July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Macular fibrosis in unilateral Coats’ Disease on Segmented Swept Source Optical Coherence Tomography Angiography- new information on morphology and pathophysiology.
Author Affiliations & Notes
  • Katarzyna M. Chwiejczak
    Manchester Vision Regeneration (MVR) Lab at Manchester Royal Eye Hospital & NIHR/Wellcome Trust, Manchester, United Kingdom
  • Susmito Biswas
    Manchester Vision Regeneration (MVR) Lab at Manchester Royal Eye Hospital & NIHR/Wellcome Trust, Manchester, United Kingdom
    Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, , Manchester, United Kingdom
  • Emmanouil Tsamis
    Manchester Vision Regeneration (MVR) Lab at Manchester Royal Eye Hospital & NIHR/Wellcome Trust, Manchester, United Kingdom
    Division of Pharmacy and Optometry, School of Health Sciences, Manchester, United Kingdom
  • Paulo E Stanga
    Manchester Vision Regeneration (MVR) Lab at Manchester Royal Eye Hospital & NIHR/Wellcome Trust, Manchester, United Kingdom
    Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, , Manchester, United Kingdom
  • Footnotes
    Commercial Relationships   Katarzyna Chwiejczak, None; Susmito Biswas, None; Emmanouil Tsamis, None; Paulo Stanga, Topcon Corporation, Tokyo, Japan (C), Topcon Corporation, Tokyo, Japan (F), Topcon Corporation, Tokyo, Japan (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4265. doi:
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      Katarzyna M. Chwiejczak, Susmito Biswas, Emmanouil Tsamis, Paulo E Stanga; Macular fibrosis in unilateral Coats’ Disease on Segmented Swept Source Optical Coherence Tomography Angiography- new information on morphology and pathophysiology.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4265.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To verify if Segmented Swept Source Optical Coherence Tomography Angiography (SS OCT-A) can provide additional information on morphology and pathophysiology of macular fibrosis in Coats’ patients.

Methods : Case Report of three male patients (5,7 and 15 years old), with macular fibrosis (stage 2b-2 patients, 3b-1patient) due to Coat’s disease.
All patients underwent SS OCT-A (Deep Range Imaging (DRI) Triton®, Topcon Corporation, Tokyo, Japan, software version: IMAGEnet® 6.0); 3x3mm macular scans of clinically healthy eyes.
We have established an in-house protocol for modified segmentation (Fig1)
1.Inner boundary was placed at internal limiting membrane
2.Outer boundary for superficial plexus- just above dense hyperreflective layer
3.Inner boundary for inner hyperreflective portion of the lesion- at the level between higher and lower hyperintensity
4.Outer portion of the lesion-from relatively decreased hyperintensity to choriocapillaris
5.Boundaries of the choriocapillaris were conducted as extension of neighbouring automated layers, as due to shadow effect no signal from the area under the lesion was obtainable
For the purpose of vascular analysis we defined a narrow layer with an inner boundary as denoted by point 2 and an outer boundary parallel to it, but 55 micrometers lower. This layer was then moved thorough the lesion to observe course of vessels. SS OCT-A B-scans were analyzed for cross-sections of vessels.
Analysis was performed by 2 independent retinal specialists. Motion and projection artifacts were taken into account.

Results : In all 3 cases SS OCT-A imaging displayed vascular structure within lesion (Fig. 2). There was associated loss of foveal avascular zone (FAZ). Inner portion of macular fibrosis displayed dense network of vessels, continuing to deeper layer. Outer portion was difficult to analyze due to shadow effect.
We have noted cross-sections of vessels at different levels on B-scans. Also, vessels penetrating deeper to the lesion were observed.
This structure was similar to retinal angiomatous proliferations (RAP).

Conclusions : Macular fibrosis has distinct vascular structure, revealed by SS OCT-A.
The imaging results suggest vascular origin of the lesion with elements resembling RAP.
SS OCT-A enables to reveal additional information about structure and pathophysiology of macular fibrosis.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

 

Fig.2 SS OCT-A imaging

Fig.2 SS OCT-A imaging

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