Abstract
Purpose :
To describe Optical Coherence Tomography Angiography (OCTA) findings in retinal arterial macroaneurysm (RAM) associated with macular edema and to correlate OCTA findings to conventional multimodal imaging (MMI).
Methods :
The clinical course, conventional MMI findings including fundus color photography, spectral domain OCT (SD-OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany), fluorescein angiography (FA, Heidelberg Engineering, Heidelberg, Germany) and OCTA (Optovue, Inc., Freemont, CA) findings at baseline and during the follow-up of 4 eyes (4 patients) with symptomatic RAM associated with macular edema were documented.
Results :
Four eyes of 4 patients, all women, aged 82, 56, 62 and 46 years, which presented with progressive visual decline were included. On conventional MMI, exudative RAM with macular edema and lipid exudation were visible in all included eyes. On OCTA, a flow was detecetd in 3 RAM at baseline and no flow in 1 RAM (case 4) consistent with FA findings in all cases. Case 1 and 2 were treated by focal laser photocoagulation. One month after treatment, FA showed RAM occlusion. SD-OCT showed a RAM and retinal thining and a decreased central foveal thickness, resulting in visual acuity improvement. On OCTA, no flow was detectable in the RAM at 1-month follow up. Case 3 was not treated at baseline. In this eye no flow was detected on OCTA at 2 months follow-up. This suggests a spontaneous occlusion during the follow-up, which was confirmed by FA. Case 4 did not present flow at baseline corresponding to FA findings consistent with a spontaneous oclusion and was not treated.
Conclusions :
OCTA is able to detect the presence or absence of flow signal within retinal arterial macroaneurysms, which may both decrease the need for dye angiography in selected cases with exudative RAM and help in treatment decision-making.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.