Differential microvascular assessment of retinal vein occlusion with coherence tomography angiography and fluorescein angiography: a blinded comparative study.

PURPOSE: To compare the imaging of retinal vein occlusion (RVO) with optical coherence tomography angiography (OCTA) and fluorescein angiography (FA) and evaluate their roles in clinical management. METHODS: RVO patients who underwent imaging with both FA and OCTA from 1 June 2015-31 December 2015 were enrolled. An independent retinal specialist blinded from patient identity assessed the FA and OCTA reports. The pixel counting technique was used for FAZ size measurement. A significant level of p < 0.05 was taken for correlation and agreement analysis. RESULTS: On OCTA, the mean FAZ size was 0.382 ± 0.152 mm2 and 0.606 ± 0.136 mm2 for the superficial and deep retinal layers, respectively, with significant correlation (p = 0.004). On FA, the mean FAZ size was 0.352 ± 0.158 mm2, better correlated with OCTA at the superficial (p = 0.062) than the deep retinal layer (p = 0.122). Between FA and OCTA, good agreement was found for microaneurysms (100%, p = 0.001) and venous congestion (83.33%, p = 0.028), but not capillary non-perfusion (p = 0.217) and venous tortuosity (p = 0.546). OCTA also revealed more capillary non-perfusion than FA (91.67 vs. 58.33%). The presenting best-corrected visual acuity was significantly correlated with capillary non-perfusion on OCTA (p = 0.001). CONCLUSION: OCTA and FA are complementary tools in RVO assessment. While OCTA is more precise in the assessment of FAZ and capillary non-perfusion, FA offers better vascular imaging of the peripheral retina.

Methicillin-resistant Staphylococcus aureus endophthalmitis after phacoemulsification in a continuous ambulatory peritoneal dialysis patient.

We report a case of methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis after phacoemulsification in a continuous ambulatory peritoneal dialysis (CAPD) patient with a history of MRSA infection. This case raised the problem of preoperative identification and subsequent management of MRSA carrier status, which might reduce the risk for sight- or life-threatening infection.