Widefield OCT angiography and ultra-widefield multimodal imaging of Susac syndrome

Giuffrè, Chiara; Miserocchi, Elisabetta; Marchese, Alessandro; Cicinelli, Maria Vittoria; Bruschi, Elena; Querques, Giuseppe; Bandello, Francesco; Modorati, Giulio

doi:10.1177/1120672119843281

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…OCT has become an indispensable ancillary test in the diagnosis and management of uveitis, allowing differential diagnosis and identification of many specific entities. 1–7 OCT has rapidly evolved in the last two decades from time-domain OCT to spectral-domain OCT (SD-OCT) and, recently, to Swept Source OCT (SS-OCT). 8–10 Although slit-lamp biomicroscopy still remains the standard method for assessment of inflammation of the anterior segment and vitreous, OCT-based methods for quantification of intraocular inflammation are gaining increasing interest as additional diagnostic tools.…”

Section: Octmentioning

confidence: 99%

Advances in imaging of uveitis

et al. 2020

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Advances in multimodal imaging have significantly contributed to the management of many uveitis diseases in recent years. The most significant developments include the use of optical coherence tomography to obtain a more accurate and reproducible assessment of ocular inflammation, the application of optical coherence tomography angiography in choroiditis and retinal vasculitis, new possibilities for studying vitritis with ultrawide field imaging, and the most recent applications of fundus autofluorescence in uveitis. In this review, we provide an overview of the most significant advances in multimodal imaging of uveitis achieved in recent years.

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Section: Octmentioning

confidence: 99%

Advances in imaging of uveitis

et al. 2020

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“…Some authors have described restored perfusion in large vessels in absence of reperfusion signs in small capillaries. 22 In our series, a vascular density loss persisted at the superficial plexus, but UWF-FA denoted that some residual flow is still present in convalescent or quiescent stages. The deep retinal plexus was observed as the main primarily affected capillary network in SS during acute stages.…”

Section: Discussionmentioning

confidence: 39%

Use of ultra-wide field retinal imaging and optical coherence tomography angiography in the diagnosis of incomplete Susac syndrome

Alba‐Linero

Liscombe-Sepúlveda

Llorenç

et al. 2020

European Journal of Ophthalmology

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Purpose: To describe clinical findings through ultra-wide field (UWF) images and optical coherence tomography angiography (OCT-A), in Susac’s syndrome (SS). Methods: SS patients were retrospectively analyzed in a single center. Clinical features, ultra-wide-field retinographies (UWF-PR), UWF fluorescein angiographies (UWF-FA), and optical coherence tomography angiography & en face (OCT-A/EF) were reviewed. Results: Twelve eyes from six patients with a mean follow-up of 35.66 months ± SD 36.88 were included. UWF-PR showed areas of retinal whitening and cotton-wool spots in all the eyes after acute attack. Segmentary mid peripheral arteriolitis could be observed in five eyes by UWF-FA in acute and convalescent stages. OCT-A revealed capillary density changes in all of the affected eyes. During the acute phase there was a well-preserved superficial capillary network, while deep retinal plexus showed a lower density in the affected areas. OCT-A/EF revealed deep retinal plexus drop-out and surrounding edematous retina in acute attacks, becoming atrophic over time. Conversely, superficial plexus was much less affected. Perifoveal reperfusion was seen in seven eyes after the acute attack. Conclusions: UWF-PR/FA and OCT-A/EF might be helpful to stablish an early diagnosis and to monitor SS progression.

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“…Early treatment initiation may stop vascular occlusion, improve perfusion of vessels already affected by inflammation, 24 and thus prevent permanent structural damage. 29 Ultra-widefield angiography findings are a very sensitive marker of the disease activity, the procedure is less invasive and usually less expensive than MRI of the brain, and offers high-quality visualization of changes pathognomonic for SS. 4,6,7,21,30 Only early diagnosis and prompt appropriate treatment can effectively prevent permanent disability.…”

Section: Discussionmentioning

confidence: 99%

“…4,6,7,21,30 Only early diagnosis and prompt appropriate treatment can effectively prevent permanent disability. [4][5][6]8,9,29…”

Section: Discussionmentioning

confidence: 99%

Widefield Fluorescein Angiography in the Diagnosis of Susac Syndrome

Turczyńska

Krajewski

Brydak-Godowska

2021

Retina

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Purpose: To present the clinical manifestations and results of key diagnostic investigations in patients with Susac syndrome, with special emphasis on the principal role of fluorescein angiography (FA) of the peripheral retina.Methods: A retrospective analysis of medical records (collected 2000-2019) of 20 patients (15 women and five men), aged 20 to 51 years (mean age: 31.6 years) with complete or incomplete Susac syndrome diagnosed by an ophthalmic examination and widefield fluorescein angiography (WF-FA) by Spectralis and Optos Tx200.Results: Fluorescein angiography abnormalities included vascular changes in the posterior pole in 64.7% and in the peripheral retina in 82.4%. Widefield FA abnormalities in the peripheral retina alone were seen in 35.3% and in the posterior pole, but without peripheral vascular involvement, in 17.6%. Secondary leakage from veins was noted in 58.8%.Conclusion: Widefield FA of the peripheral retina has a key role in cases of suspected Susac syndrome as it confirms the diagnosis and assesses disease activity. In addition to the characteristic findings, late-phase FA revealed leakage from veins which is not a typical sign. Patients experiencing migraine headaches may benefit from increasing awareness of neurologists and otologists who more promptly referred patients with suspected Susac syndrome for ophthalmologic evaluation and WF-FA of the peripheral retina.

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Widefield OCT angiography and ultra-widefield multimodal imaging of Susac syndrome

Cited by 6 publications

References 9 publications

Advances in imaging of uveitis

Advances in imaging of uveitis

Use of ultra-wide field retinal imaging and optical coherence tomography angiography in the diagnosis of incomplete Susac syndrome

Widefield Fluorescein Angiography in the Diagnosis of Susac Syndrome

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