Aqueous misdirection syndrome in persistent fetal vasculature (PFV) / Síndrome de mau direcionamento do humor aquoso em persistência da vasculatura fetal (PVF)

ABSTRACT We report a case of a 5-year-old girl with persistent fetal vasculature who presented with unilateral acute angle closure caused by aqueous misdirection syndrome that was apparently associated with regression of cycloplegia. Initial treatment with topical steroids, anti-glaucomatous drops, and atropine showed insufficient control of the intraocular pressure (IOP). Surgical treatment with lensectomy and vitrectomy resulted in satisfactory IOP control and no complications at the 6-month follow-up.

RESUMO Relatamos o caso de uma criança de 5 anos, sexo feminino com persistência do vítreo primário que apresentou crise de fechamento angular por síndrome do mau direcionamento do humor aquoso, aparentemente associado a regressão da cicloplegia. Tratamento inicial com corticoide tópico, colírios antiglaucomatosos e atropina mostraram controle insuficiente da pressão intraocular (PIO). Tratamento cirúrgico com lensectomia e vitrectomia anterior permitiu o controle satisfatório da PIO, sem intercorrências no seguimento de 6 meses.

Comparison of Optical Coherence Tomography Angiography and Fluorescein Angiography for the Identification of Retinal Vascular Changes in Eyes With Diabetic Macular Edema.

BACKGROUND AND OBJECTIVE: To compare the visualization of microaneurysms (MA) and the foveal avascular zone (FAZ) area using optical coherence tomography angiography (OCTA) versus fluorescein angiography (FA) in patients with diabetic macular edema (DME). PATIENTS AND METHODS: Patients were prospectively recruited for same-day imaging on spectral-domain OCTA and FA. OCTA images were automatically segmented into superficial (sOCTA) and deep (dOCTA) capillary plexuses. The number of visible MAs and the FAZ area were compared between the two imaging modalities. RESULTS: Nineteen eyes of 10 patients were included. There was a statistically significant difference between MA counts for FA, sOCTA, and dOCTA (P = .002), and median MA counts were 14.5 (range: 2-43), 9.75 (range: 0-37.5), and 22.5 (range: 5.5-46.5), respectively. dOCTA showed significantly more MAs than sOCTA (P < .001). Although not significant statistically, dOCTA revealed more MAs than FA (P = .06). There was a statistically significant difference between FAZ area for FA, sOCTA, and dOCTA (P = .046), and median FAZ areas were 0.444 (range: 0.1-0.689), 0.224 (range: 0.335-0.806), and 0.345 (range: 0.106-0.881), respectively. FA showed a significantly larger FAZ area than sOCTA (P = .04). CONCLUSIONS: Deep plexus OCTA can better identify microaneurysms compared to either sOCTA or FA. The FAZ area appears larger on FA in contrast to OCTA of both plexuses. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1013-1019.].