Atlas of Ophthalmology

Thinned Retina in Ischemic Areas in Diabetic Retinopathy (Optical Coherence Tomography Angiography, Colour Photography Posterior Pole, FFA)

Systemic Diseases -> Endocrine Disorders -> Diabetes Mellitus -> Retina -> Proliferative (PDR)
Patient: 29 years of age, female, Visual Acuity 20/40. General Medical History: type I diabetes, glycated hemoglobin 9.1%. Ocular Medical History: decreased vision in OD. Purpose: to present regional coincidence between areas with retinal ischemia and retinal thinning using Optical Coherence Tomography Angiography . Methods: Colour Photography Posterior Pole, Fluorescein Angiography (HRA), OCT-angiogram (ZeissAngioPlex), OCT-thickness (ZeissAngioPlex). Findings: Colour Photography Posterior Pole: retinal hemorrhages, papillary neovascularization (NVD). Fluorescein Angiography (midphase): enlarged foveolar avascular zone, capillary loss in temporal, superior and inferior area, IRMAS, microaneuryms, retinal neovascularization (NVE) in temporal inferior region. OCT-Angio Map: capillary loss, enlarged foveolar avascular zone, IRMAS, mircoaneurysms. OCT-Thickness Map: thinned retina (blue) corresponding to retinal areas with capillary loss in OCT-Angio Map. Discussion: Optical coherence tomography angiography (OCTA) allows the evaluation of functional retinal vascular networks without a need for contrast dyes. Zhang Q et al. (1) reported that OCTA is capable of providing wide-field and high definition images of retinal vasculature in a single image. They showed that OCTA with motion tracking through an auxiliary real-time line scan ophthalmoscope images functional retinal vasculature with a coverage of more than 60 degrees of retina. Literature: (1) Zhang Q, Lee CS, Chao J, Chen CL, Zhang T, Sharma U, Zhang A, Liu J, Rezaei K, Pepple KL, Munsen R, Kinyoun J, Johnstone M, Van Gelder RN, Wang RK. Wide-field optical coherence tomography based microangiography for retinal imaging. Sci Rep. 2016 Feb 25;6:22017

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