8/13/2023 0 Comments Annan retina eye centerLaboratory tests were negative for human T-cell lymphotropic virus 1, syphilis, toxoplasma, and cytomegalovirus sera, and negative for the enzyme-linked immunospot assay. However no nonperfusion area (NPA) was seen on FA or on the en-face widefield OCTA image (Fig. Fundus fluorescein angiography (FA) (Fig. 1A) revealed optic disk swelling and yellowish-white retinal lesions with discrete borders characteristic of retinal vasculitis. Fundus examination of the right eye (Fig. Anterior segment slit-lamp examination revealed inflammation of the anterior segment of the eye and mutton fat keratic precipitates (KPs). Best-corrected visual acuity was 16/20 in his right eye at the initial examination, and intraocular pressure was 25 mmHg. Findings Case 1Ī 15-year-old male with visual crowding in his right eye was referred to our department for a detailed examination. Here we report retinal vascular change in acute retinal necrosis that occurred over 1 year, observed using the OCTA imaging system. Recently, OCT have enabled a clear diagnosis to be obtained in a non-invasive manner. Optical coherence tomography angiography (OCTA) cannot detect leakage but can delineate changes in the vascular density of the superficial and deep capillary plexus in vasculitis. However, FA cannot be performed frequently because of the high risk of side effects such as nausea, vomiting, and anaphylactic shock. In active vascular disease, leakage of fluorescein and staining of the blood vessel wall indicates breakdown of the inner blood–retinal barrier. ![]() Fundus fluorescein angiography (FA) has high sensitivity for detecting inflammation of the retinal vessels. Occlusive retinal vasculitis is a typical finding in ARN, and can include capillary nonperfusion and ischemia, vascular occlusions, preretinal neovascularization, microaneurysms, and telangiectasia. The rate of ARN among all forms of uveitis is 1.3%–1.7%. It seems difficult for a while to completely replace FA due to the problem of image clarity.Īcute retinal necrosis (ARN) is an uncommon form of uveitis that is associated with herpes virus infection. These will remain as issues in the future. OCTA artifacts due to intraocular inflammation appeared, making interpretation difficult. Wide-angle OCTA is used to non-invasively examine retinal vascular dynamic changes in ARN. ![]() Conclusions and importanceĮn-face widefield OCTA is useful for monitoring the structure of retinal vessels over time in acute retinal necrosis. The images showed arteriovenous anastomosis and the nonperfused area on the surface of the retina. In both patients, dynamic changes could be tracked by en-face ultra-widefield OCTA imaging before and up to 1 year after surgical treatment. Case 2 was a 57-year-old male with visual crowding in his left eye who had best-corrected visual acuity of 20/20 in his left eye on initial examination and intraocular pressure of 19.3 mmHg. ![]() Case 1 was a 15-year-old male with visual crowding in his right eye who had best-corrected visual acuity of 16/20 and intraocular pressure of 25 mmHg in his right eye on initial evaluation. OCTA images of two cases of acute retinal necrosis were analyzed. The present study assesses the utility of en-face widefield optical coherence tomography angiography (OCTA) imaging for evaluating the retinal vascular network during the course of treatment in acute retinal necrosis(ARN).
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