부산대학교 도서관

To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.ajo.2017.02.015 Byline: Khalil Ghasemi Falavarjani (a,b,c,d), Nopasak Phasukkijwatana (a,c,e), K. Bailey Freund (f), Emmett T. Cunningham Jr. (g,h,i,j), Ananda Kalevar (g,j), H. Richard McDonald (g,j), Rosa Dolz-Marco (f), Philipp K. Roberts (k), Irena Tsui (a,b,c), Richard Rosen (l), Lee M. Jampol (m), Srinivas R. Sadda (a,b), David Sarraf [sarraf@jsei.ucla.edu] (a,c,n,*) Purpose To assess the spectrum of perivenular ischemia in eyes with retinal vascular obstruction (typically central or hemicentral retinal vein obstruction) using en face optical coherence tomography (OCT). Design Retrospective observational case series. Methods Eyes with recent retinal vascular occlusion illustrating paracentral acute middle maculopathy (PAMM) in a perivenular fern-like pattern with en face OCT were evaluated in this study. Multimodal retinal imaging including en face OCT segmentation of the inner nuclear layer was performed in all patients. Color fundus photography and fluorescein angiography (FA) images were used to create a vascular overlay of the retinal veins vs the retinal arteries to map the distribution of PAMM with en face OCT analysis. Results Multimodal retinal imaging was performed in 11 eyes with acute retinal vascular obstruction. While 7 eyes demonstrated obvious findings of retinal vein obstruction (5 with central and 2 with hemicentral retinal vein occlusion), 4 eyes were unremarkable at presentation. En face OCT analysis demonstrated a spectrum of perivenular PAMM illustrating a fern-like pattern with sparing of the periarteriolar area in all cases. Conclusion En face OCT may illustrate a remarkable perivenular pattern of PAMM in eyes with retinal vascular obstruction even in the absence of significant funduscopic findings. Perivenular PAMM with en face OCT demonstrates a wide spectrum of variation with narrow fern-like perivenular lesions at the mildest end and more diffuse lesions with only periarterial sparing at the most severe end of the spectrum. Arterial hypoperfusion secondary to outflow obstruction from a central retinal vein obstruction appears to be the most common cause of this presentation, although primary arterial hypoperfusion may also be an etiology. Author Affiliation: (a) Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California (b) Doheny Eye Institute, University of California Los Angeles, Los Angeles, California (c) Stein Eye Institute, University of California Los Angeles, Los Angeles, California (d) Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran (e) Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (f) Vitreous Retina Macula Consultants of New York, New York, New York (g) Department of Ophthalmology, California Pacific Medical Center, San Francisco, California (h) Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California (i) The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California (j) West Coast Retina Medical Group, San Francisco, California (k) Department of Ophthalmology, Medical University of Vienna, Vienna, Austria (l) Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, New York (m) Feinberg School of Medicine, Northwestern University, Chicago, Illinois (n) Greater Los Angeles VA Healthcare Center, Los Angeles, California * Inquiries to David Sarraf, Stein Eye Institute, 100 Stein Plaza, Los Angeles, CA 90095 Article History: Accepted 15 February 2017 (footnote) Supplemental Material available at AJO.com(http://AJO.com).