En Face OCT Analysis to Assess the Spectrum of Perivenular Ischemia and PAMM in Retinal Vascular Occlusion

Abstract

Purpose : To assess the spectrum of perivenular ischemia in eyes with retinal vein occlusion using en face optical coherence tomography (OCT).

Methods : Eyes with recent retinal vascular occlusion illustrating paracentral acute middle maculopathy (PAMM) in a perivenular pattern with en face OCT were evaluated in this study. Multimodal retinal imaging including en face OCT segmentation of the inner nuclear layer was performed in all patients. Color fundus photography and fluorescein angiography (FA) images were used to create a vascular overlay of the retinal veins versus the retinal arteries to map the distribution of PAMM with en face OCT analysis.

Results : Multimodal retinal imaging was performed in 11 eyes with acute retinal vascular obstruction. While 7 eyes demonstrated obvious findings of retinal vein obstruction (5 with central and 2 with hemicentral retinal vein occlusion), 4 eyes were unremarkable at baseline. One of these 4 eyes progressed to CRVO. En face OCT analysis demonstrated a spectrum of perivenular PAMM illustrating progressive wider perivenular lesions with sparing of the periarteriolar area in all cases.

Conclusions : En face OCT may illustrate a remarkable perivenular pattern of PAMM in eyes with retinal vascular obstruction even in the absence of significant funduscopic findings. Perivenular PAMM with en face OCT demonstrates a wide spectrum of variation that may develop due to outflow obstruction causing perfusion pressure reduction in the affected eye resulting from different severities of retinal vein occlusion.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.