Projection-resolved OCT angiography of microvascular changes in paracentral acute middle maculopathy and acute macular neuroretinopathy

Sally Chu; Peter L. Nesper; Brian T. Soetikno; Sophie J. Bakri; Amani A. Fawzi

doi:10.1167/iovs.18-24112

Projection-resolved OCT angiography of microvascular changes in paracentral acute middle maculopathy and acute macular neuroretinopathy

Sally Chu, Peter L. Nesper, Brian T. Soetikno, Sophie J. Bakri, Amani A. Fawzi^*

^*Corresponding author for this work

Ophthalmology

Research output: Contribution to journal › Article › peer-review

79 Scopus citations

Abstract

PURPOSE. To identify the microvascular changes associated with paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) and to improve our understanding of the relevant involvement of the three retinal capillary plexuses using projection-resolved optical coherence tomography angiography (PR-OCTA). METHODS. This was a retrospective study of 18 eyes with AMN or PAMM imaged with OCTA. We used cross-sectional PR-OCTA to localize reduced flow signal to the superficial (SCP), middle (MCP), or deep capillary plexus (DCP) or choriocapillaris that corresponded to inner retinal PAMM or outer retinal AMN lesions on OCT. RESULTS. Five eyes with AMN showed outer retinal disruption on OCT associated with reduced DCP flow signal. All three eyes with AMN and follow-up had recovery of DCP flow. Thirteen eyes with PAMM showed middle retinal disruption on OCT associated with reduced flow signal in both the MCP and DCP. Of these, five also had reduced flow signal in the SCP. All 10 eyes with PAMM and follow-up showed variable recovery of flow signal in one or more plexuses. PAMM reperfusion was primarily arterial in nature. Three eyes with PAMM and no evidence of MCP reperfusion experienced severe thinning of the inner nuclear layer (INL), while seven eyes with robust MCP flow signal recovery showed relative preservation of INL thickness. CONCLUSIONS. Using PR-OCTA, we found that AMN was associated with reduced DCP flow signal, while PAMM was associated with reduced MCP and DCP flow signal and occasionally the SCP. The MCP appears to be important in sustaining INL thickness in these eyes.

Original language	English (US)
Pages (from-to)	2913-2922
Number of pages	10
Journal	Investigative Ophthalmology and Visual Science
Volume	59
Issue number	7
DOIs	https://doi.org/10.1167/iovs.18-24112
State	Published - Jun 2018

Funding

Supported in part by National Institutes of Health DP3DK108248 (AAF), F30EY026472 (BTS), T32GM008152 (BTS); Research to Prevent Blindness Awards to Mayo Clinic Department of Ophthalmology and to Northwestern University Department of Ophthalmology; and research instrument support by Optovue, Inc. (Fremont, CA, USA). The authors alone are responsible for the writing and content of this paper. Disclosure: S. Chu, None; P.L. Nesper, None; B.T. Soetikno, None; S.J. Bakri, None; A.A. Fawzi, None

Keywords

AMN
Acute macular neuroretinopathy
OCT
OCTA
PAMM
Paracentral acute middle maculopathy
Projection-resolved optical coherence tomography angiography

ASJC Scopus subject areas

Sensory Systems
Cellular and Molecular Neuroscience
Ophthalmology

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10.1167/iovs.18-24112

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@article{3bb996e1e1e34c9b8032343616f59259,

title = "Projection-resolved OCT angiography of microvascular changes in paracentral acute middle maculopathy and acute macular neuroretinopathy",

abstract = "PURPOSE. To identify the microvascular changes associated with paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) and to improve our understanding of the relevant involvement of the three retinal capillary plexuses using projection-resolved optical coherence tomography angiography (PR-OCTA). METHODS. This was a retrospective study of 18 eyes with AMN or PAMM imaged with OCTA. We used cross-sectional PR-OCTA to localize reduced flow signal to the superficial (SCP), middle (MCP), or deep capillary plexus (DCP) or choriocapillaris that corresponded to inner retinal PAMM or outer retinal AMN lesions on OCT. RESULTS. Five eyes with AMN showed outer retinal disruption on OCT associated with reduced DCP flow signal. All three eyes with AMN and follow-up had recovery of DCP flow. Thirteen eyes with PAMM showed middle retinal disruption on OCT associated with reduced flow signal in both the MCP and DCP. Of these, five also had reduced flow signal in the SCP. All 10 eyes with PAMM and follow-up showed variable recovery of flow signal in one or more plexuses. PAMM reperfusion was primarily arterial in nature. Three eyes with PAMM and no evidence of MCP reperfusion experienced severe thinning of the inner nuclear layer (INL), while seven eyes with robust MCP flow signal recovery showed relative preservation of INL thickness. CONCLUSIONS. Using PR-OCTA, we found that AMN was associated with reduced DCP flow signal, while PAMM was associated with reduced MCP and DCP flow signal and occasionally the SCP. The MCP appears to be important in sustaining INL thickness in these eyes.",

keywords = "AMN, Acute macular neuroretinopathy, OCT, OCTA, PAMM, Paracentral acute middle maculopathy, Projection-resolved optical coherence tomography angiography",

author = "Sally Chu and Nesper, {Peter L.} and Soetikno, {Brian T.} and Bakri, {Sophie J.} and Fawzi, {Amani A.}",

note = "Publisher Copyright: {\textcopyright} 2018 The Authors.",

year = "2018",

month = jun,

doi = "10.1167/iovs.18-24112",

language = "English (US)",

volume = "59",

pages = "2913--2922",

journal = "Investigative Ophthalmology and Visual Science",

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T1 - Projection-resolved OCT angiography of microvascular changes in paracentral acute middle maculopathy and acute macular neuroretinopathy

AU - Chu, Sally

AU - Nesper, Peter L.

AU - Soetikno, Brian T.

AU - Bakri, Sophie J.

AU - Fawzi, Amani A.

PY - 2018/6

Y1 - 2018/6

N2 - PURPOSE. To identify the microvascular changes associated with paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) and to improve our understanding of the relevant involvement of the three retinal capillary plexuses using projection-resolved optical coherence tomography angiography (PR-OCTA). METHODS. This was a retrospective study of 18 eyes with AMN or PAMM imaged with OCTA. We used cross-sectional PR-OCTA to localize reduced flow signal to the superficial (SCP), middle (MCP), or deep capillary plexus (DCP) or choriocapillaris that corresponded to inner retinal PAMM or outer retinal AMN lesions on OCT. RESULTS. Five eyes with AMN showed outer retinal disruption on OCT associated with reduced DCP flow signal. All three eyes with AMN and follow-up had recovery of DCP flow. Thirteen eyes with PAMM showed middle retinal disruption on OCT associated with reduced flow signal in both the MCP and DCP. Of these, five also had reduced flow signal in the SCP. All 10 eyes with PAMM and follow-up showed variable recovery of flow signal in one or more plexuses. PAMM reperfusion was primarily arterial in nature. Three eyes with PAMM and no evidence of MCP reperfusion experienced severe thinning of the inner nuclear layer (INL), while seven eyes with robust MCP flow signal recovery showed relative preservation of INL thickness. CONCLUSIONS. Using PR-OCTA, we found that AMN was associated with reduced DCP flow signal, while PAMM was associated with reduced MCP and DCP flow signal and occasionally the SCP. The MCP appears to be important in sustaining INL thickness in these eyes.

AB - PURPOSE. To identify the microvascular changes associated with paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) and to improve our understanding of the relevant involvement of the three retinal capillary plexuses using projection-resolved optical coherence tomography angiography (PR-OCTA). METHODS. This was a retrospective study of 18 eyes with AMN or PAMM imaged with OCTA. We used cross-sectional PR-OCTA to localize reduced flow signal to the superficial (SCP), middle (MCP), or deep capillary plexus (DCP) or choriocapillaris that corresponded to inner retinal PAMM or outer retinal AMN lesions on OCT. RESULTS. Five eyes with AMN showed outer retinal disruption on OCT associated with reduced DCP flow signal. All three eyes with AMN and follow-up had recovery of DCP flow. Thirteen eyes with PAMM showed middle retinal disruption on OCT associated with reduced flow signal in both the MCP and DCP. Of these, five also had reduced flow signal in the SCP. All 10 eyes with PAMM and follow-up showed variable recovery of flow signal in one or more plexuses. PAMM reperfusion was primarily arterial in nature. Three eyes with PAMM and no evidence of MCP reperfusion experienced severe thinning of the inner nuclear layer (INL), while seven eyes with robust MCP flow signal recovery showed relative preservation of INL thickness. CONCLUSIONS. Using PR-OCTA, we found that AMN was associated with reduced DCP flow signal, while PAMM was associated with reduced MCP and DCP flow signal and occasionally the SCP. The MCP appears to be important in sustaining INL thickness in these eyes.

KW - AMN

KW - Acute macular neuroretinopathy

KW - OCT

KW - OCTA

KW - PAMM

KW - Paracentral acute middle maculopathy

KW - Projection-resolved optical coherence tomography angiography

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AN - SCOPUS:85048279695

SN - 0146-0404

VL - 59

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EP - 2922

JO - Investigative Ophthalmology and Visual Science

JF - Investigative Ophthalmology and Visual Science

IS - 7

ER -

Projection-resolved OCT angiography of microvascular changes in paracentral acute middle maculopathy and acute macular neuroretinopathy

Abstract

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Keywords

ASJC Scopus subject areas

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