Atlas of Ophthalmology

Increased Diameter of Foveolar Avascular Zone in Optic Nerve Atrophy (Triton OCT-Angiography)

Increased Diameter of Foveolar Avascular Zone in Optic Nerve Atrophy (Triton OCT-Angiography)
Triton, OCT-angiography, OD : increased diameter of foveolar avascular zone Patient: 55 years of age, male, BCVA 0.1 at OD , 1.0 at OS, IOP 10/10 mmHg under topical medication. ___General Medical History: aortic valve insufficiency, arterial hypertension. ___Ocular Medical History: acute increase of intraocular pressure with values of 40 mmHg with glaucomatous optic nerve atrophy, followed by an incomplete central retinal vein occlusion with cystoid macular edema, and an intravitreal antiVEGF-injection. ___Main Complaint: decline of visual acuity at OD. ___Purpose: to present asymmetric macular capillary rarefication shown by OCT-angiography. ___Methods: colour photography posterior pole, Triton OCT-angiography, Triton OCT, visual field. ___Findings: Colour Photography Posterior Pole, OD: pale optic nerve atrophy, focal retinal hemorrhages. Visual field, OD: concentric visual field defect. Triton OCT, OD: thinning of retinal nerve layer. Triton, OCT-angiography, OD : increased diameter of foveolar avascular Zone. Triton, OCT-angiography, Mosaic OD & OS: in OD increased diameter of foveolar avascular zone compared to OS with regular foveolar avascular zone. ___Discussion: In presented case the increased foveolar avascular zone and the rarefication of macular capillaries in OD may be caused by the venous vascular dysregulation, and glaucomatous optic nerve atrophy. Glaucoma is a chronic, progressive optic neuropathy with optic nerve deterioration, visual field defects, and vascular dysregulation and rarefication. Müller et al. and Zivkovicet al. investigated macular capillaries in glaucoma by OCT-angiography. Zivkovic M et al. (2) measured foveal avascular zone (FAZ) in NTG and healthy subjects. He reported that mean horizontal, mean vertical diameter, and FAZ area were significantly enlarged in the NTG group. Müller et al. (1) investigated central macular microvasculature in glaucoma patients. He found in perimetric glaucoma patients significantly reduced density maps of superficial foveal flow. ___Literature: 1. Müller O1,2, Todorova MG2, Schlote T1. OCT Angiography of the Central Macular Capillary Network in Glaucoma Patients and Healthy Controls. . Klin Monbl Augenheilkd. 2018 Feb 1. 2. Zivkovic M1,2, Dayanir V3, Kocaturk T4, Zlatanovic M2, Zlatanovic G1,2, Jaksic V5, Radenkovic M2, Jovanovic P1,2, Sefic Kasumovic S6, Golubovic M7, Jovanovic S8. Foveal Avascular Zone in Normal Tension Glaucoma Measured by Optical Coherence Tomography Angiography. Biomed Res Int. 2017;2017:3079141
Michelson, Georg, Prof. Dr. med., Interdisziplinäres Zentrum für augenheilkundliche Präventivmedizin und Imaging, Augenklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Erlangen, Deutschland
H47.01
Retina -> Vascular Diseases (see also: Systemic Immunologic Diseases) -> Retinal Vein Occlusion -> Increased Foveolar Avascular Zone after Incomplete Central Retinal Venous Occlusion in Secondary Open Angle Glaucoma (Colour Photography Posterior Pole, Triton OCT-Angiography, Visual Field)
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