PMC9626219_01
(a, d) Optical coherence tomography of the right and left eyes. Remarkable for distortion and hyperreflectivity of the outer retinal layers and disruption of the ellipsoid zone, with preservation of the retinal pigment epithelium (RPE). (b, e) Corresponding infrared reflectance photographs of the right and left eyes. Remarkable for hyporeflective macular lesions that correspond to areas of hypofluorescence seen in the indocyanine angiograms. (c, f) Late phase indocyanine green angiography of the right and left eye. Remarkable for mottled hypofluorescent macular lesions that correspond to the hypopreflective macular lesions seen on the infrared reflectance photographs.
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fig1
Optical coherence tomography showed outer retinal layer hyperreflectivity with distortion of the ellipsoid layer but intact retinal pigment epithelium (RPE) (Figures 1(a) and 1(d)). Hyporeflective macular lesions were seen most clearly on the infrared reflectance photographs (Figures 1(b) and 1(e)). Fluorescein angiography and fundus autofluorescence were within normal limits; however, indocyanine green angiography (Figures 1(c) and 1(f)) showed macular hypofluorescent lesions corresponding to the lesions seen on the infrared reflectance photographs.
PMC9626219_02
Optical coherence tomography angiography (OCT-A) of both eyes compared to healthy control, demonstrating choriocapillaris flow voids that roughly correspond to the overlying macular lesions seen on the infrared reflectance photographs, supporting the hypothesis that these represent areas of relative ischemia.
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fig2
Optical coherence tomography angiography (OCT-A) imaging revealed choriocapillaris flow voids that roughly correspond to the lesions seen on infrared reflectance photographs (Figure 2).
Surface hyalocyte distribution and morphology in right and left eye in our patient with AMN compared to 35-year-old healthy control, using en face OCT. (a-c) OCT-reflectance slab segmented 3 mum above the ILM surface shows higher density of surface macrophage cells in eyes with AMN (more apparent on A4, B4, and C4). Orange and blue outlined images correspond to two different regions of interest with magnified view of surface macrophages (A1-C2). (A1-C2) Magnified view of surface macrophages in right and left eye in our patient with AMN and a healthy control. In the eyes with AMN, the cells appear round with fewer, shortened processes, consistent with in an "activated" state. In the healthy control, there are fewer cells and they appear slender with spindle- or star-like configuration consistent with a "quiescent" state. (A3, B3, C3) OCT-A full vascular layer of right and left eye in our patient with AMN and a healthy control. (A4, B4, C4) Overlay of hyalocyte density map onto the OCT-A. Surface hyalocyte density increases in acute ischemic conditions such as AMN. Cell density: AMN eyes, OD 9.26 cells/mm2, OS 10.38 cells/mm2, and control eye: 2.39 cells/mm2.
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fig3
The morphology of the surface hyalocytes was distinctively round with few processes, consistent with an "activated" phenotype (Figure 3).