PMC6537067_01
Fundus photographs and spectral domain optical coherence tomography (SD-OCT)
images of the case: (a) normal examination of the right eye; (b) hard
exudates, microaneurysms, and a few intraretinal hemorrhages were seen
around the macula in the left eye; and (c) SD-OCT showed cystoid macular
edema and serous macular detachment.
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The right eye was normal (Figure 1(a) and (b)). SD-OCT showed cystoid macular edema and serous macular detachment (Figure 1(c)).
Fundus fluorescein angiography (FFA) images of the case. (a) Arteriovenous
phase of the FFA at 15 s. Upper blue arrow shows the superior temporal
artery, and lower blue arrow shows the inferior temporal vein. Laminar flow
pattern with a railroad track appearance was seen in the filling venules.
(b) Still arteriovenous phase of the FFA at 17 s. Red arrow shows an
anastomosis between the inferior venous vascular arcade and the superior
arterial vascular arcade. (c) Venous phase of the FFA at 32 s. Red arrow
shows giant arteriovenous aneurysmal malformation with a bean-like
morphology. Blue stars show telangiectatic capillaries and dilated
collateral venous channels across the horizontal raphe between inferior and
superior vascular arcades.
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FFA showed bean-like arteriovenous aneurysmal anastomosis between the inferior venous vascular arcade and the superior arterial vascular arcade (Figure 2(a) and (b)). FFA also showed telangiectatic capillaries around the macula (Figure 2(c)).
Optical coherence tomography angiography (OCTA) images of the case: (a)
superficial capillary plexus segmentation, (b) deep capillary plexus
segmentation, (c) outer retina segmentation of the case, and (d) color
overlay images of the lesion. The yellowish part of the image shows the
malformation located in the outer retina.
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OCTA revealed flow voids in the arteriovenous aneurysmal malformation and en face angiogram within the deep capillary plexus, which showed venous collateral channels across the horizontal raphe (Figures 3-5).
En face images of the case via optical coherence tomography angiography: (a)
superficial capillary plexus segmentation, (b) deep capillary plexus
segmentation, and (c, d) outer retina segmentation of the case. In (b), red
arrows show collateral venous vessels across the horizontal raphe between
inferior and superior vascular arcades.
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OCTA revealed flow voids in the arteriovenous aneurysmal malformation and en face angiogram within the deep capillary plexus, which showed venous collateral channels across the horizontal raphe (Figures 3-5).
Optical coherence tomography angiography (OCTA) revealed flow voids within
the arteriovenous aneurysmal malformation (red line) in deep capillary
plexus and avascular outer retina: (a) manual segmentation of OCTA through
the outer retina and (b) en face angiogram of OCTA after the aflibercept
therapy.
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OCTA revealed flow voids in the arteriovenous aneurysmal malformation and en face angiogram within the deep capillary plexus, which showed venous collateral channels across the horizontal raphe (Figures 3-5).
Spectral domain optical coherence tomography (SD-OCT) changes during the
follow-up: (a) SD-OCT image at baseline examination; (b-d) SD-OCT images at
first-, second-, and third-month examinations, respectively; (e) SD-OCT
image at the sixth-month examination after the fifth intravitreal injection
of aflibercept; and (f) SD-OCT image at the 12th-month examination.
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Figure 6 shows optical coherence tomography images from the follow-up, and no changes were noted in the arteriovenous malformation.