Optical coherence tomography for guidance of distal cell recrossing in bifurcation stenting: choosing the right cell matters

2012 ◽  
Vol 8 (2) ◽  
pp. 205-213 ◽  
Author(s):  
Eduardo Alegría-Barrero ◽  
Nicolas Foin ◽  
Pak Hei Chan ◽  
Dimitrios Syrseloudis ◽  
Alistair C Lindsay ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence ◽  
Bifurcation Stenting ◽  
The Right ◽  
Distal Cell

scholarly journals New Stenting Technique to Achieve Favorable Jailing Configuration on Side Branch Ostium: Bent Stent Technique

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Fumiaki Nakao
Keyword(s):  
Optical Coherence Tomography ◽  
Three Dimensional ◽  
Side Branch ◽  
Optical Coherence ◽  
Coronary Bifurcation ◽  
First Report ◽  
Incomplete Stent Apposition ◽  
Bifurcation Stenting ◽  
Distal Cell

According to data from stent-enhanced three-dimensional optical coherence tomography, incomplete stent apposition after side branch dilation in coronary bifurcation stenting can be reduced by the free carina type (no links bridged from a carina) and by distal cell rewiring. This is the first report to describe a bent stent technique that was devised to achieve the free carina type (no links bridged from a carina), as a favorable jailing configuration.

scholarly journals Instant Stent-Accentuated Three-Dimensional Optical Coherence Tomography Guided Selection of Proper Distal Cell for Side Branch Dilatation in Bifurcation Stenting

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Fumiaki Nakao
Keyword(s):  
Optical Coherence Tomography ◽  
Three Dimensional ◽  
Side Branch ◽  
Optical Coherence ◽  
Two Dimensional ◽  
Bifurcation Stenting ◽  
Distal Cell ◽  
Selection Of

In the bifurcation stenting, the distal rewiring for the side branch postdilatation confirmed by two-dimensional modalities may not lead to favorable results in some cases. If there are two distal cells divided by the link bridging from the carina, the rewiring through the larger distal cell may be recommended for the side branch postdilatation. Detailed confirmation of the rewired cell by the intraprocedural instant stent-accentuated three-dimensional optical coherence tomography is important.

scholarly journals 949. Use of Optical Coherence Tomography Angiography to Assess Microvascular Health Among Persons with HIV: Employing the Retina as a Convenient Window

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S507-S507
Author(s):  
Lauren F Collins ◽  
Jessica G Shantha ◽  
Peter L Nesper ◽  
Anandi N Sheth ◽  
Amani A Fawzi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Vasculitis ◽  
Organ Damage ◽  
Screening Tools ◽  
Foveal Avascular Zone ◽  
Invasive Technique ◽  
Optical Coherence ◽  
Hiv Diagnosis ◽  
The Right

Abstract Background Mechanisms underlying the rising burden of non-AIDS comorbidities (NACM) among persons with HIV (PWH) remain unclear. Microvasculopathy may link HIV-related chronic inflammation and premature multimorbidity, similar to diabetes and other conditions characterized by inflammatory end-organ damage. We used a novel retinovascular imaging tool, optical coherence tomography angiography (OCTA), to evaluate the retina as a convenient assessment of microvascular health among PWH. Methods Data from 4 PWH who underwent OCTA (Zeiss CIRRUSTM HD-OCT 5000) at the Emory Eye Center from 2018-2020 were analyzed. Demographics, HIV-specific indices and NACM were summarized at the time of OCTA. Images were reviewed qualitatively and metrics of microvascular health – the foveal avascular zone (FAZ) area and vessel density (VD) from the superficial capillary plexus (SCP) – were calculated by ImageJ. Results The median age was 39 years, 100% were male, 100% were black, 25% had ever smoked, and median body mass index was 25.4 kg/m2. Median time since HIV diagnosis was 19 years, all patients had a history of clinical AIDS, including 2 with prior cytomegalovirus retinitis. Median current CD4 count was 84 cells/mm3, 100% were prescribed antiretroviral therapy and 50% had HIV viral suppression. Prevalent NACM included (each n=1): hypertension, dyslipidemia, diabetes, chronic kidney disease and asthma. Qualitatively, all 7 of the eyes evaluated by OCTA had evidence of microvascular pathology: 2 eyes demonstrated diffuse capillary nonperfusion, while the remaining 5 eyes had focal areas of nonperfusion around the FAZ. Mean FAZ area was 0.31 (SD±0.10) mm2 and mean VD of the SCP was 43.9% (SD±10.9%). Retinovascular pathology identified by fundoscopy and OCTA is shown in the figure. Figure. Retinal imaging of a PWH with bilateral retinal vasculitis. Fundus photos of the right (A) and left (C) eyes show retinal vasculitis highlighted by the red arrows. OCTA of the right (B) and left (D) maculae (3X3 scan Zeiss AngioplexTM) show the FAZ areas outlined in yellow, both of irregular contour. OCTA of the left macula demonstrates areas of significant flow voids marked by the asterisks and the FAZ area is enlarged. Conclusion Among patients with longstanding HIV, OCTA identified microvascular abnormalities in all retinae examined. Retinovascular evaluation by OCTA is a feasible, non-invasive technique for assessing microvascular health and findings support additional study in a larger, more diverse group of PWH. Screening tools targeting microvasculopathy among PWH may aid in earlier detection of those at greatest risk of NACM and allow for aggressive risk-modification strategies. Disclosures All Authors: No reported disclosures

scholarly journals Optical Coherence Tomography Angiography Features of Macular Epiretinal Neovascularization In Eales’ Disease: A Case Rreport

2021 ◽  
Author(s):  
Nora Alyousif ◽  
Abrar K. Alsalamah ◽  
Hassan Aldhibi
Keyword(s):  
Optical Coherence Tomography ◽  
Blood Vessels ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Internal Limiting Membrane ◽  
Peripheral Retina ◽  
Optical Coherence ◽  
Retinal Capillary ◽  
Eales Disease ◽  
The Right

Abstract Background: Eales disease primarily affects the peripheral retina. However, posterior involvement can be seen. Macular epiretinal neovascularization is not commonly seen in Eales disease. This report highlights the morphology and origin of macular epiretinal neovascularization (ERN) using multimodal retinal imaging, including optical coherence tomography angiography (OCTA). Results: A 35-year-old man with no history of systemic disorders presented with gradual decrease of vision in his left eye. Fundus examination of his right eye showed peripheral sclerosed blood vessels, neovascularization of the optic disc and elsewhere, and macular ERN. The view of the left fundus was limited by vitreous haemorrhage. Fluorescein angiography (FA), of the right eye showed widespread peripheral capillary nonperfusion and leakage of dye from the retinal neovascularization and macular ERN. Macular Spectral domain optical coherence tomography (SD-OCT) of the right eye showed an epiretinal membrane and the presence of epiretinal neovascular lesions extending above the internal limiting membrane towards the vitreous. Optical coherence tomography angiography (OCTA) showed multiple tiny blood vessels at the macula that arose from the superficial retinal capillary plexuses and extended toward the vitreous. The corresponding B-scan showed flow signal through these vessels and the signal extend above the internal limiting membrane. Systemic work-up was negative except for strongly positive tuberculin skin testing giving the classic diagnosis of Eales disease. Patient was started on empirical anti-tubercular therapy and oral corticosteroids. Scatter laser photocoagulation was applied to nonperfused retinal zones. Despite adequate scatter laser ablation, the ERN failed to regress fully. Conclusions: Macular ERN can be seen in cases of classic Eales disease. The origin of macular ERN in our case was shown to be from the superficial retinal capillary plexuses. We also noted the slower regression rate of macular ERN as compared to the major neovascularizations of the optic disc and peripheral retina. Further research is needed to establish the pathogenesis of ERN and its optimal management.

scholarly journals Neovessel as first manifestation of relapse of associated multifocal choroiditis and MEWDS

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Eduardo Morizot ◽  
Camila Schiavo Froner
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Inflammatory Diseases ◽  
Clinical Findings ◽  
Optical Coherence ◽  
Retrospective Case ◽  
Multifocal Choroiditis ◽  
White Dot Syndrome ◽  
Contralateral Eye ◽  
The Right

Abstract Purpose To report a case of multifocal choroiditis (MC) that has relapsed as choroidal neovascularization in the contralateral eye followed by a mixed aspect of multiple evanescent white dot syndrome (MEWDS) and MC. Methods Retrospective case report and literature review. The clinical findings were documented by fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography (OCT-A). Results The authors describe the case of a 39-year-old woman with prior ocular history of presumed MEWDS in her left eye, which developed into MC 7 years later in the same eye and 11 years later in the right eye, starting as choroidal neovascularization and developing into MEWDS. OCT-A showed neovessel in a supposedly active MC area outside the macular region in right and left eyes. OCT showed increased choroidal thickness in both eyes and a choroidal neovascularization in the right eye, treated using anti- VEGF therapy. Conclusion This case corroborates the proximity of some inflammatory diseases such as MC and MEWDS. OCT-A has opened new horizons for the better understanding of some retinal diseases by providing more thorough and promising morphological analyses using enhanced tools.

scholarly journals Exudative Type 3 Retinal Arteriovenous Malformation in a Pediatric Patient

2018 ◽  
Vol 9 (3) ◽  
pp. 504-509
Author(s):  
Helena Dens ◽  
Ingele Casteels
Keyword(s):  
Optical Coherence Tomography ◽  
Differential Diagnosis ◽  
Arteriovenous Malformation ◽  
Fluorescein Angiography ◽  
Optic Disc ◽  
Optical Coherence Tomography Angiography ◽  
Imaging Techniques ◽  
Optical Coherence ◽  
The Right ◽  
Type 3

We describe a 7-year-old girl who developed exudation nasally to the right optic disc due to retinal arteriovenous malformation. Fluorescein angiography, spectral domain optical coherence tomography, and optical coherence tomography angiography were performed. We give an overview of the different imaging techniques and discuss the differential diagnosis. Since there was no visual impairment, no treatment was started. A spontaneous decrease in edema and exudation was noted after 6 months.

A triad of retinal signs in Alport syndrome: The ‘stair-case’ fovea, choroidal thinning and peripheral schisis

2019 ◽  
Vol 29 (1_suppl) ◽  
pp. 10-14
Author(s):  
NJ Ghadiri ◽  
N Stanojcic ◽  
MSA Raja ◽  
BJ Burton
Keyword(s):  
Renal Failure ◽  
Optical Coherence Tomography ◽  
Alport Syndrome ◽  
Optical Coherence ◽  
Membrane Structures ◽  
Tomography Imaging ◽  
Type Iv ◽  
Ophthalmic Manifestations ◽  
Optical Coherence Tomography Imaging ◽  
The Right

Background: Alport syndrome is an inherited Type IV collagenopathy characterised by renal failure, hearing loss and ophthalmic manifestations such as lenticonus and dot-and-fleck retinopathy. New signs have been described which can be useful both for diagnosis and for prognosticating the risk of complications. This study examines and describes a triad comprising the unusual ‘stair-case’ foveal sign, together with choroidal thinning and late-stage peripheral schisis in a patient with Alport syndrome. Case presentation: This is a case report of a 49-year-old Caucasian male with a background of X-linked Alport syndrome presenting with gradual and progressive diminution of vision in the left eye with a central blur. He had already undergone three renal allografts, was deaf and suffered from hypertension by the time of his first presentation to ophthalmology. On examination, corrected visual acuity was 6/9.5 in the right eye and 6/30 in the left eye. Optical coherence tomography imaging showed an unusual ‘stair-case’ sign of the fovea in both eyes, together with choroidal thinning. We postulate that an abnormal vitreomacular interface followed by vitreomacular traction and eventually separation, removing layers of the inner retina with the vitreous, led to this unusual appearance. Subsequently, this patient also developed schitic changes more peripherally in the retina which progressed over the following 5 years. Conclusion: The stair-case foveal sign, choroidal thinning and mid-peripheral schisis are three signs that clinicians might expect to encounter on optical coherence tomography imaging of patients with Alport syndrome. These findings can be attributed to unique mutations of collagen IV which lead to a variety of clinical phenotypes affecting basement membrane structures. Identification of these features may not only be useful diagnostically and in forecasting complications such as macular holes, but also predict mode of inheritance and likelihood of early-onset renal failure.

Optical Coherence Tomography Angiography in idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome: A case report

2020 ◽  
pp. 112067212095759
Author(s):  
Meriem Ouederni ◽  
Hela Sassi ◽  
Zied Chelly ◽  
Fehmy Nefaa ◽  
Monia Cheour
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Vasculitis ◽  
Retinal Neovascularization ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography ◽  
Blurred Vision ◽  
Additional Tool ◽  
The Right

Purpose: Since its first description by Chang et al. in 1995, the diagnosis of Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome has been based on the findings of Fundus Fluorescein Angiography (FFA). Our purpose was to describe the utility of optical coherence tomography angiography (OCT-A) in its diagnosis and management. Case description: A 40-year-old female presented with bilateral blurred vision. Her best corrected visual acuity was at 8/10. Fundus examination revealed blurred disc margins, perivascular exudates, arterial sheaths and retinal hemorrhages bilaterally. FFA showed staining of the optic disc with dye leakage in the right eye, a punctuate hyperfluorescence of the temporosuperior artery in the left eye, bilateral vascular sheathing and capillary dropout. OCT-A showed simultaneous presence of papillary aneurysm and neovascularization of the optic nerve head in the right eye, a papillary aneurysm in the left eye and bilateral capillary non-perfusion. Our patient was diagnosed with IRVAN syndrome. Oral steroids associated with panretinal laser photocoagulation and intravitreal injection of bevacizumab in the right eye resulted in vanishing of the papillary neovascularization with no recurrence on OCT-A at 10-month follow-up. Conclusions: OCT-A is an additional tool to FFA for visualization of arterial macroaneurysms and retinal neovascularization without the interference of dye leakage. It well demarcates nonperfused areas and ensures follow-up of retinal neovascularization. Its limitations are the limited field of view and the low sensitivity in detecting arteriolar dilations. Thus, OCT-A is unable to outplace FFA but should be considered alternately with it for non-invasive follow-up of IRVAN syndrome.

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