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Purpose: To report the case 70-year-old patient presenting with preretinal, abnormal vascularization accompanying an idiopathic epiretinal membrane (ERM), identified by optical coherence tomography angiography., Methods: Observational case report of one patient., Results: The authors describe the case of a patient presenting with an ERM on the right eye since March 2011, diagnosed by fundus biomicroscopy and spectral domain optical coherence tomography (Spectralis; Heidelberg Engineering, Heidelberg, Germany). At the last follow-up visit, the patient had a Snellen best-corrected visual acuity of 20/32 in her right eye and 20/20 in her left eye. Although on spectral domain optical coherence tomography the aspect on the right eye was unchanged since prior examination, optical coherence tomography angiography (Angiovue; Optovue, Fremont, CA) was able to reveal a high-flow, abnormal vascular network in the preretinal manual segmentation corresponding to the ERM., Conclusion: Spectral domain optical coherence tomography, routinely performed in these patients, may underestimate the presence of abnormal vascularization, as both preretinal neovascular complexes and thick ERMs appear as hyperreflective structures. Optical coherence tomography angiography allows a fast and depth-resolved visualization of these abnormal vascular complexes inside idiopathic ERMs. Diagnosis of a vascularized epiretinal structure could be noteworthy before decision of retinal surgery.

Purpose: To illustrate errors in the automated segmentation image analysis of optical coherence tomography angiography after laser photocoagulation therapy for Type 2 neovascularization., Methods: This case report describes a patient with extrafoveal Type 2 neovascularization treated with argon laser photocoagulation evaluated before and after treatment by optical coherence tomography angiography., Results: Disrupted retinal layers after laser photocoagulation therapy lead to segmentation errors., Conclusion: Images of optical coherence tomography angiography are prone to degradation by artifacts in cases in which there is disruption of the retinal layers. Clinicians must be aware of these errors because they can be misinterpreted as active Type 2 neovascularization. Improvement in optical coherence tomography angiography image analysis to minimize automated segmentation errors needs to be further explored.

Purpose: To describe the quantitative optical coherence tomography angiography analysis of the superficial and deep retinal capillary plexus in a case of A29 birdshot chorioretinopathy (BCR) complicated by retinal neovascularization., Methods: Multimodal retinal imaging, including optical coherence tomography angiography with quantitated vessel density analysis of the superficial and deep retinal capillary plexus, was performed in a case of A29 BCR. Capillary density (mm) was defined as the total vessel length (mm) per area (mm)., Results: A 39-year-old healthy white man presented with vitreous hemorrhage and retinal neovascularization at baseline. Clinical presentation was consistent with BCR and human leukocyte antigen testing confirmed A29 positivity. Optical coherence tomography angiography was performed 6 years after the diagnosis and revealed capillary density reduction in the superficial and especially in the deep retinal capillary plexus. Quantitative vessel density analysis was compared with the mean capillary density of 11 age-matched normal eyes and demonstrated 6% and 18% reduction of the superficial plexus in the right and left eyes of our patient, respectively. For the deep plexus, a reduction of 25% and 32% was found in the right and left eyes, respectively., Conclusion: In this patient with BCR, capillary density reduction was most marked at the deep retinal capillary plexus level and may explain the development of retinal neovascularization in this case. Quantitative optical coherence tomography angiography may be a useful tool to study and to monitor retinal microvascular changes in patients with BCR and should be further explored as a biomarker of therapeutic response.