PMC4966643_01
Evaluation of anatomical and functional status before and after treatment using FA, OCT, and ERG.. Notes: (A) Ischemic retinopathy with alteration of foveal reflex (arrow) in the right eye. (B) Retinal FA showing ischemic retinopathy, especially involving the macular area (arrow). (C) OCT showed thickening and hyperreflectivity of the inner retinal layers (arrow). (D) Multifocal ERG showed a decrease in electrical responses from central macula (arrow). (E) Resolution of cotton wool spots (arrow). (F) Reperfusion of some previously ischemic areas during examination with fluorescein (arrow). (G) OCT showed formation of epiretinal membrane (arrow). (H) Multifocal ERG remained at low amplitudes corresponding to central area (arrow), indicating macular dysfunction.. Abbreviations: Amp, amplitude; ERG, electroretinography; FA, fluorescein angiography; N/I, inferior nasal; N/S, superior nasal; OCT, optical coherence tomography; P1, peak amplitude response; T/I, inferior temporal; T/S, superior temporal.
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Ophthalmoscopic examination with mydriasis showed severe ischemic retinopathy in the right eye (Figure 1A). Retinal fluorescein angiography showed ischemic retinopathy, especially involving the macular area (Figure 1B). Optical coherence tomography showed thickening and hyperreflectivity of the inner retinal layers, including the nerve fiber and ganglion cell layers owing to ischemia of the superficial capillary plexus (Figure 1C) and multifocal electroretinography showed a decrease of electrical responses representing central macula (Figure 1D). Visual acuity showed a slight improvement (20/150), with resolution of cotton wool spots (Figure 1E) and reperfusion of some previously ischemic areas during examination with fluorescein (Figure 1F). After 3 months, we observed the formation of an epiretinal membrane (Figure 1G), but without significant macular edema or bleeding. Multifocal electroretinography remained at low amplitudes meaning macular dysfunction (Figure 1H).