Abstract
Purpose :
To describe optical coherence tomography angiography (OCTA) imaging findings in patients with vascular iris disorders.
Methods :
Cross-sectional observational clinical study. Patients with various vascular iris conditions were evaluated using 840 nm-SD-OCT adapted with an anterior segment lens. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to detect flow and construct the three-dimensional OCT angiograms using 6x6 mm and 3x3 mm scan size patterns. All eyes were evaluated with iris fluorescein angiography (IFA) using confocal laser scanning ophthalmoscope (cSLO) and retinal camera with anterior focus and anterior segment photography.
Results :
Thirteen eyes with iris conditions were evaluated: iris neovascularization or rubeosis iridis, 5 eyes (secondary to diabetes mellitus, 2; uveitis, 2; and retinal vein occlusion, 1); iris atrophy, 4 eyes (secondary to angle-supported phakic intraocular lens, 2; cosmetic iris implant, 2); iris hypoperfusion, 2 eyes (scleral buckle for retinal detachment, 1; strabismus surgery, 1); iris racemose hemangioma, 1 eye; and dense persistent pupillary membrane, 1 eye. Considering the neovascular conditions of the iris: OCTA could detect the new vessels with more detail than IFA; and IFA was able to show contrast leakage, which could not be detected with OCTA. Considering iris atrophy: OCTA and IFA were able to identify vascular disorganization in areas compromised. The conditions with vascular dilation and increased tortuosity were well identified with OCTA and IFA. Intense iris pigmentation did not allow an adequate evaluation of the iris vasculature with OCTA nor with IFA. OCTA presented motion artifacts with pupil oscillation.
Conclusions :
Without the need for intravenous contrast administration, OCTA showed the capability to detect iris neovascularization, vascular disorganization, dilation and increased tortuosity of anomalous vessels as well as IFA. OCTA was able to differentiate normal from abnormal iris vessels based on their architecture. OCTA was not able to detect contrast leaking, delay or impregnation as IFA, with limitation for detection hypoperfusion of the iris.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.