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Table 1 Summary of publications on the implementation of OCTA in white dot syndromes

From: Optical coherence tomography angiography (OCTA) as a new diagnostic tool in uveitis

Disease Publication Number of eyes/patients Study type Main results and points of discussion OCTA device
MCP and PIC Zahid S, Chen Kc, Jung Jj, Balaratnasingam C, Ghadiali Q, Sorenson J, Et Al. Optical coherence tomography angiography Of chorioretinal lesions due to idiopathic multifocal choroiditis. Retina. 2017;37(8):1451–63. 18 eyes of 14 patients with MCP Descriptive, retrospective study OCTA flow signals consistent with neovascularization were identifiable in 83% of eyes including 0% of subretinal pigment epithelium, 91% of subretinal, and 100% of mixed lesions
OCTA also identified CNV in cases where FA was inconclusive for the presence of CNV
No change in quantitative measurements of greatest linear diameter, area, and largest vessel diameter of the neovascular complex following anti-VEGF therapy was observed
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
or
Cirrus Angioplex OMAGC (Carl Zeiss Meditec Inc)
Levison Al, Baynes Km, Lowder Cy, Kaiser Pk, Srivastava Sk. Choroidal neovascularisation on optical coherence tomography angiography in punctate inner choroidopathy and multifocal choroiditis. Br J Ophthalmol. 2017;101(5):616–22. 17 eyes of 12 patients, (7 with PIC and 5 with MCP), out of which 9 patients longitudinally followed and 11 identified with CNV Prospective, descriptive case series OCTA identified CNV in cases where FA was inconclusive for the presence of CNV
Correlation between OCT and OCTA findings as for suspected activity could confirm the diagnosis
OCTA could be particularly helpful in distinguishing CNV from inflammatory lesions
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Cheng L, Chen X, Weng S, Mao L, Gong Y, Yu S, Et Al. Spectral-domain optical coherence tomography angiography findings in multifocal choroiditis with active lesions. Am J Ophthalmol. 2016;169:145–61. 52 eyes of 26 MCP patients (14 bilaterally affected and 12 unilaterally affected) Reliability and validity analysis (prospective) 20 of 23 active CNV cases were confirmed on OCTA
3 invalid OCTA results due to motion artifacts
32 of 34 inflammatory lesions in 13 eyes did not show blood flow in the outer retina on OCTA while the other 2 did
OCTA could be helpful in distinguishing CNV from inflammatory lesions
OCTA could not reliably give information about CNV activity (in contrast to FA) and thus, FA was still necessary to make therapy decisions in recurrent cases
Optovue RTVue XR Avanti (Optovue, Inc., Fremont, California, USA)
Cerquaglia A, Lupidi M, Fiore T, Iaccheri B, Perri P, Cagini C. Deep inside multifocal choroiditis: an optical coherence tomography angiography approach. International Ophthalmology. 2017;37(4):1047–51. 1 eye of 1 patient Single case report Distinction of inflammation versus CNV is possible by multimodal imaging, especially OCTA was crucial for the therapeutic decision in this particular case
OCTA may help in characterizing inflammatory lesions pattern and to detect the presence of CNV within a subretinal inflammatory or fibrotic tissue
OCTA prototype based on Spectralis OCT2 (Heidelberg Engineering, Heidelberg, Germany)
Nakao S, Kaizu Y, Oshima Y, Sakamoto T, Ishibashi T, Sonoda Kh. Optical coherence tomography angiography for detecting choroidal neovascularization secondary to punctate inner choroidopathy. Ophthalmic Surg Lasers Imaging Retina. 2016;47(12):1157–61. 2 eyes of 1 patient Single case report OCTA detected abnormal flow in the outer retina, corresponding to type 2 CNV in PIC lesions
OCTA showed remodeling of the choroidal capillaries and decreased flow in CNV after the treatment with anti-VEGF
OCTA could be useful for the follow-up and evaluation of therapeutic strategies used to treat PIC and might prevent excessive administration of anti-VEGF therapy
Spectral-domain OCT (SD-OCT) (HRA; Heidelberg Engineering, Heidelberg, Germany)
Astroz, P., Et Al., Optical coherence tomography angiography to distinguish choroidal neovascularization from macular inflammatory lesions in multifocal choroiditis. Retina, 2018. 38(2): P. 299–309. 18 eyes of 13 patients Retrospective case series Active CNV and inactive CNV were not significantly different concerning the different features on OCTA
5/15 (33.3%) eyes presented multifocal high-flow networks in the outer retina segmentation on OCTA images
After anti-VEGF treatment, CNV size decreased on OCTA (but not statistically significant)
OCTA can be useful in differentiating active inflammatory chorioretinal lesions from CNV, but not distinguish between active and inactive CNV
Optovue RTVue XR Avanti (Optovue, Inc., Fremont, California, USA)
MEWDS Yannuzzi Na, Swaminathan Ss, Zheng F, Miller A, Gregori G, Davis Jl, Et Al. Swept-Source OCT angiography shows sparing of the choriocapillaris in multiple evanescent white dot syndrome. Ophthalmic Surg Lasers Imaging Retina. 2017;48(1):69–74. 2 eyes of 2 patients Case reports OCTA revealed choriocapillary circulation to be normal in the acute phase
Suggestion that MEWDS is a result of an injury of the photoreceptors, and that hypofluorescence in ICGA imaging may be caused by irregular staining of tissue by extravasated ICG dye rather than a choroidal vascular abnormality
Swept-source OCTA, no details available
Pichi F, Srvivastava Sk, Chexal S, Lembo A, Lima Lh, Neri P, Et Al. En face optical coherence tomography and optical coherence tomography angiography of multiple evanescent white dot syndrome: new insights into pathogenesis. Retina. 2016;36 Suppl 1:S178-S88. 29 eyes of 35 patients Retrospective case series Normal OCTA findings of the choroid and choroidal hypofluorescence in ICGA could be due to the reduced absorption capacity of malfunctioning RPE (theory of Chang et al.)
Proposition that MEWDS is primarily the result of inflammation at the RPE and outer photoreceptor level leading to a “photoreceptoritis”
Temporary loss of the inner and outer segments could be due to inflammation of the photoreceptor segments or the RPE with secondary photoreceptor involvement
Hyperautofluorescent “spots” on FAF may be the result of either an unmasking effect of RPE autofluorescence or secondary to thickened RPE cells
Hyperautofluorescent “dots” may represent disrupted and shed photoreceptor segments that stain with FA and/or associated Muller cell disruption
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Pereira F, Lima Lh, De Azevedo Agb, Zett C, Farah Me, Belfort R, Jr. Swept-source OCT in patients with multiple evanescent white dot syndrome. J Ophthalmic Inflamm Infect. 2018;8(1):16. 2 eyes of 2 patients Case reports Normal OCTA findings of outer retina and of choriocapillaris during the acute phase of disease may suggest the primary injury in the outer retina and the photoreceptors Spectral-domain-OCTA (DRI Swept
Source OCT Triton, Topcon, Japan)
Nozaki M, Hamada S, Kimura M, Yoshida M, Ogura Y. Value of OCT angiography in the diagnosis of choroidal neovascularization complicating multiple evanescence white dot syndrome. Ophthalmic Surg Lasers Imaging Retina. 2016;47(6):580–4. 1 eye of 1 patient Case report OCTA can be a useful tool and easier applicable than ICGA for diagnosing and follow-up of type 2 CNV in MEWDS, also in case of recurrence Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
POHS Liu Tya, Zhang Ay, Wenick A. Evolution of choroidal neovascularization due to presumed ocular histoplasmosis syndrome on multimodal imaging including optical coherence tomography angiography. Case Reports In Ophthalmological Medicine. 2018;2018:4098419. 2 eyes of 1 patient Single case report OCTA made CNV lesions visible when no CNV activity was seen on FA or SD-OCT at follow-up visits
Suggestion that OCTA is more sensitive than FA or SD-OCT in detecting the presence of persistent CNV related to POHS
The central trunk of CNV can be relatively resistant to anti-VEGF treatments
Increase in CNV activity on OCTA does not necessarily lead to significant visual impairment
Spectral-domain-OCTA, no details available
APMPPE Werner Ju, Enders C, Lang Gk, Lang Ge. Multi-modal imaging including optical coherence tomography angiography in patients with posterior multifocal placoid pigment epitheliopathy. Ophthalmic Surg Lasers Imaging Retina. 2017;48(9):727–33. 8 eyes of 4 patients Case series OCTA showed perfusion defects in choriocapillaris and choroid in APMPPE lesions
OCTA perfusion deficits resolved in the choroid and later in the choriocapillaris over the course of the disease
Suggestion that involvement of the choroidal circulation leads secondarily to damage of the outer retina
OCTA might be able to replace FA and ICGA for diagnosing APMPPE
Cirrus 5000 equipped with the AngioPlex module (Carl Zeiss Meditec, Dublin, CA)
Salvatore S, Steeples Lr, Ross Ah, Bailey C, Lee Rw, Carreno E. Multimodal imaging in acute posterior multifocal placoid pigment epitheliopathy demonstrating obstruction of the choriocapillaris. Ophthalmic Surg Lasers Imaging Retina. 2016;47(7):677–81. 2 eyes of 1 patient Single case report OCTA showed isolated choriocapillaris nonperfusion within APMPPE lesions in the active disease phase and improvement in flow over the course of the disease
Choriocapillaris is suggested to be the primary focus of the disease
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Maier M, Wehrmann K, Lohmann Cp, Feucht N. [OCT angiography findings in acute posterior multifocal placoid pigment epitheliopathy (Apmppe)]. Ophthalmologe. 2017;114(1):60–5. 2 eyes of 1 patient Single case report Hypofluorescent areas visible on ICGA in the early and late phases showed corresponding hypoperfused areas by OCTA of APMPPE lesions Spectral-domain-OCTA, no details available
Heifermann Mj, Rahmani S, Jampol Lm, Nesper Pl, Skondra D, Kim La, Et Al. Acute posterior multifocal placoid pigment epitheliopathy on optical coherence tomography angiography. Retina. 2017;37(11):2084–94. 10 eyes of 5 patients Retrospective observational case series In APMPPE lesions, conclusive resolvement of the choroidal vasculature on OCTA was difficult through overlying RPE thickening and inflammatory changes
In 1 of 5 patients, choriocapillaris flow deficit extended outside the visible intraretinal lesion
Recovery of choroidal flow parallel with healing of the APMPPE lesions
Attenuated OCTA signal related to acute lesions was impossible to distinguish from primary choriocapillaris nonperfusion on OCTA
Hypointensity on en face OCT could be due to projection artifacts and signal attenuation from chronic RPE thickening and pigmentary of acute and subacute lesions
Suggestion of theory that isolated disruption to the choriocapillaris leaves the choroid in a sufficiently functional state to largely maintain the RPE/photoreceptor integrity
Findings support decreased blood flow to be consistent with choriocapillary changes leading to a primary ischemic insult to the RPE rather than a primary RPE inflammatory etiology, but choriocapillaris changes could also be secondary to subclinical overlying RPE and retinal damage
True course of RPE, retinal, and choroidal injury in APMPPE remains unclear
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA) with split-spectrum amplitude-decorrelation angiography software
Dolz-Marco R, Sarraf D, Giovinazzo V, Freund Kb. Optical coherence tomography angiography shows inner clumbrohoroidal ischemia in acute posterior multifocal placoid pigment epitheliopathy. Retin Cases Brief Rep. 2017;11 Suppl 1:S136-S43. 1 eye of 1 patient Single case report OCTA demonstrated inner choroidal flow improvement to accelerate after the initiation of oral prednisone
Theory of primary choroidal pathophysiology is supported with OCTA findings
Hypothesis, that a compensatory vascular mechanism is induced by the more central area of choroidal ischemia, because in the acute phase perilesional areas show increased inner choroidal flow that fades over time
OCTA, compared to fundus examination, was more sensitive in detecting new lesions
Compared to ultra-widefield dye-based angiographies, en face reconstructions of OCTA might be more sensitive, but conclusive findings outside the posterior pole are limited
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
BSR De Carlo Te, Bonini Filho Ma, Adhi M, Duker Js. Retinal and choroidal vasculature in birdshot chorioretinopathy analyzed using spectral domain optical coherence tomography angiography. Retina. 2015;35(11):2392–9. 8 eyes of 4 patients Prospective observational review On OCTA, BSR lesions showed areas of choriocapillaris flow reduction below retinal pigment epithelium disruption with larger choroidal vessels bordering or traversing those areas
Suggestion of interpretation of those vessels being either a compensatory response by the choroid or being vessels from Sattler’s layer that are pushed into the choriocapillaris plane
Flow reduction can be interpreted as greatly reduced blood flow or true choriocapillaris loss
OCTA provided limited view of deeper choroidal layers
OCTA showed abnormally tortuous vessels and increased intercapillary space in the retinal vasculature in all affected eyes
88% of affected eyes showed capillary loops and focal dilatations
AngioVue OCTA software on the com- mercially available Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Phasukkijwatana N, Iafe N, Sarraf D. Optical coherence tomography angiography of A29 birdshot chorioretinopathy complicated by retinal neovascularization. Retin Cases Brief Rep. 2017;11 Suppl 1:S68-S72. 2 eyes of 1 patient Single case report OCTA allowed quantification and specific distinction between superficial and deep capillary plexus pathology in BSR
Diffuse reduction in the flow of both the SCP and DCP of the patient as compared with normal eyes, on OCTA
OCTA demonstrated the DCP being more affected then the SCP
Significant projection artifacts in the OCTA of the DCP were dealt with by adjusting and subtracting procedures
DCP was considered to be more prone to hypoxic injury because if its blood supply
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Pepple Kl, Chu Z, Weinstein J, Munk Mr., Van Gelder Rn, Wang Rk. Use of en face swept-source optical coherence tomography angiography in identifying choroidal flow voids in 3 patients with birdshot chorioretinopathy. Jama Ophthalmology. 2018;136(11):1288–92. 6 eyes of 3 patients Prospective, longitudinal, observational case series Choroidal flow voids in SS-OCTA ultra-widefield images colocalize with hypofluorescent ICGA lesions in BSR
Suggestion that acute lesions are localized in Haller’s layer and chronic lesions may involve the entire choroid
Hypothesis: true perfusion abnormality might be caused by choroidal vascular destruction in chronic disease, as opposite to flow voids in acute disease that might be due to change in the tissue’s optical properties by the presence of inflammatory cells
PLEX Elite 9000 (Carl Zeiss AG, Dublin, CA) (widefield images approximately 100°) were achieved by montaging sixteen 6 × 6-mm or five 12 × 12- mm cubes)
Serpiginous chorioiditis El Ameen A, Herbort Cp, Jr. Serpiginous choroiditis imaged by optical coherence tomography angiography. Retin Cases Brief Rep. 2016;12(4):279–85. 2 eyes of 1 patient Single case report OCTA showed geographically shaped dark areas in lesions suggestive of decreased flow of the choriocapillaris
OCTA could replace ICGA during some of the subsequent follow-up visits, whereas at initial evaluation, ICGA remains preferable
Intermediate phase ICGA seemed to be more sensitive than OCTA for detecting hypoperfusion
Hypoperfused areas diminished after cyclosporine was introduced
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Montorio D, Giuffre C, Miserocchi E, Modorati G, Sacconi R, Mercuri S, Et Al. Swept-source optical coherence tomography angiography in serpiginous choroiditis. Br J Ophthalmol. 2017;102(7):991–95. 22 eyes of 11 patients Retrospective cross-sectional and observational study OCTA showed atrophy of choriocapillaris with an impairment of its detectable flow and greater visibility of choroidal vessels in inactive lesions
OCTA showed no decorrelation signal in active lesions in choriocalipparis and the whole choroid
Vessel density of the outer border of inactive lesions seemed to be lower than vessel density of unaffected areas
Swept-source OCTA (AngioPlex Elite 9000 SS-OCT, Carl Zeiss Meditech)
Pakzad-Vaezi K, Khaksari K, Chu Z, Van Gelder Rn, Wang Rk, Pepple Kl. Swept-source OCT angiography of serpiginous choroiditis. Ophthalmology Retina. 2018;2(7):712–9. 6 eyes of 3 patients (4 eyes with choroidal lesions) Prospective, observational case series OCTA showed larger lesions of the choriocapillaris slab during active disease than in the outer nuclear layer slab and FAF areas
Resolution of those lesions occurred, where OCTA findings were not associated with corresponding abnormal FAF (without clinical scarring after treatment)
OCTA results seem to support the theory that the choriocapillaris is the primary site of pathology
Suggestion of a simple grading system based on OCT, OCA and/or ICGA
Swept-source OCTA
PLEX Elite 9000 (Carl Zeiss AG, Dublin, CA)
Ahn Sj, Park Sh, Lee Br. Multimodal imaging including optical coherence tomography angiography in serpiginous choroiditis. Ocul Immunol Inflamm. 2017;25(2):287–91. 2 eyes of 1 patient Single case report OCTA demonstrated decreased vascularity on the choriocapillaris slab
Loss of capillaries is partially replaced with irregular capillaris, but photoreceptor defect persisted following systemic corticosteroid therapy
Choriocapillaris was seen as the main pathology of serpiginous choroiditis which may lead to the photoreceptor disruption
Swept-source OCTA, no details available
Khan Ha, Shahzad Ma. Multimodal imaging of serpiginous choroiditis. Optometry And Vision Science: Official Publication Of The American Academy Of Optometry. 2017;94(2):265–9. 2 eyes of 1 patient (1 eye with choroidal lesions) Single case report OCTA revealed normal retinal architecture in lesions, but disruption of homogeneity of the choriocapillaris
Role of choriocapillaris loss and hypoperfusion as a contributing factor towards the development of choroidal neovascularization in the later course is supported by OCTA findings
Choriocapillaris was suggested to be affected most in earlier and later stages of the disease and its involvement might be the possible mechanism behind the development of CNVv in these cases
Swept-source OCTA, no details available
AMN Aggarwal, K., A. Agarwal, D. Katoch, M. Sharma And V. Gupta (2017). “Optical coherence tomography angiography features of acute macular neuroretinopathy in dengue fever.” Indian J Ophthalmol 65(11):1235–1238. 2 eyes of 1 patient (1 eye with macular lesion) Single case report OCTA en face images showed disruption of both the SCP and DCP with flow deficit in the affected foveal region
OCTA showed an increase of size of the FAZ
SCP and DCP ischemia on OCTA did not change much at 6-month follow-up
OCTA provided insights into the level of pathophysiological alterations in the affected eyes and helped in determining the visual prognosis
No details available
Casalino, G., A. Arrigo, F. Romano, M. R. Munk, F. Bandello And M. B. Parodi (2019). “Acute macular neuroretinopathy: pathogenetic insights from optical coherence tomography angiography.” Br J Ophthalmol 103(3):410–414 11 eyes of 7 patients Prospective, observational, cross-sectional study OCTA revealed that global vascular perfusion is not impaired in the SCP and DCP, while a general flow void was found to be present in the choriocapillaris and focal impairment of the DCP
Persistent difficulty to determine at which level the primary vascular insult occurs
PLEX Elite 9000 (Carl Zeiss AG, Dublin, CA)
Kulikov, A. N., D. S. Maltsev And T. A. Leongardt (2018). Retinal microvasculature alteration in paracentral acute middle maculopathy and acute macular neuroretinopathy: a quantitative optical coherence tomography angiography study. Retin Cases Brief Rep. https://doi.org/10.1097/ICB.0000000000000709 6 eyes with PAMM and 2 eyes with AMN of 6 patients Case series OCTA revealed decreased vessel density of the SCP and DCP and changes in the shape of the superficial FAZ in PAMM and AMN eyes
No difference was found in the FAZ area between PAMM/AMN eyes and healthy control eyes
Copernicus REVO (software Version 7.2; Optopol, Zawiercie, Poland)
Lee, S. Y., J. L. Cheng, K. M. Gehrs, J. C. Folk, E. H. Sohn, S. R. Russell, Z. Guo, M. D. Abramoff And I. C. Han (2017). Choroidal features of acute macular neuroretinopathy via optical coherence tomography angiography and correlation with serial multimodal imaging. Jama Ophthalmol 135(11): 1177–1183. 9 eyes of 7 patients Retrospective case series OCTA revealed choriocapillaris flow void that colocalized to the AMN lesions in all affected eyes
Using an automatic algorithm allowed a comparison between the areas of interest of two different imaging modalities using vascular registration
OCTA did not reveal low abnormalities within the DCP
Persistence of OCTA choroidal flow void after the resolution of the hyperreflectivity of the outer retinal layers
Suggestion that decreased flow in choriocapillaris might be the primary insult in AMN, followed by hypoxic insult to the middle, then outer retina
AngioPlex, Cirrus HD-OCT 5000 (Carl-Zeiss Meditec Inc.)
Nemiroff, J., D. Sarraf, J. P. Davila And D. Rodger (2018). Optical coherence tomography angiography of acute macular neuroretinopathy reveals deep capillary ischemia. Retin Cases Brief Rep 12 Suppl 1: S12-S15. 2 eyes of 1 patient (1 eye with macular lesion) Single case report OCTA showed flow deficit at the level of the DCP corresponding to the AMN lesion and OCT imaging Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Thanos, A., L. J. Faia, Y. Yonekawa And S. Randhawa (2016). Optical coherence tomographic angiography in acute macular neuroretinopathy. Jama Ophthalmol 134(11): 1310–1314. 3 eyes of 2 patients Case reports OCTA did not reveal DCP nor SCP flow loss in AMN lesions
Choriocapillaris flow abnormalities colocalised with the OCT alterations of the outer nuclear layer and ellipsoid zone identified with en face OCT, but were larger
Suggestion that a vascular insult in the choriocapillaris is the pathogenic mechanism of the AMN lesions
OCTA device of Carl Zeiss Meditec, no details available
Chu, S., P. L. Nesper, B. T. Soetikno, S. J. Bakri And A. A. Fawzi (2018). Projection-resolved OCT angiography of microvascular changes in paracentral acute middle maculopathy and acute macular neuroretinopathy. Invest Ophthalmol Vis Sci 59(7): 2913–2922. 22 eyes of 21 patients with 4 eyes being excluded (5 eyes with AMN and 13 eyes with PAMM) Retrospective case series On OCTA, PAMM lesions were associated with reduced MCP and DCP flow signals with partially additional reduced flow signal in the SCP
PAMM eyes without later reperfusion of the MCP showed more severe inner nuclear layer thinning
AMN lesions were associated with reduced DCP flow signals
Conclusion that isolated focal DCP ischemia at the photoreceptor axons in the OPL is the trigger for AMN pathology, thereby leading to long-term outer nuclear layer thinning
All AMN and PAMM lesions had evidence of variable recovery of capillary flow signal at the different capillary level
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Pecen, P. E., A. G. Smith And J. P. Ehlers (2015). Optical coherence tomography angiography of acute macular neuroretinopathy and paracentral acute middle maculopathy. Jama Ophthalmol 133(12): 1478–1480. 2 eyes of 1 patient (1 eye with macular lesion) Single case report OCTA showed capillary nonperfusion correlating with subsequent inner nuclear layer atrophy in the presented case of PAMM
OCTA could be used to differentiate laminar focal capillary defects that may be undetected by FA or when FA is not applicable for medical reasons in AMN and PAMM
Spectral-domain-OCTA, no details available
AZOOR Levison, A. L., K. Baynes, C. Y. Lowder And S. K. Srivastava (2016). OCT angiography identification of choroidal neovascularization secondary to acute zonal occult outer retinopathy. Ophthalmic Surg Lasers Imaging Retina 47(1): 73–75. 1 eye of 1 patient Single case report Distinctive changes identified on OCTA aided in the diagnosis and management of CNV in AZOOR
Suggestion that OCTA can be useful in distinguishing inflammatory changes versus neovascular changes in patients with posterior uveitis
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Mehrotra, N., M. Nagpal, J. Khandelwal And R. Juneja (2018). Panoramic Optical Coherence Tomography Angiography Features In Acute Zonal Occult Outer Retinopathy. Indian J Ophthalmol 66(12): 1856–1858. 2 eyes of 1 patient Single case report Panoramic OCTA showed increased decorrelation signal at the DCP in the watershed zone of AZOOR lesions RS-3000 Advance OCT (Nidek, Japan)
Naik, A. U., N. Ezhilvathani And J. Biswas (2018). Acute zonal occult outer retinopathy: is optical coherence tomography angiography useful? Indian J Ophthalmol 66(11): 1637–1639. 2 eyes of 1 patient Single case report En-face OCTA images demonstrated hyperreflective dot structures at at the level of ellipsoid zone at presentation
Vasculature of the SCP, DCP, choriocapillaris, and the choroid at presentation and over two consecutive monthly follow-ups was within normal limits
Rise of question, whether AZOOR was part of pachychoroid spectrum
Speculation that the en-face OCTA findings might represent the degenerating photoreceptor segments
AngioPlex (Carl Zeiss Meditec Inc., Dublin, CA, USA)
Miscellaneous Wang Jc, Lains I, Sobrin L, Miller Jb. Distinguishing White Dot Syndromes Aith Patterns of Choroidal Hypoperfusion on Optical Coherence Tomography Angiography. Ophthalmic Surg Lasers Imaging Retina. 2017;48(8):638–46. 7 eyes of 4 patients with different WDS (APMPPE, BCR, MEWDS, POHS) Case reports APMPPE: hypoperfusion was more pronounced in the choriocapillaris than in the deeper choroid in OCTA and more widespread than the retinal lesions
BCR: abnormalities in perfusion, that were more pronounced in the choroid than in the choriocapillaris; smaller areas of choroidal hypoperfusion did not have corresponding fundus lesions making OCTA probably a more sensitive diagnostic tool for early lesions
MEWDS: well-demarcated focal areas of hypoperfusion in the choriocapillaris of larger lesions corresponded well to the white dots, which supports the hypothesis that the outer retina is the location of primary pathology
POHS: focal injury appeared to occur in POHS as opposed to more widespread immune response in BCR, APMPPE, and MEWDS. OCTA revealed the correlation between the “punched out” lesions of POHS and hypoperfusion of choriocapillaris and choroid
OCTA revealed hypoperfusion of the choriocapillaris and choroid as a shared feature among different white dot syndromes and the differences in the distribution, depth, and extend of these OCTA changes may aid in diagnosis
AngioPlex OCT Angiography (Carl Zeiss AG, Oberkochen, Germany)
or
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
Mangeon M, Zett C, Amaral C, Novais E, Muccioli C, Andrade G, Et Al. Multimodal evaluation of patients with acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis. Ocular Immunology And Inflammation. 2018;26(8):1212–18. 8 eyes of 4 patients (6 eyes with serpiginous choroiditis and two eyes with acute posterior multifocal placoid pigment epitheliopathy) Case reports APMPPE: OCTA showed, despite of the stage of disease, choriocapillaris hypoperfusion, but partial reperfusion in the choriocapillaris 2 months after treatment in one case
Serpiginous choroiditis: OCTA allowed the diagnosis of CNV; RPE atrophy (as clarified on OCT and FAF) corresponded to localized OCTA hypoperfusion pattern of the choriocapillaris, which could generate a quantitative parameter usable for follow-up
Optovue Avanti-RTVue-XR (Optovue, Fremont, California, USA)
  1. AMN acute macular neuroretinopathy, anti-VEGF anti-vascular endothelial growth factor, APMPPE acute posterior multifocal placoid pigmentepitheliopathy, AZOOR acute zonal occult outer retinopathy, BSR birdshot chorioretinopathy, CNV choroidal neovascularization, DCP deep capillary plexus, FA fluorescein angiography, FAF fundus autofluorescence, ICG indocyanine green, ICGA indocyanine green angiography, MEWDS multiple evanescent white dot syndrome, MCP multifocal choroiditis and panuveitis, OCT optical coherence tomography, OCTA optical coherence tomography angiography, PAMM paracentral acute middle maculopathy, PIC punctate inner choroidopathy, POHS presumed ocular histoplasmosis syndrome, RPE retinal pigment epithelium, SCP superficial capillary plexus, SD-OCTA spectral domain OCTA, SS-OCTA swept-source OCTA