PMC5782462_01
Fluorescein angiography (FA) (a: 25 seconds; b: 1 minute and 12 seconds) and optical coherenct Tomography angiography (OCTA) (6 x 6 mm) images of the superficial capillary plexus at initial examination (c) and 6 hours later (d). Red arrows show arteries and blue arrows show veins. White squares on FA correspond to the OCT angiograms. c: Superimposition of the angiogram and optic disc angiogram at the initial examination: a flow is observed in the supero-temporal artery (upper red arrow) whereas its filling is delayed on FA. The other red arrow shows another small artery with a thin flow. d: Superimposition of angiogram, 6 hours after first examination.
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F1
FA confirmed the occlusion of the supero-temporal retinal artery near the optic disc with sparing of an arteriole supplying the macula [Figure 1a]. However, after several minutes, the occluded artery slowly filled with dye from the central retinal artery to the proximal portion, and by a countercurrent flow from adjacent venules to the distal portion [Figure 1b]. On the initial 6 x 6-mm scan, some flow signal was present at the origin of the (partially) occluded temporal artery near the optic disc, corresponding to the slow filling on FA [Figure 1c]. It revealed that flow signal was re-established in the ischemic area [Figures 1d, 2c, 2d] in both the SCP and DCP, and in the branches of the initially occluded artery [Figures 2c and d]. Comparisons of OCT angiograms also showed recovery of the peripapillary capillary perfusion [Figure 1d].
OCTA images (6 x 6 mm) and green lines corresponding to B-scans on initial examination (a and b) and 6 hours later (c and d). a. On the initial superficial capillary plexus (SCP) angiogram, capillaries and arteries (red arrow) are not visible in the occluded area, but venules (blue arrow) are. b. The initial deep capillary plexus (DCP) angiogram shows the absence of flow in the occluded area. c. The SCP angiogram 6 hours later shows the artery (red arrow) and capillaries in the upper part of the occluded area. d. The DCP angiogram 6 hours later shows homogenous capillary flow.
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F2
However, flow was not detected in the superficial or deep capillary plexus (SCP, DCP), in the area of inner retinal whitening [Figures 2a and b]. No flow signal was detected in the macular branches of the occluded artery, but a flow signal was present in the adjacent venules draining the spared macular area [Figures 2a and b]. It revealed that flow signal was re-established in the ischemic area [Figures 1d, 2c, 2d] in both the SCP and DCP, and in the branches of the initially occluded artery [Figures 2c and d].