Jacobs Journal of Ophthalmology

Multimodal Imaging Before and After Retinal Embolectomy

*L Terracciano
Department Of Surgery, University Of Florence, Italy

*Corresponding Author:
L Terracciano
Department Of Surgery, University Of Florence, Italy
Email:lucter23@gmail.com

Published on: 2019-06-03

Abstract

Brief summary statement: To report a case of retinal embolectomy in a branch retinal artery occlusion (BRAO) evaluated with a multimodal imaging approach before and after the surgery. Purpose: To report a case of retinal embolectomy in a branch retinal artery occlusion (BRAO) evaluated with a multimodal imaging approach before and after the surgery. Methods: We evaluated, using Optical Coherence Tomography – Angiography (OCTA), a case of BRAO with visible embolus treated with surgical embolectomy. Patient: a 67-years-old man with sudden visual field defect in his right eye and previous history of retinal occlusive disorders. Results: OCT-A analysis showed a normal superficial vascular plexus although the deeper one resulted still abnormal with significant alteration of the blood vessels flow at 30 days after the surgery. Conclusion: In our case OCT-A resulted a fundamental examination, as the patient was not keen to receive FFA and allowed us to study the blood flow characteristic before and after the operation.

Keywords

Angiography; Branch retinal artery occlusion; Intravascular embolus; Optical Coherence Tomography, Retinal embolectomy; Retinal fybrinolysis

Introduction

Retinal artery occlusion is a quite common and visual-threatening ocular vascular occlusive disorder. Systemic conditions as diabetes mellitus, arterial hypertension, ischemic heart or cerebral diseases were often associated with OAR, and more prevalent in the BRAO patients as shown in previous studies (p<0.0001) [1]

A definite diagnosis of BRAO lies on history of sudden onset of painless visual deterioration in the eye, depending on the extent and location of the affected branch, and evidence of acute retinal ischemia whitening - in the distribution area of the occluded artery branch. It is often possible to observe, at the fundus oculi examination, the presence of intravascular emboli, usually located at the bifurcation of the vessels, - where the luminal diameter is narrowest. Fluorescein Fundus angiography (FFA - considered the gold standard to define the morpho-functional retinal alterations, both in terms of diagnosis and follow-up) demonstrates, in the early stages of the disease, the absence or the marked filling delay of the branch involved (except in eyes with transient BRAO).