First Author: J.Soós HUNGARY
Co Author(s): L. Smeller R. Degi A. Facsko
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To compare optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A) with fluorescein angiography (FA) in diagnosis and analysis of a rare case of combined central rertinal vein occlusion (CRVO) and cilioretinal artery occlusion.
Optovue RTVue XR 100 Avanti angio-OCT and Topcon TRC-50 DX/D90 fundus camera.
47 years old otherwise healthy man presented with slightly decreased visual acuity (BCVA 1,0/0,8) and paracentral scotoma on his left eye. Anterior segment examination was normal. Retinal examination of the affected eye revealed a central retinal vein occlusion associated with cilioretinal artery occlusion or branch retinal artery occlusion. Ophthalmic evaluation of the patient included FA, OCT, and OCT-A. Systemic evaluation was unremarkable. The genetic screening revealed resistance to activated protein C (APC).
En face OCT demonstrates the exact extent of the ischaemic retina. The OCT presents thickening and increased inner retinal reflectivity and gives a reliable depth-resolved information of the affected ishmaemic retinal layers. Inspite of the detected ischaemic changes the FA shows normal filling of the arteries, blocked fluorescence according to the haemorrhage caused by CRVO, but the OCT-A shows that the superficial vascular network loses some collateral branches and in the deep layer capillary dropout is also seen.
CRVO associated with branch cilioretinal artery occlusion constitutes a distinct clinical entity and pathogenesis remains controversial. Recent development in imaging techniques such as OCT-A will enable better understanding of the retinal vascular abnormalities.