PMC9837467_01
Color fundus and OCT imaging: HIV retinopathy and INL thinning. a Right eye at presentation: cotton wool spots, pre-, and intraretinal hemorrhages. OCT scan frame and scan lines are presented as green square and arrows. b Left eye at presentation: cotton wool spots, pre-, and intraretinal hemorrhages, extending in a larger region than in the right eye but respecting the macula. c, e, g OCT scans of the right eye, revealing areas with INL thinning (arrows), including the macula. Scan lines are presented in A above as green arrows. d, f, h OCT scans of the left eye, revealing areas with INL thinning (arrows), respecting the macula. Scan lines are presented in B above as green arrows.
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F1
Dilated fundus examination revealed cotton wool spots and pre- and intraretinal hemorrhages in both eyes compatible with HIV retinopathy (Fig. 1a, b). OCT (SD-OCT, Spectralis HRA + OCT; Heidelberg Engineering GmbH, Heidelberg, Germany) revealed the presence of INL thinning below the fovea in OD in the parafoveal area in OD and OS (Fig. 1c-h). OCT angiography (OCTA; Triton Swept Source OCT, Topcon) revealed areas of DCP ischemia devoid of capillaries (Fig. 2a, b).
En face OCT reconstruction, OCT angiography, and FA. a, b OCT angiography at the level of the deep capillary plexus. The areas devoid of capillaries coincide with the areas of thinning in a and b above, indicating the conjunction of DCP ischemia with the late PAMM-like lesions. c, d Enlarged images of the FA, to facilitate the comparison with the en face reconstructed images and OCT angiography. e, f En face OCT reconstruction at the INL-OPL level with concurrent shadow removal revealing dark areas of INL thinning consistent with late PAMM lesions. FA, fluorescein angiography; OPL, outer plexiform layer.
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F2
OCT (SD-OCT, Spectralis HRA + OCT; Heidelberg Engineering GmbH, Heidelberg, Germany) revealed the presence of INL thinning below the fovea in OD in the parafoveal area in OD and OS (Fig. 1c-h). OCT angiography (OCTA; Triton Swept Source OCT, Topcon) revealed areas of DCP ischemia devoid of capillaries (Fig. 2a, b). Fluorescein angiography revealed microaneurysms and areas of late leakage in both eyes (Fig. 2c, d and 3a, b).
Full (55 ) view of late-phase FA. Evident microaneurysms and areas of late leakage in both eyes. a Right eye. b Left eye. FA, fluorescein angiography.
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F3
Fluorescein angiography revealed microaneurysms and areas of late leakage in both eyes (Fig. 2c, d and 3a, b).
VFs (SITA Fast, 10-2). a Left eye. b Right eye.
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F4
Visual field (VF) testing (Zeiss Humphrey Field Analyzer 3) documented the presence of central (OD) and paracentral (OD and OS) scotomas (Fig. 4a, b).