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Erschienen in: Spektrum der Augenheilkunde 6/2017

07.09.2017 | Angio-OCT / Medical Retina

The mirror artifact effect on OCTA reconstructions of patients with high myopia

verfasst von: Luisa Pierro, Emanuela Aragona, Alessandro Arrigo, Marco Gagliardi, Francesco Bandello

Erschienen in: Spektrum der Augenheilkunde | Ausgabe 6/2017

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Summary

Background

Optical coherence tomography angiography (OCTA) is a useful technique for the noninvasive study of retinal vascularization; nevertheless artifacts may occur, especially in myopic patients, and this may lead to diagnostic issues.

Methods

Four myopic patients (2 males, mean age 45 years, axial length 27–30 mm) were analyzed using swept source OCT Triton Topcon (DRI Triton; Topcon, Tokyo, Japan) and 3 × 3, 4.5 × 4.5, and 9 × 9 mm scans were obtained. Topcon Image6 software was used to segment retinal layers and to extract both OCTA reconstructions of superficial, deep and choriocapillary plexa, and en face images.

Results

OCT analysis clearly revealed retinochoroidal structures, including both inner and outer choroidal segments, the external limiting membrane, and the retinal pigment epithelium in all patients. OCTA analysis was able to reconstruct superficial, deep and choriocapillary plexa in all patients. On 9 × 9 OCTA and en face reconstructions of every patient, a circular, linear, hyporeflective area was found circumscribing the retinal vascular arcades, as a frame; no vessels were detected in this area.

Discussion

In accordance with previous studies, vessel rarefaction was reported. The dark circular area found in 9 × 9 scans had characteristic aspects, as the presence in both eyes, specularity, absence of vascularization, and lack of ophthalmoscopic evidence. In the B‑scan images, a mirror reflection of retinal profile, appearing upside down, was observed. This aspect can be due to the reflection of retinal reconstruction caused by the high curvature of the eye and to the staphyloma. Differential diagnosis might be choroidal rupture, even though the specularity and the presence of the dark area in all the layers clear the picture.

Conclusion

This study confirmed that OCTA in high myopia can be affected by a number of pitfalls and this should be taken into account for the right interpretation of OCTA reconstructions.
Literatur
1.
Zurück zum Zitat de Carlo TE, Romano A, Waheed NK, Duker JS. A review of optical coherence tomography angiography (OCTA). Int J Retin Vitreous. 2015;1:5. CrossRef de Carlo TE, Romano A, Waheed NK, Duker JS. A review of optical coherence tomography angiography (OCTA). Int J Retin Vitreous. 2015;1:5. CrossRef
Metadaten
Titel
The mirror artifact effect on OCTA reconstructions of patients with high myopia
verfasst von
Luisa Pierro
Emanuela Aragona
Alessandro Arrigo
Marco Gagliardi
Francesco Bandello
Publikationsdatum
07.09.2017
Verlag
Springer Vienna
Erschienen in
Spektrum der Augenheilkunde / Ausgabe 6/2017
Print ISSN: 0930-4282
Elektronische ISSN: 1613-7523
DOI
https://doi.org/10.1007/s00717-017-0370-9