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Hideyuki Shimizu, Hiroki Kaneko, Taichi Tsunekawa, Toshiyuki Matsuura, Ayana Suzumura, Hiroko Terasaki; Clinical advantage of Swept-Source Optical Coherence Tomography for the patients with retinal hemorrhage due to retinal microaneurysms: a case series. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1093. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Optical Coherence Tomography (OCT) is very useful to understand the retinal structures in many retinal diseases. However, it is not easy to obtain clear images in cases with dense hemorrhage in the eye. For instance, in cases with dense intraretinal hemorrhage caused by the retinal microaneurysms, it is difficult to obtain precise retinal images even with high-spec Specral Domain–OCT (SD-OCT). The purpose of this study is to propose strong advantage of using Swept-Source-OCT (SS-OCT) in cases with dense retinal hemorrhage caused by retinal microaneurysm .
This prospective case series included 6 patients (6 female) with massive intraretinal hemorrhage due to the ruptures of retinal micro aneurysms from October 2016 to May 2017 at Nagoya University Hospital. The average age was 82.5±4.14 years. All of them were evaluated by SS-OCT (PLEX Elite 9000, Carl Zeiss Meditec) and SD-OCT (Spectralis, Heidelberg Engineering).
In all cases , the retina structures under retinal hemorrhage managed to be acquired by SS-OCT, but not by SD-OCT. The images by SS-OCT provided the information that the dense intraretinal hemorrhage was not caused by the ruptured polypoidal choroidal vasculopathy (PCV). Three patients had preretinal and subretinal hemorrhage, 2 patients had only preretinal hemorrhage, and 1 patients had intraretinal and subretinal hemorrhage. Four patients underwent vitrctomy surgeries and 2 patients were followed without treatment. During the surgeries, ruptured retinal microaneurysms were found around macula and laser photocoagulation was used for the treatment. After a few weeks, hemorrhage disappeared and visual acuity was recovered.
SS-OCT is equipped longer wave length than SD-OCT. Longer wavelength penetrates more easily through massive hemorrhage. Therefore, we propose that SS-OCT is very useful tool to decide the thrapeutic strategy, e.g. vitrectomy for microanuerysn or anti-VEGF drugs. for AMD.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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