Taiji Hasegawa1, Nahoko Ogata. 1. Department of Ophthalmology, Nara Medical University, Kashihara, Japan.
Abstract
PURPOSE: To report the case of a patient with an occluded congenital retinal macrovessel accompanied by retinal deep capillary ischemia. METHODS: A 38-year-old woman presented with a 2-day history of a paracentral scotoma of her right eye. RESULTS: Fundus photograph showed a dilated congenital retinal macrovessel with arteriovenous anastomosis, an intravascular white region indicating the thrombus at arteriovenous anastomotic region, and an area of retinal whitening temporal to the fovea. The spectral domain optical coherence tomography images through the area of retinal whitening showed a thickening and highly reflectivity at the level of the inner nuclear layer, which is likely due to the deep capillary ischemia. After 6 weeks, spectral domain optical coherence tomography images through the same area demonstrated a thinning and atrophy of only the inner nuclear layer, and the patient's paracentral scotoma persisted. CONCLUSION: Acute capillary hemodynamic changes caused deep capillary ischemia. The spectral domain optical coherence tomography showed a highly reflective lesion at the level of the inner nuclear layer in the acute phase.
PURPOSE: To report the case of a patient with an occluded congenital retinal macrovessel accompanied by retinal deep capillary ischemia. METHODS: A 38-year-old woman presented with a 2-day history of a paracentral scotoma of her right eye. RESULTS: Fundus photograph showed a dilated congenital retinal macrovessel with arteriovenous anastomosis, an intravascular white region indicating the thrombus at arteriovenous anastomotic region, and an area of retinal whitening temporal to the fovea. The spectral domain optical coherence tomography images through the area of retinal whitening showed a thickening and highly reflectivity at the level of the inner nuclear layer, which is likely due to the deep capillary ischemia. After 6 weeks, spectral domain optical coherence tomography images through the same area demonstrated a thinning and atrophy of only the inner nuclear layer, and the patient's paracentral scotoma persisted. CONCLUSION: Acute capillary hemodynamic changes caused deep capillary ischemia. The spectral domain optical coherence tomography showed a highly reflective lesion at the level of the inner nuclear layer in the acute phase.
Authors: Francesco Pichi; K Bailey Freund; Antonio Ciardella; Mariachiara Morara; Emad B Abboud; Nicola Ghazi; Christine Dackiw; Netan Choudhry; Eduardo Cunha Souza; Leonardo Provetti Cunha; J Fernando Arevalo; T Y Alvin Liu; Adam Wenick; Lingmin He; Guadalupe Villarreal; Piergiorgio Neri; David Sarraf Journal: JAMA Ophthalmol Date: 2018-04-01 Impact factor: 7.389