First Author: M.Olivera SPAIN
Co Author(s): A. Laiseca J. Elizalde
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To demonstrate by a clinical case the correlation between the findings in OCT-A and fluorescein angiography in a patient affected by retinal macroaneurysm
Retinal specialist consult
A forty-nine years old male with a non-treated systemic hypertension presented to our service with a non-painfull sudden vision loss on his left eye. The visual acuity was counting fingers at 20 cm. Clinical examination revealed a hypertensive retinopathy in both eyes with a subfoveal haemorrhage in the left eye together with intraretinal haemorrhages in the territory of a macular branch retinal vein, and a presumed arterial macroaneurysm in the inferior temporal artery. The patient had a severe hypertension (230/130) so we performed an OCT-A scan in order to asses a simple and fast diagnosis
The OCT-A scan showed an abnormal arterial dilation on the inferior temporal artery, consistent with an arterial macroaneurysm. Twenty-four hours later (with the patient haemodynamically stable) the fluorescein angiography confirmed the presence of an arterial macroaneurysm, but partially occluded. A pars plana vitrectomy, subretinal injection of rTPA and an air bubble exchange was performed. Three months later the visual acuity on the left eye was 20/50, with no blood remnants on the subretinal space and some residual intraretinal haemorrhages.
In our patient we found a strong correlation between the information obtained from both the OCT-A and the fluorescein angiography except for the limitation to assess the permeability of the macroaneurysm vascular lumen with the OCT-A. The OCT-A scan is a fast, safe and non-invasive diagnostic tool that could be crucial in cases where a fluorescein angiography could be dangerous in haemodynamically unstable patients.