williams

McAvoy

et al. 2016

Eye

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Purpose To report the clinical course and the optical coherence tomography angiography (OCTA) findings of patients presenting with paracentral acute middle maculopathy (PAMM) and central retinal vein occlusion (CRVO). Methods Retrospective case series. Clincal records and multimodal imaging findings of patients presenting with PAMM and CRVO were reviewed. Results Three eyes of three patients (2 males; mean age: 66 years) were included in the study. Mean follow-up was 9 months and images using OCTA (AngioVue OCT angiography system, Optovue, Inc., Fremont, CA, USA) were available at the last follow-up visit. During follow-up, best corrected visual acuity (BCVA) of case 1 was unchanged at 85 ETDRS letters and OCTA revealed a mild attenuation of the perifoveal deep capillary plexus (DCP); in case 2, BCVA changed from 83 to 77 ETDRS letters and OCTA revealed patchy areas of attenuation and pruning of the DCP; in case 3, BCVA decreased from 26 to 8 ETDRS letters and OCTA revealed extensive areas of DCP dropout. Conclusion The natural course of visual acuity in patients with PAMM secondary to CRVO may vary. In these patients, the extent of DCP dropout on OCTA may reflect the extent of visual acuity impairment.

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“…It may also be a consequence of perivasculitis, which may cause thickening of the vessel wall, disruption of blood flow, and thrombosis (6) . Yu et al (7) identified the following three patterns of retinal capillary ischemia using optical coherence tomography in arterial occlusive disease in the acute phase: (1) thickening and hyperreflectivity of the inner retinal layers owing to ischemia of the superficial capillary plexus, (2) hyperreflective band at the level of the inner nuclear layer represen- ting ischemia of the intermediate and deep capillary plexuses, and (3) diffuse thickening and hyperreflectivity of the inner and middle retinal layers representing both superficial and deep capillary ischemia. In the chronic phase, thinning and atrophy of the affected retinal layers were seen.…”

Section: Discussionmentioning

confidence: 99%

Combined branch retinal vein and artery occlusion in toxoplasmosis

Aggio¹,

Novelli²,

Rosa³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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The Spectrum of Superficial and Deep Capillary Ischemia in Retinal Artery Occlusion

Cited by 177 publications

References 14 publications

Characterization of Inner Retinal Spots With Inverted Reflectivity on En Face Optical Coherence Tomography in Diabetic Retinopathy

Characterization of Inner Retinal Spots With Inverted Reflectivity on En Face Optical Coherence Tomography in Diabetic Retinopathy

Optical coherence tomography angiography in paracentral acute middle maculopathy secondary to central retinal vein occlusion

Combined branch retinal vein and artery occlusion in toxoplasmosis

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