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      Optical Coherence Tomography Angiography in Chiasmitis


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          A 29-year-old girl presented complaining of acute bilateral visual loss associated with mild headache and retrobulbar pain. She was diagnosed with chiasmal optic neuritis caused by multiple sclerosis. Her visual acuity and visual field defect promptly improved after steroid therapy. However optical coherence tomography angiography showed a progressive reduction of superficial capillary plexus density of the retina and optic nerve consistent with the progressive impairment of the retinal ganglionar cell layer. Contrary to chiasmal compression, in chiasmal optic neuritis, the superficial capillary plexus density reduction is diffuse and does not reflect the peculiar anatomy of the chiasm.

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          Most cited references20

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          Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration.

          To detect and quantify choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) using optical coherence tomography (OCT) angiography. Observational, cross-sectional study. A total of 5 normal subjects and 5 subjects with neovascular AMD were included. A total of 5 eyes with neovascular AMD and 5 normal age-matched controls were scanned by a high-speed (100 000 A-scans/seconds) 1050-nm wavelength swept-source OCT. The macular angiography scan covered a 3 × 3-mm area and comprised 200 × 200 × 8 A-scans acquired in 3.5 seconds. Flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Motion artifacts were removed by 3-dimensional (3D) orthogonal registration and merging of 4 scans. The 3D angiography was segmented into 3 layers: inner retina (to show retinal vasculature), outer retina (to identify CNV), and choroid. En face maximum projection was used to obtain 2-dimensional angiograms from the 3 layers. The CNV area and flow index were computed from the en face OCT angiogram of the outer retinal layer. Flow (decorrelation) and structural data were combined in composite color angiograms for both en face and cross-sectional views. The CNV angiogram, CNV area, and CNV flow index. En face OCT angiograms of CNV showed sizes and locations that were confirmed by fluorescein angiography (FA). Optical coherence tomography angiography provided more distinct vascular network patterns that were less obscured by subretinal hemorrhage. The en face angiograms also showed areas of reduced choroidal flow adjacent to the CNV in all cases and significantly reduced retinal flow in 1 case. Cross-sectional angiograms were used to visualize CNV location relative to the retinal pigment epithelium and Bruch's layer and classify type I and type II CNV. A feeder vessel could be identified in 1 case. Higher flow indexes were associated with larger CNV and type II CNV. Optical coherence tomography angiography provides depth-resolved information and detailed images of CNV in neovascular AMD. Quantitative information regarding CNV flow and area can be obtained. Further studies are needed to assess the role of quantitative OCT angiography in the evaluation and treatment of neovascular AMD. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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            Optical Coherence Tomography Angiography Findings in Optic Nerve Sheath Meningioma

            A 46-year-old female with a history of 5 months of progressive painless visual loss in the left eye was found to have an optic nerve sheath meningioma. Optical coherence tomography angiography showed a reduction in the superficial capillary plexus density consistent with her visual field defect and peripapillary retinal nerve fiber layer thinning. Moreover, abnormalities in the choriocapillaris were found in the affected eye compared to the fellow eye. Possible explanations for these findings are discussed. Further studies and a consistent number of cases are needed to correctly assess the impairment of ocular blood flow in optic nerve sheath meningioma.
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              • Abstract: not found
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              Swept-source optical coherence tomography angiography of the optic disk in optic neuropathy


                Author and article information

                Case Reports in Ophthalmology
                S. Karger AG
                May - August 2022
                28 June 2022
                : 13
                : 2
                : 517-522
                [_a] aDepartment of Ophthalmology, De Gironcoli Hospital, Conegliano, Italy
                [_b] bDepartment of Ophthalmology, Santo Spirito Hospital, Pescara, Italy
                [_c] cDepartment of Ophthalmology, Ospedale del Mare, Naples, Italy
                [_d] dDepartment of Ophthalmology, Maria Paternò Arezzo Hospital, Ragusa, Italy
                [_e] eDepartment of Ophthalmology, Fabriano Hospital, Fabriano, Italy
                [_f] fDepartment of Ophthalmology, Ospedale Monfalcone e Gorizia, Monfalcone, Italy
                Author information
                525465 PMC9294930 Case Rep Ophthalmol 2022;13:517–522
                © 2022 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

                : 20 February 2022
                : 31 May 2022
                Page count
                Figures: 3, Pages: 6
                The present study was carried out with no funding.
                Case Report

                Vision sciences,Ophthalmology & Optometry,Pathology
                Neuro-ophthalmology,Optical coherence tomography angiography,Multimodal imaging,Chiasmal optic neuritis,Bitemporal hemianopia


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