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This study compared macular capillary parameters between healthy black and white subjects using optical coherence tomography angiography (OCTA). We measured vessel density (VD) of superficial (SCP), intermediate (ICP), and deep (DCP) capillary plexuses and choriocapillaris blood flow area (BFA) of the fovea, parafovea and total 3 mm-diameter circular area centered on the fovea, as well as the foveal avascular zone (FAZ) parameters, controlling for axial length. Black subjects had lower foveal and parafoveal VD in the SCP (p = 0.043 and p = 0.014) and the ICP (p = 0.014 and p = 0.002). In the DCP, black subjects had a trend toward lower foveal and parafoveal VD. Black subjects had decreased choriocapillaris BFA in the total 3 mm area (p = 0.011) and the parafovea (p = 0.033), larger FAZ area (p = 0.006) and perimeter (p = 0.014), and a higher capillary density in a 300 μm wide region around the FAZ (FD-300) (p = 0.001). There was no significant difference in FAZ acircularity index. To our knowledge, this is the first report analyzing the three distinct retinal capillary plexuses and identifying differing baseline VD, choriocapillaris and FAZ parameters in healthy young black compared to white subjects. Larger studies are needed to validate these findings and better understand racial differences in vulnerability to ocular diseases.

Purpose: The purpose of this study was to analyze retinal capillary parameters using optical coherence tomography angiography (OCTA) of the affected eye and the fellow eye of unilateral normal tension glaucoma (NTG) patients and compare the findings with eyes from a normal control group.Methods: A retrospective cross-sectional study was carried out on patients diagnosed with unilateral NTG (24 affected eyes and 24 fellow eyes each) and normal individuals (29 eyes, the control group). OCTA was used to measure the vascular density (VD) and perfusion density (PD) of the macular area and the peripapillary area.Results: In the superficial capillary plexus, the fellow eye group of unilateral NTG patients showed a decrease in VD of the inner-inferior and PD of the inner-inferior and outer-average peripapillary area, compared with the normal control group (p = 0.008, p < 0.001, and p = 0.001). In the affected NTG eye group, the VD (p = 0.014, p = 0.011, p < 0.001, p < 0.001, and p < 0.001) and PD (p = 0.017, p = 0.023, p < 0.001, p = 0.001, and p < 0.001) of the total, inner-average, inner-inferior, and outer-inferior peripapillary area, and the outer-inferior macular area decreased compared to the fellow eye and normal control group, as well as the VD of the outer-average peripapillary area (p = 0.010). The PD of the outer-average peripapillary area (p = 0.003); the VD (p = 0.041, p = 0.008, p = 0.006) and the PD (p = 0.013, p < 0.001, p = 0.001) of the total, inner-inferior, and outer-average macular area; and the PD of the outer-temporal macular area (p = 0.003) were lower than the normal control group. There was no difference in the VD or PD obtained from the deep capillary plexus of the macular area among the groups.Conclusions: It is useful to observe retinal capillary parameters using OCTA for patients with unilateral NTG.

PURPOSE Macular neovascularization (MNV) secondary to age-related macular degeneration can be characterized by quantitative optical coherence tomography angiography. The aim of the study was to assess the evolution of quantitative optical coherence tomography angiography parameters after 1 year of antivascular endothelial growth factor injections. METHODS Naive age-related macular degeneration-related MNV eyes were prospectively recruited to analyze optical coherence tomography and optical coherence tomography angiography parameters, including MNV vessel tortuosity (VT) and reflectivity, at baseline and at the end of the follow-up. Macular neovascularization eyes were categorized by a MNV VT cutoff, and quantitative parameter variations were documented after 1 year of treatment. We divided MNV eyes into Group 1 (MNV VT 8.40). RESULTS Thrity naive age-related macular degeneration-related MNV eyes (30 patients) were included. Our cohort included 18 Type 1 MNV and 12 Type 2 MNV lesions. Baseline central macular thickness (411 ± 85 µm) improved to 323 ± 54 µm at 1 year (P < 0.01). Only Group 1 MNV displayed significant visual improvement. Macular neovascularization VT values remained stable over the follow-up in both subgroups. Group 2 MNV eyes showed increased MNV reflectivity and increased MNV area at the end of the follow-up. Quantitative retinal capillary plexa parameters were found to be worse in Group 2 MNV. Outer retinal atrophy occurred in 2 of the 18 eyes in MNV Group 1 (11%) and in 6 of the 12 eyes in MNV Group 2 (50%) after 1 year. Vessel density proved to be always worse in Group 2 than in Group 1. CONCLUSION Macular neovascularization VT provides information on the blood flow and identifies two subgroups with different final anatomical and visual outcomes, regardless of the treatment effect.

A series is presented of sixteen cases of retinal capillary haemangioma (RCH) from consecutive patients at an ophthalmology teaching hospital in Mexico City. There were seven primary haemangioblastomas, and nine due to von Hippel-Lindau disease (VHL). All cases associated with VHL already had systemic manifestations, such as, cerebellar, medullary and renal tumours. Treatment of capillary haemangiomas must be individualised, based on several factors, including the number of lesions, exudation, or presence of retinal detachment. A multidisciplinary approach is essential.

BACKGROUND A nocturnal non-dipping pattern has been associated with hypertension-mediated organ damage (HMOD), morbidity and mortality. Retinal imaging through application of modern technologies including optical coherence tomography angiography (OCT-A) can provide detailed insights into early vascular damage. In this observational study, we investigated the relationship of microscopic vascular density in the retina measured with OCT-A and nocturnal blood pressure (BP) dipping. METHODS Retinal OCT-A and ambulatory BP monitoring (ABPM) data prospectively obtained from 142 patients referred to a tertiary hypertension clinic were analysed with regression models for associations between BP night-time dipping and retinal capillary vascular density in three different zones around the fovea. RESULTS More pronounced nocturnal SBP and DBP dipping was significantly associated with increased vascular density in the central foveal area of the retina. These associations were robust to adjustment for other available risk factors including mean daytime BP. Parafoveal and whole image vascular density did not show equivalent significant associations with nocturnal BP dipping. The results were reproducible when assessed in a subgroup of patients who had concomitant type 2 diabetes. CONCLUSION Foveal vascular density was associated with the nocturnal BP dipping pattern in hypertensive patients. These associations were robust to adjustment of relevant factors such as daytime BP. Our findings highlight the importance of nocturnal BP features reflected in ambulatory BP monitoring in the assessment of HMOD. Whether routine assessment of retinal damage markers may improve risk management of hypertensive patients remains to be determined.

PURPOSE: The present study investigates by optical coherence tomography angiography (OCTA) the retinal capillary plexus and choriocapillaris flow voids and their possible correlation with MEKAR. METHODS: 34 eyes of 17 patients (61.5 years [30.4-77.4]) with stage IV cutaneous melanoma were included prospectively. All patients showed disease progression under treatment with Nivolumab/Ipilimumab and were subsequently treated with the MEK-inhibitor Trametinib 2 mg once daily. At the start and every 6 weeks during follow-up of 4 months, patients underwent a complete ophthalmologic exam, OCTA and when needed fluorescein angiography. RESULTS: Statistical analysis was performed on 17 eyes of 9 patients. Eight patients were excluded due to missing OCTA images or due to drop-out because of decease or change of treatment. Comparing vessel area density (P = .625 and 0.681, respectively), vessel skeleton density (P = .996 and 0.766, respectively) of the superficial and deep capillary plexus, flow void number and total flow void area (mm2 and %) (P = .495; 0.197 and 0.298, respectively) of choriocapillaris slab, before and after treatment, revealed no significant difference. The evolution of choriocapillaris flow void parameter did not significantly differ in patients, who developed MEKAR compared to patients who did not. CONCLUSION: In patients receiving MEK-inhibitor with and without MEKAR, no significant different characteristics of the retinal capillary plexus and choriocapillaris were found. These data suggest that the development of MEKAR, has no correlation with vascular alteration.

Systemic lupus erythematosus can affect any organ system at presentation and throughout its course. Lupus retinal vasculitis is responsible for the visual loss of variable severity and typically ascribed to the involvement of pre-capillary superficial arterial vasculature. Using multimodal imaging techniques and electrophysiology, we demonstrate the first-ever case of severe lupus retinal vasculitis resulting in the rare association of paracentral acute middle maculopathy. The findings showcase the involvement of both superficial and deep retinal capillary vasculature and the localisation of retinal dysfunction. This precise evaluation facilitated the timely use of combination immunomodulatory therapy with localised pan-retinal laser photocoagulation, resulting in the preservation of vision.

PurposeTo test whether a single or composite set of parameters evaluated with optical coherence tomography angiography (OCTA), representing retinal capillary closure, can predict non-proliferative diabetic retinopathy (NPDR) staging according to the gold standard ETDRS grading scheme.Methods105 patients with diabetes, either without retinopathy or with different degrees of retinopathy (NPDR up to ETDRS grade 53), were prospectively evaluated using swept-source OCTA (SS-OCTA, PlexElite, Carl Zeiss Meditec) with 15×9 mm and 3×3 mm angiography protocols. Seven-field photographs of the fundus were obtained for ETDRS staging. Eyes from age-matched healthy subjects were also imaged as control.ResultsIn eyes of patients with type 2 diabetes without retinopathy or ETDRS levels 20 and 35, retinal capillary closure was in the macular area, with predominant alterations in the parafoveal retinal circulation (inner ring). Retinal capillary closure in ETDRS stages 43–53 becomes predominant in the retinal midperiphery with vessel density average values of 25.2±7.9 (p=0.001) in ETDRS 43 and 23.5±3.4 (p=0.001) in ETDRS 47–53, when evaluating extended areas of 15×9 protocol. Combination of acquisition protocols 3×3 mm and 15×9 mm, using SS-OCTA, allows discrimination between eyes with mild NPDR (ETDRS 10, 20, 35) and eyes with moderate-to-severe NPDR (ETDRS grades 43–53).ConclusionsRetinal capillary closure, quantified by SS-OCTA, can identify NPDR severity progression. It is located mainly in the perifoveal retinal capillary circulation in the initial stages of NPDR, whereas the retinal midperiphery is predominantly affected in moderate-to-severe NPDR.

Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus. Optical coherence tomography angiography (OCTA) has been developed to visualize the retinal microvasculature and choriocapillaris based on the motion contrast of circulating blood cells. Depth-resolved ability and non-invasive nature of OCTA allow for repeated examinations and visualization of microvasculature at the retinal capillary plexuses and choriocapillaris. OCTA enables quantification of microvascular alterations in the retinal capillary network, in addition to the detection of classical features associated with DR, including microaneurysms, intraretinal microvascular abnormalities, and neovascularization. OCTA has a promising role as an objective tool for quantifying extent of microvascular damage and identify eyes with diabetic macular ischaemia contributed to visual loss. Furthermore, OCTA can identify preclinical microvascular abnormalities preceding the onset of clinically detectable DR. In this review, we focused on the applications of OCTA derived quantitative metrics that are relevant to early detection, staging and progression of DR. Advancement of OCTA technology in clinical research will ultimately lead to enhancement of individualised management of DR and prevention of visual impairment in patients with diabetes.

PURPOSE This study aimed to evaluate parafoveal and peripapillary microvascular alterations in eyes with optic neuritis (ON) along with their fellow eyes compared to healthy control eyes using optical coherence tomography angiography (OCT-A). METHODS We included 31 ON-affected eyes and 31 fellow eyes of 31 patients who had experienced unilateral ON and 33 eyes of 33 healthy controls in this exploratory retrospective cross-sectional study. Optical coherence tomography angiography (OCT-A) was used to generate microvascular structural images and quantify the vessel density of the superficial retinal capillary plexus (SRCP), the deep retinal capillary plexus (DRCP) and radial peripapillary capillary (RPC) segments. We used the Kruskal-Wallis test for the comparison of OCT-A results between the three groups and generalized estimating equation models for the pairwise comparisons. RESULTS There were significant differences of SRCP (p = 0.0003) and RPC segment (p

PURPOSE To measure the vascular density (VD) of the retinal capillary plexuses by optical coherence tomography angiography (OCTA) after surgery for an idiopathic macular hole. METHODS Retrospective, observational case series.Sixteen eyes of 16 patients with an idiopathic macular hole underwent vitrectomy with internal limiting membrane peeling. The VDs of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were determined by OCTA, and the retinal sensitivity (RS) and the inner retinal thickness (IRT) were measured before, and at 3, 6, and 12 months after the surgery. The VD, RS, and IRT were measured at the four parafoveal quadrants. RESULTS The mean age was 68.9 years. The VDs of the SCP and DCP were significantly correlated with the RS and IRT at 12 months postoperatively (all P < 0.001 for both SCP and DCP). The VDs of the SCP and DCP were higher, the RS more sensitive, and the IRT thicker in the nasal than the temporal quadrant at 12 months (P < 0.001

Objective To characterize the microvascular retinal changes after repair of macula-off rhegmatogenous retinal detachment (RRD) using optical coherence tomography angiography (OCT-A). Patients and methods A retrospective review of patients who underwent repair of macula-off RRD. Fellow unaffected eyes were used as controls. Post-operative OCT-A allowed comparison of vessel density (VD) and foveal avascular zone (FAZ) area in the superficial and deep retinal capillary plexus (DCP) as well as VD in the choriocapillaris layer. Results Seventeen eyes of 17 RRD patients were included in the final analysis. There was a reduction in VD of the deep retinal capillary plexus in affected eyes compared to fellow eyes (p = 0.046). RRD eyes with reduced VD in DCP compared with their fellow control eyes had worse visual acuity after repair compared to those without (p = 0.032). No significant microvasculature changes were detected in the FAZ area and VD in the superficial capillary plexus and choriocapillaris compared to fellow eyes. Conclusion In macula-off RRD eyes, significant microvascular changes were detected in the DCP using OCT-A even after successful anatomical repair. Decreased VD in the DCP compared to the fellow healthy eyes was correlated with worse visual acuity.

PURPOSE To explore the peripapillary capillary density distribution and its correlation with nerve fibre layer in superficial and deep retinal layers of healthy Chinese. METHODS Images of superficial and deep retinal capillary networks were obtained by optical coherence tomography angiography (OCTA) using a CIRRUS TM HD-OCT Model 5000 system and analyzed by Image-Pro Plus (Medical Cybernetics, Version 6.0). Peripapillary capillary density was defined as the mean optical density of the annular region between two concentric circles of 3.085 mm and 3.835 mm diameter. Parafoveal capillary density was defined as the mean optical density between the foveal avascular zone (FAZ) boarder and a 2.5 mm diameter circle. Retinal nerve fibre layer (RNFL) thickness was also measured and the correlation with capillary density determined. RESULTS Mean peripapillary capillary density was 4.16±1.06 in the superficial and 2.92±0.80 in the deep layer. Corresponding mean parafoveal densities were 2.65±0.55 and 2.51±0.55. Capillary densities were higher in the superficial layer of all quadrants for both peripapillary and parafoveal regions (P

Purpose: To develop an algorithm for the diagnosis of Behçet's disease (BD) uveitis based on ocular findings.Methods: Following an initial survey among uveitis experts, we collected multi-center retrospective data on 211 patients with BD uveitis and 207 patients with other uveitides, and identified ocular findings with a high diagnostic odds ratio (DOR). Subsequently, we collected multi-center prospective data on 127 patients with BD uveitis and 322 controls and developed a diagnostic algorithm using Classification and Regression Tree (CART) analysis and expert opinion.Results: We identified 10 items with DOR >5. The items that provided the highest accuracy in CART analysis included superficial retinal infiltrate, signs of occlusive retinal vasculitis, and diffuse retinal capillary leakage as well as the absence of granulomatous anterior uveitis or choroiditis in patients with vitritis.Conclusion: This study provides a diagnostic tree for BD uveitis that needs to be validated in future studies.

The aim of this study was to compare the macular and peripapillary capillary vessel density (CVD) and foveal avascular zone (FAZ) in amblyopic eyes of adults with their fellow eyes and with eyes of healthy controls using optical coherence tomography-angiography (OCT-A). A total of 34 eyes of 17 patients with anisometropic amblyopia and 80 eyes of 40 age- and gender-matched healthy controls were included. CVD in superficial (SCP) and deep retinal capillary plexuses (DCP), peripapillary region, and FAZ were analyzed by OCT-A. The median ages were 31 years (range 20–64) in patients with amblyopia and 34.5 years (range 24–65) in healthy controls (p = 0.242). The mean FAZ area measured was 0.329 ± 0.024 mm2 in amblyopic eyes, 0.332 ± 0.025 mm2 in fellow eyes, and 0.269 ± 0.015 mm2 in control eyes (p

To study the retinal capillary microvasculature and the choriocapillaris (CC) in myopic eyes using swept-source optical coherence tomography angiography (SS-OCTA). Patients with high myopia (≥ − 6D; axial length ≥ 26.5 mm), moderate myopia (≥ − 3D, 0.05). The VLDs of the SCP were lower in the high and moderate myopia groups compared with the control group (p 0.05). The retinal microvasculature may demonstrate alterations in highly myopia eyes. The CC in macular regions shows greater impairment in eyes with high myopia compared with eyes with lesser degrees of myopia, and these deficits are already present in the absence of features of pathologic or degenerative myopia. The threshold of CC FD leading to myopic maculopathy remains to be defined.

Purpose: To quantitatively assess the retinal capillary vessel density (VD) and foveal avascular zone (FAZ) area in acute and chronic central serous chorioretinopathy (CSC) patients compared to healthy subjects using optical coherence tomography angiography (OCTA) and determine their correlation with visual acuity (VA). Methods: This was a cross-sectional, case-control study. All subjects were divided into three groups: acute CSC, chronic CSC, and healthy controls. The best-corrected VA test, optical coherence tomography, and OCTA were performed on the same day. In this study, we recorded and compared the main data of FAZ and VD in 3 × 3 mm OCTA images among three groups, also calculated the correlation between OCTA variables and VA in CSC patients. Results: A total of 148 subjects (148 eyes) were included in this study, with 50 eyes in acute CSC, 48 eyes in chronic CSC, and 50 eyes in control groups. The mean age was 50.11 ± 8.14 years. Chronic CSC had the significantly lowest VD both on the superficial and deep retina and the largest FAZ (0.39 ± 0.13 mm2) compared to acute CSC and controls (all p < 0.05). There was no statistical difference between acute CSC and controls on VD or FAZ (both p > 0.05). In chronic CSC, both the decreased VD on deep retina and expanded FAZ were correlated with a worse VA (both p < 0.05). Conclusions: OCTA could serve as a reliable tool to evaluate different courses of CSC quantitively. In 3 × 3 mm OCTA images, both decreased VD and expanded FAZ were observed in chronic CSC patients.

OBJECTIVE The aim: Improvement of early diagnostics quality and efficiency of chronic pharyngeal diseases (CPD) treatment in children with DM-1 by studying the clinical and laboratory features of the disease course and complex therapy administration. PATIENTS AND METHODS Materials and methods: A comprehensive examination of 707 children with diabetes mellitus-1, aged 3 to 18, was conducted, which determined clinical and laboratory features of their state in the presence and absence of chronic tonsillitis (CT). RESULTS Results: Using microbiological and cytological examination of the palatine tonsils (PT) crypts, the leading role of microbial associations in the pathogenesis of HT in the formation of immune inflammation was determined, their influence on the local immunity indices was defined. Significant disturbances of the microcirculatory bed (MCB) in the presence of HT in children with DM-1, direct correlation between CPD and the presence of vascular glomeruli, changes in the retinal capillary structure (r = 0,332; p

Purpose: To assess the characteristics of parafoveal microvascular abnormalities in Behcet's uveitis (BDU) using projection-resolved optical coherence tomographic angiography (PR-OCTA).Methods: A retrospective study of BDU patients who underwent PR-OCTA examination between April 1, 2017 and October 31, 2018.Results: Sixty consecutive BDU patients (102 eyes) were included. Sixty-two (124 eyes) healthy subjects served as normal controls (NCs). As compared with NCs, the vessel densities (VDs) of superficial and deep retinal capillary plexuses were decreased, and the fovea avascular zone area, perimeter and acircularity index were increased in BDU eyes (all p

Introduction Being underweight (body-mass index < 18.50 kg/m2) is associated with significantly higher morbidity than having normal weight. We aimed to investigate the changes in choroid and retinal capillary microcirculation with optical coherence tomography angiography in underweight female subjects compared with an age- and sex-matched population of healthy subjects. Methods This prospective, cross-sectional study included 48 eyes of 48 healthy female subjects, of whom 23 were underweight and 25 had normal weight. Optical coherence tomography angiography was used for the evaluation of retinal vessel density, foveal avascular zone, subfoveal central macular thickness, subfoveal choroidal thickness, and choriocapillaris flow area. Results The mean choriocapillaris flow area was statistically significantly higher in the underweight group (2.201 ± 0.11 mm2) compared to the control group (2.111 ± 0.11 mm2) (p=0.005). The subfoveal choroidal thickness was higher in the underweight group (340 ± 61.2 µm) compared to the control group (317 ± 20.8 µm) but the difference was not statistically significant (p=0.099). Similarly, no statistically significant difference was determined between the groups concerning the vessel density, subfoveal central macular thickness, and foveal avascular zone. Conclusions Being underweight is associated with a higher subfoveal choroidal thickness and choriocapillaris flow area, independent of additional factors, such as age, axial length, intraocular pressure, and major ocular diseases.

Purpose: To investigate the correlation between retinal capillary structure and macular function in patients with idiopathic epiretinal membrane (iERM) by using optical coherence tomography angiography (OCTA) and microperimetry.Methods: This retrospective and observational study included 30 idiopathic ERM eyes of 30 consecutive patients. OCTA was performed to evaluate macular microvasculature including the superficial capillary plexus, deep capillary plexus, and foveal avascular zone. Best corrected visual acuity (BCVA) and microperimetry were measured at baseline and 3 months after surgery. Associations between macular microvasculature and visual function were assessed.Results: Visual function including BCVA and macular sensitivity improved significantly at 3 months post-operatively (p < 0.001). At baseline, BCVA was positively correlated with foveal or parafoveal sensitivities and negatively correlated with central foveal thickness (p < 0.05). Pre-operative foveal sensitivity was significantly correlated with the vessel density of foveal or parafoveal superficial capillary plexus (p < 0.05). A multiple regression model revealed that pre-operative vessel density of foveal deep capillary plexus was an independent positive prognostic factor for post-operative BCVA (B = −0.020 ± 0.006, p = 0.006) and macular sensitivity (B = 0.200 ± 0.081, p = 0.027).Conclusion: Integrated evaluation of iERM by using OCTA and microperimetry shows an association between microvasculature and macular sensitivity. Pre-operative vessel density of foveal deep capillary plexus assessed by OCTA may be a potentially valuable prognostic factor for iERM surgery.

ObjectiveTo determine whether swept-source optical coherence tomographic angiography (SS-OCTA) can demonstrate choroidal perfusion abnormalities seen on fluorescein angiography (FA) in giant cell arteritis (GCA).DesignObservational case series.ParticipantsSix eyes of 3 patients with bilateral ischemic optic neuropathy secondary to GCA, and one control patient without ocular involvement from biopsy-confirmed GCA.MethodsEn face SS-OCTA (DRI OCT Triton, Topcon, Tokyo, Japan) and FA centered on the macula were obtained at presentation. SS-OCTA was segmented into superficial and deep retinal capillary plexuses and the choriocapillaris laminae. SS-OCTA images were independently analyzed for perfusion abnormalities and compared with corresponding FA images.Main Outcome MeasuresCorrespondence of choroidal angiographic abnormalities on SS-OCTA and FA.ResultsSS-OCTA showed decreased angiographic signal within the choriocapillaris in 5/6 eyes and corresponded to hypoperfusion abnormalities on FA in similar geographic distributions in 5/5 eyes. SS-OCTA also showed dilation of the deep retinal capillary plexus overlying the area of choroidal hypoperfusion in one eye. In the one eye without angiographic signal abnormalities on SS-OCTA, no perfusion changes were noted on FA. One control patient without ocular involvement from biopsy-confirmed GCA did not show choroidal perfusion changes on SS-OCTA or FA.ConclusionsThis case series demonstrates comparability between SS-OCTA and FA in detection and characterization of choroidal hypoperfusion secondary to GCA. As a rapid and non-invasive tool, SS-OCTA may serve as a viable alternative to FA in the diagnostic evaluation of GCA.

The segmentation of en face retinal capillary angiograms from volumetric optical coherence tomographic angiography (OCTA) usually relies on retinal layer segmentation, which is time-consuming and error-prone. In this study, we developed a deep-learning-based method to segment vessels in the superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) directly from volumetric OCTA data. The method contains a three-dimensional convolutional neural network (CNN) for extracting distinct retinal layers, a custom projection module to generate three vascular plexuses from OCTA data, and three parallel CNNs to segment vasculature. Experimental results on OCTA data from rat eyes demonstrated the feasibility of the proposed method. This end-to-end network has the potential to simplify OCTA data processing on retinal vasculature segmentation. The main contribution of this study is that we propose a custom projection module to connect retinal layer segmentation and vasculature segmentation modules and automatically convert data from three to two dimensions, thus establishing an end-to-end method to segment three retinal capillary plexuses from volumetric OCTA without any human intervention.

In this case report, SS-OCTA identified the key diagnostic features of JRCH seen with multimodal imaging. Serial SS-OCTA imaging showed transient decreases in vascular congestion and exudation after intravitreal anti-VEGF injections. SS-OCTA may be the sole imaging modality needed for the diagnosis of JRCH, an important entity that is commonly misdiagnosed as disc edema or choroidal neovascularization. Transient responses to anti-VEGF therapy suggests that higher dose or sustained-release anti-VEGF therapy may be effective for retinal capillary hemangioblastomas.

Purpose:To investigate eyes with solitary large aneurysms arising from retinal capillaries.Methods:Consecutive patients with aneurysms greater than 200 µm in diameter were evaluated with a comprehensive ophthalmologic examination including optical coherence tomography, optical coherence tomography a

PURPOSE To examine the relationship between ischemia and disorganization of the retinal inner layers (DRIL). METHODS Cross-sectional retrospective study of 20 patients (22 eyes) with diabetic retinopathy presenting to a tertiary academic referral center, who had DRIL on structural optical coherence tomography (OCT) using Spectralis HRA + OCT (Heidelberg Engineering, Heidelberg, Germany) and OCT angiography with XR Avanti (Optovue Inc, Fremont, CA) on the same day. Optical coherence tomography angiography images were further processed to remove flow signal projection artifacts using a software algorithm adapted from recent studies. Retinal capillary perfusion in the superficial capillary plexuses, middle capillary plexuses, and deep capillary plexuses, as well as integrity of the photoreceptor lines on OCT was compared in areas with DRIL to control areas without DRIL in the same eye. RESULTS Qualitative assessment of projection-resolved OCT angiography of eyes with DRIL on structural OCT demonstrated significant perfusion deficits compared with adjacent control areas (P < 0.001). Most lesions (85.7%) showed superimposed superficial capillary plexus and/or middle capillary plexus nonperfusion in addition to deep capillary plexus nonflow. Areas of DRIL were significantly associated with photoreceptor disruption (P = 0.035) compared with adjacent DRIL-free areas. CONCLUSION We found that DRIL is associated with multilevel retinal capillary nonperfusion, suggesting an important role for ischemia in this OCT phenotype.

Background To investigate the retinal capillary density (RCD) of the macula using optical coherence tomography angiography (OCT-A) in type 2 diabetic patients and to further determine the association with risk factors. Methods A total of 212 eyes from 212 subjects were recruited; subjects included diabetics with no retinopathy (NDR, n = 90 eyes), diabetics with mild retinopathy DR (MDR, n = 36 eyes), and healthy participants (Control, n = 86 eyes). All participants underwent OCT-A scanning. RCD was quantified by superficial and deep retinal capillary layers (SRCL and DRCL) from OCT-A images. Results RCD in SRCL and DRCL was lower in NDR (P 55y, HbA1c > 7% had significantly reduced DRCL (P 8.2 mmol/L had significantly reduced SRCL and DRCL when compared to the other group of diabetics. Conclusions Risk factors including older age, higher level of HbA1c, LDL-C and BUN, were associated with lower RCDs found in type 2 diabetic patients with and without mild DR by OCT-A. The impairment of retinal capillary by OCT-A may play a key role in the early monitoring of management in diabetes.

Transsynaptic retrograde degeneration (TSRD) of the visual pathways is the loss of retinal ganglion cells occurring upstream from a posterior visual pathway lesion. We present a case of a 54-year-old woman with an epidermoid cyst at the right temporo-occipital junction, in whom retinal optical coherence tomography angiography showed a reduction of the superficial retinal capillary density consistent with TSRD. While this reduction has been described in chronic optic neuropathies and pregeniculate lesions, to our knowledge, this is the first case report showing how a reduction in the superficial retinal capillary density occurs also for a postgeniculate lesion.

Background: Retinal capillary hemangiomas (RCH) are rare, benign, vascular tumours characterized by capillary andglial cell proliferation. We report the management of a patient with a unilateral endophytic papillary RCH withexudations and serous retinal detachment.Methods: Case reportResults: A 46-year old female presented with papillary RCH without association with von Hippel-Lindau syndrome.She was given two doses of intravitreal bevacizumab following which the serous detachment resolved. When theedema recurred again, she was given a dose of 4mg intravitreal triamcinolone acetate. The edema resolved and didnot recur till the end of three months. She was given the option of photodynamic therapy, however, she did notconsent for the procedure due to the high costs involved.Conclusion: Intravitreal injections can be used as a temporary remedy for the treatment of macular edema causedby RCH. However, currently there is no ideal definitive treatment available for papillary RCH. Larger studies arenecessary to establish the treatment for this condition.

Purpose: To investigate the retinal capillary perfusion density by means of optical coherence tomography angiography (OCT-A) in idiopathic epiretinal membrane (ERM) and macular pseudoholes (MPH). Methods: This observational cross-sectional study examined consecutive patients affected by ERM and MPH presenting between June 2017 and December 2017, as well as the 30 eyes of 30 healthy subjects. All patients underwent swept-source OCT-A examination. For each patient, vessel perfusion density and foveal avascular zone (FAZ) area were measured. Results: Twenty-five eyes of 20 patients with ERM and 28 eyes of 24 patients with MPH were enrolled. Thirty eyes of 30 age-matched healthy controls were included. The perfusion density in the superficial capillary plexus (SCP) of ERM (0.401 ± 0.012) turned out to be inferior that MPH (0.419 ± 0.018) and controls (0.415 ± 0.017) (p < 0.01), while no significant differences were evident among the three subgroups in the deep capillary plexus (DCP) (p = 0.1). The FAZ area in the SCP was smaller in the ERM group (0.168 ± 0.123mm2), respectively, than MPH (0.295 ± 0.013mm2) and controls (0.213 ± 0.107mm2) (p < 0.01), otherwise no difference were noted in the DCP (p = 0.14). Conclusions: OCT-A morphological features differ between idiopathic ERM and MPH, showing lower perfusion density in idiopathic ERM compared to MPH.

Objective: Reduction in capillary density or rarefaction is a hallmark of essential hypertension. We measured the retinal capillary density using noninvasive optical coherence tomographic angiography (OCT-A) in adults with treated systemic hypertension and determined possible correlations with ambulatory blood pressure (BP) and renal parameters. Methods: This observational cross-sectional study consisted of 153 normal eyes from 77 nondiabetic hypertensive adults [mean (SD) age, 58 (9) years; 49% women; 23% poorly controlled BP]. Data on 24-h ambulatory BP monitoring, serum creatinine, and urine microalbumin/creatinine ratio (MCR) were collected. Estimated glomerular filtration rate (eGFR) was calculated based on CKD-EPI Creatinine Equation. Retinal capillary density measured with the OCT-A (AngioVue) at superficial (SVP) and deep vascular plexuses (DVP). Linear regression was used to investigate the association of risk factors with capillary density. Results: Retinal capillary density (percentage) at DVP was reduced in patients with poorly controlled BP (SBP = 148 ± 8 mmHg; 27.2 ± 13.0) compared with those with well controlled BP (SBP = 125 ± 9 mmHg; 34.7 ± 11.3). In the multivariable analysis, poorly controlled BP [β = −6.49, 95% confidence interval (CI), −12.39 to −0.59], higher SBP (β = −0.23, 95% CI −0.44 to −0.02) and lower eGFR (β = 6.42, 95% CI 1.25–11.60) were associated with sparser retinal capillary density. Systemic factors were not associated with capillary density at SVP (all P > 0.05). Conclusion: In adults with treated systemic hypertension, retinal capillary density reduced with higher BP and poorer eGFR. These findings highlight the potential role of OCT-A to study early microvascular changes because of systemic hypertension. National Medical Research Council (NMRC) Published version L.S.Funding received for this workfrom National Medical Research Council (NMRC/CG/C010A/2017), Singapore.

Retinal angiomas are rare tumors that develop within the vascular bed of the retina. Their occurrence may be sporadic or as part of the multisystem disorder called von Hippel-Lindau disease. It is well established in literature that retinal angiomas have a natural history of evolving as small aneurysmal dilatations and progressing to vision-threatening retinal detachments. Several approaches to the management of these angiomas have been reported in the literature, but it is difficult to decipher which modality is best suited for which type of angioma. A classification of retinal angiomas is proposed herein. A classification system may help in developing future guidelines for the study, screening, treatment, and prognostication of patients with retinal angiomas.

To quantify and to study the relationship between retinal microvascular changes and different stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA). This prospective observational study included the eyes of patients with different stages of DR. OCTA was performed in all eyes using a 9 × 9 mm protocol. We analyzed the superficial and deep retinal capillary plexuses, for the following OCTA parameters: number of microaneurysms (MA), number of intraretinal microvascular abnormalities (IRMA), the total surface of capillary non-perfusion (CNP) areas, and vascular density (VD). The association between those parameters and the severity of DR was studied. A total of 70 eyes of 45 patients were included. The number of MA in the superficial capillary plexus (SCP) showed a significant association with DR severity (p = 0.03). The number of IRMA and the total surface of CNP areas were associated with the severity of DR in both plexuses (p = 0.019 in the SCP and p = 0.044 in the DCP for IRMA; p