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Beitragstitel Ultra-Wide Field Fluorescence Angiography and Wide Field OCT-Angiography in Susac Syndrome
Autor:innen
  1. Timothy Hamann UniversitätsSpital Zürich Präsentierende:r
  2. Joel Baur University Hospital of Zurich, University of Zurich, Department of Ophthalmology, Switzerland
  3. Katrin Fasler UniversitätsSpital & Universität Zürich
  4. Sandrine Zweifel UniversitätsSpital & Universität Zürich
Präsentationsform ePoster
Themengebiete
  • Others
  • Retina Vitreous
  • Uveitis / Intraocular Inflammation
Abstract-Text Purpose
Susac syndrome (ScS), a rare autoimmune microangiopathy classically presents with the triad of branch retinal artery occlusion, encephalopathy and sensorineural deafness. This study presents multimodal imaging findings including swept source optical coherence tomography-angiography (OCTA) and ultra-wide field fluorescence-angiography (ultra-wide field-FA) in (ScS).
Methods
Clinical and imaging findings including OCTA (Zeiss PlexElite 9000 device), wide field fluorescence angiography (FA) (Optomap) of two male patients (21 a, 51 a) with ScS treated with cyclophosphamide and acetylsalicylic acid were analyzed. Vessel density (VD) and vessel length density (VLD) of the superficial and deep capillary plexus were assessed and compared to those obtained from healthy controls (11 individuals).
Results
ScS manifested with the triad of encephalopathy, sensorineural hearing loss and visual impairment due to branch retinal arteriolar occlusions (BRAO). In FA predominantly peripheral retinal arteries were affected by narrowing and or occlusion. UW-FA showed extensive arterial wall hyperfluorescence and retinal arterial occlusions in the periphery as well as vascular leakage with a significant decrease over time. Qualitative analysis of wide field OCTA imaging showed peripheral retinal ischemia as reduced flow signal in the superficial and deep capillary plexus (DCP, SCP) which was confirmed by correlating FA findings in both patients. In comparison to a healthy control group the quantitative OCTA analysis revealed a mean VD of the central SCP (superficial capillary plexus) of 0.413, compared to 0.31 in the healthy controls (11 male individuals). The mean VLD in the SCP was 17.72 in the ScS group compared to 13.27 in the healthy group. Ultra-wide field FA showed a treatment response in form of resolve of vascular leakage and partial reperfusion of affected retinal tissue.
Conclusions
Ultra-wide field fluorescence angiography is a useful tool for diagnosing and monitoring disease progression and treatment response in patients with ScS. Wide field OCTA seems to have additional value in diagnosis and monitoring of ScS patients. Quantitative analysis of central OCTA scans of the macula revealed an increased VD and VLD of the SCP and DCP in ScS patients in comparison to a healthy control group which might be explained by autoregulative mechanisms as a tissue response to hypoperfusion. Further studies are warranted to evaluate the relevance of these findings.