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Konstantinos A.A. Douglas, Jose Daniel Diaz, Patrick Oellers, John B Miller; Large Retinal Arterial Microaneurysm detection with Optical Coherence Tomography-Angiography. Invest. Ophthalmol. Vis. Sci. 2019;60(11):PB085. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal microaneurysms are small saccular outpouchings that arise from the retinal capillary system. The purpose of this study was to compare the ability of traditional imaging methods and Optical Coherence Tomography-Angiography (OCT-A) to detect retinal microaneurysms.
This is a case of a 63-year-old healthy woman who was presented to our department in the context of a routine eye exam. She denied any vision changes. On examination, best-corrected visual acuity was 20/20 OU. Biomicroscopy of the anterior segment was unremarkable apart from mild nuclear sclerosis of both eyes. Dilated fundus examination of the left eye revealed small retinal hemorrhage with surrounding exudation, most consistent with a large retinal microaneurysm. Fluorescein angiography, OCT and OCT-A were performed.
FA showed correlating hyperfluorescence, consistent with a retinal microaneurysm (Fig.1).OCT-A with segmentation of the superficial retinal layers accurately depicted the exact anatomy of the microaneurysm (Fig. 2). In addition, structural en-face OCT revealed exudation nearby. OCT-A B-scan indicated blood flow through the aneurysm and a high resolution OCT image demonstrated hard exudates and focal retinal edema. The patient was referred to her internist for workup of cardiovascular risk factors. The lesion was observed with plans for laser treatment for foveal threatening complications such as progression of lipid exudates or development of intraretinal fluid.
This case is interesting, since the aneurysm is fairly large, yet isolated without any other fundus abnormalities consistent with vascular disease. While microaneurysms can be visualized on fundus examination, further imaging modalities such as fluorescein angiography and OCT-A can be used to confirm the diagnosis, especially if they occur in the setting of hemorrhage and/or exudation. OCT-A imaging allows for efficient and noninvasive detection of a large retinal microaneurysms and provides detailed anatomical information.
This abstract was presented at the 2019 ARVO Imaging in the Eye Conference, held in Vancouver, Canada, April 26-27, 2019.
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