Search Results (5)

Background: Glaucoma is a multifactorial optic neuropathy and the leading cause of irreversible blindness worldwide. Vascular mechanisms, including impaired perfusion of the optic nerve head, are increasingly recognized as contributors to disease progression. Optical coherence tomography angiography (OCTA) enables non-invasive assessment of retinal and choroidal microvasculature, including peripapillary microvasculature dropout (MvD), which may serve as a marker of glaucomatous damage. Methods: A cross-sectional case–control study was conducted, including patients with primary open-angle glaucoma (OAG) and healthy controls. All participants underwent a comprehensive ophthalmic evaluation and OCTA imaging using the PLEX Elite 9000 system. Peripapillary vessel density (pVD), flow index (pFI), peripapillary choroidal thickness (PCT), β-zone parapapillary atrophy (β-PPA), and choroidal vascular indices were measured. MvD was defined as the complete absence of microvasculature within the β-PPA boundary. Statistical analyses included univariate and multivariate regression models to examine variables associated with PCT and to assess the association between MvD and visual field mean defect (MD), as well as other glaucoma characteristics. ROC curve analysis was performed to evaluate the ability of MvD to discriminate between different levels of visual field defects. Results: A total of 87 eyes (41 glaucomatous, 46 controls) were analyzed. Glaucoma patients exhibited significantly lower pVD, pFI, PCT, and choroidal vascular indices compared to the controls. MvD was detected in 10 glaucomatous eyes and was associated with a larger β-PPA area, smaller choroidal luminal and stromal areas, and worse mean deviation (MD) values. Multivariate regression showed that the number of ocular hypotensive treatments and StructureIndex variables were significantly associated with PCT (adjusted R² = 0.14). Logistic regression analysis identified MD, MD slope, and β-PPA area as variables significantly associated with the presence of MvD. ROC analysis showed that the presence of MvD had good discriminatory ability for visual field mean defects (MDs) (AUC = 0.77, 95% CI: 0.69–0.87; p = 0.005). Conclusions: Peripapillary MvD detected by OCTA is associated with reduced choroidal vascularity, increased β-PPA, and greater visual field deterioration in glaucoma patients. MvD may serve as a structural marker associated with functional deterioration in glaucoma patients. Full article

Uveal melanoma is the most common primary intraocular malignancy in adults, most frequently arising from the choroid, followed by the ciliary body and iris. Its diagnosis and management require precise characterization of tumor morphology, localization, and associated complications to optimize visual and systemic outcomes. Recent advances in optical coherence tomography (OCT), anterior segment OCT (AS-OCT), and OCT angiography (OCTA) have expanded the ophthalmologist’s ability to non-invasively visualize structural and vascular changes associated with this disease. In fact, enhanced depth imaging (EDI) and swept-source (SS) OCT can provide detailed views of deep ocular structures, enabling early detection of hallmark features such as subretinal fluid, retinal pigment epithelium disruption, and dome- or mushroom-shaped choroidal elevations; AS-OCT improves evaluation of lesions of the anterior segment, revealing iris architecture distortion and angle involvement; OCTA facilitates the visualization of abnormal tumor vasculature and detection of radiation-induced microvascular changes, including capillary dropout and foveal avascular zone enlargement. Moreover, these imaging modalities have demonstrated utility in differentiating uveal melanoma from pseudomelanomas, such as choroidal nevi, hemangiomas, and metastases. The present review aims at objectively assessing the use of OCT and OCTA in the diagnosis, treatment, and follow up of ocular melanoma, emphasizing their crucial role in identifying pathologic biomarkers of this potentially fatal ocular disease. Full article

(1) Background: The microstructural alterations of the peripapillary choriocapillaris in high myopes remain elusive. Here, we used optical coherence tomography angiography (OCTA) to explore factors involved in these alterations. (2) Methods: This cross-sectional control study included 205 young adults’ eyes (95 with high myopia and 110 with mild to moderate myopia). The choroidal vascular network was imaged using OCTA, and the images underwent manual adjustments to determine the peripapillary atrophy (PPA)-β zone and microvascular dropout (MvD). The area of MvD and the PPA-β zone, spherical equivalent (SE), and axial length (AL) were collected and compared across groups. (3) Results: The MvD was identified in 195 eyes (95.1%). Highly myopic eyes exhibited a significantly greater area for the PPA-β zone (1.221 ± 0.073 vs. 0.562 ± 0.383 mm², p = 0.001) and MvD (0.248 ± 0.191 vs. 0.089 ± 0.082 mm², p < 0.001) compared with mildly to moderately myopic eyes, and a lower average density in the choriocapillaris. Linear regression analysis showed that the MvD area correlated with age, SE, AL, and the PPA-β area (all p < 0.05). (4) Conclusions: This study found that MvDs represent choroidal microvascular alterations in young-adult high myopes, which were correlated with age, SE, AL, and the PPA-β zone. In this disorder, OCTA is important for characterizing the underlying pathophysiological adaptations. Full article

We sought to analyze the parameters associated with retinal nerve fiber layer (RNFL)-dominant progression or ganglion cell–inner plexiform layer (GCIPL)-dominant progression in patients with open-angle glaucoma. A prospective observational study was conducted. Overall, 58 eyes from 33 patients with open-angle glaucoma were categorized into the following two groups: patients with RNFL- and GCIPL-dominant progression, and the primary outcome was the difference in associated factors between two groups. Higher pre-treatment and mean IOP, greater lamina cribrosa curvature index (LCCI), and younger age were more significantly associated with the RNFL-dominant progression group than the GCIPL-dominant progression group. When adjusting for mean IOP, age, LCCI, and microvascular dropout (MVD), only pre-treatment IOP was significantly associated with the RNFL-dominant progression group. However, when adjusting for pre-treatment IOP, age, LCCI, and MVD, both higher mean IOP and greater LCCI were significantly associated with RNFL-dominant progression. In conclusion, pre-treatment and mean IOP and LCCI were more strongly associated with the RNFL-dominant progression group than the GCIPL-dominant progression group. In contrast, age, peripapillary choroidal microvascular dropout, and systolic and diastolic blood pressures tended to damage the GCIPL predominantly rather than the RNFL. Therefore, our findings suggest the potential to set different treatment targets and identify various treatment methods for each group. Full article

Choroidal dystrophies comprise a group of chorioretinal degenerations. However, the different findings observed among these patients make it difficult to establish a correct clinical diagnosis. The objective of this study was to characterize new clinical findings by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in these patients. Four family members with a PRPH2 gene mutation (p.Arg195Leu) were included. OCT was performed at the macula, and the thickness of the outer and inner retina, total retina, and choroid was measured. The features of the vascular network were analyzed by OCTA. Patients showed a decreased outer nuclear layer in the avascular area compared with the controls. Two patients presented greater foveal and parafoveal degeneration of the outer retina, whereas the most degenerated area in the rest was the perifovea. Disruption of the third outer band at the foveola is one of the first-altered outer bands. Slow blood flow areas or capillary dropout were main signs in the deep capillary plexus. Microaneurysms were frequently observed in less degenerated retinas. Vascular loops and intraretinal microvascular abnormalities (IRMAs) were present in the superficial plexus. Extensive degeneration of the choriocapillaris was detected. Phenotypic differences were found between patients: two showed central areolar choroidal dystrophy and the rest had extensive chorioretinal atrophy. These signs observed in OCT and OCTA can help to more appropriately define the clinical disease in patients with choroidal dystrophies. Full article