ABSTRACT
Objective:To observe the multimodal imaging characteristics of tamoxifen retinopathy.Methods:A retrospective case study. From January 2019 to December 2021, 4 patients (8 eyes) with tamoxifen retinopathy diagnosed in Tangshan Eye Hospital were included in the study. All patients were female, with sick binoculus. The age was 59.5±4.6 years. After breast cancer resection, tamoxifen 20 mg/d was taken orally consecutively, including 1, 1, and 2 cases who took tamoxifen orally for 5, 7, and ≥10 years. All eyes were examined by fundus color photography, optical coherence tomography (OCT), OCT angiography (OCTA), fundus fluorescein angiography (FFA), and fundus autofluorescence (AF). The multi-mode image features of the fundus of the affected eyes were observed.Results:The yellow white dot crystal like material deposition in the macular area was observed in all eyes. In fundus AF examination, macular area showed patchy strong AF. FFA examination showed telangiectasia and fluorescein leakage in macular area at late stage. OCT showed that punctate strong reflexes could be seen between the neuroepithelial layers in the macular region with the formation of a space between the neuroepithelial layers, the interruption of the elliptical zone (EZ), and the formation of a hole in the outer lamella including 4, 5 and 3 eyes; The thickness of ganglion cells in macular region decreased in 7 eyes. OCTA showed that the blood flow density of the superficial retinal capillary plexus around the arch ring was decreased, and the retinal venules were dilated in 2 eyes; Deep capillary plexus (DCP) showed telangiectasia.Conclusion:Deposition of yellowish white dot like crystals can be seen in the macular region of tamoxifen retinopathy; dotted strong reflex between neuroepithelial layers, cavity formation, thinning of ganglion cell layer, EZ middle fissure and outer lamellar fissure; DCP capillaries and venules around the arch were dilated; telangiectasia in macular region; flaky strong AF in macular region.
ABSTRACT
Objective:To observe and analyze the detection rate of optical disc and retinal neovascularization in stage Ⅳ diabetic retinopathy by multidirectional OCT angiography (OCTA).Methods:A retrospective study. From September to October 2018, 50 eyes of 46 patients with diabetic retinopathy of stage Ⅳ diagnosed in Tangshan Ophthalmological Hospital were included in the study. Among them, there were 18 males (19 eyes) and 28 females (31 eyes). The age ranged from 31 to 78 years, with an average age of 56.64±10.64 years. All patients underwent medical optometry, mydriasis fundus examination and FFA examination. All patients met the diagnostic criteria of stage Ⅳ diabetic retinopathy. All patients underwent multidirectional OCTA examination on the same day after mydriasis fundus examination and FFA examination. Angiography 6 mm × 6 mm scanning mode was selected for OCTA examination. The retinal areas of macular area, optic disc, superior nasal disc, superior optic disc, superior macular area, superior temporal macular area, temporal macular area, inferior nasal disc, inferior optic disc, inferior macular area and inferior temporal macular area were scanned respectively. All images were taken by the same physician and read by two physicians independently. Cases with inconsistent opinions between the two physicians were not included in this study. The optical disc and retinal neovascularization in patients with stage Ⅳ diabetic retinopathy were observed on FFA and multidirectional OCTA images.Results:In 50 eyes, the positive number of screening optic disc neovascularization using FFA was 8 eyes, OCTA was 15 eyes (100%). In the 42 eyes without optic disc neovascularization detected by FFA, OCTA detected 7 eyes, all located on the optic disc surface. Four of the eyes were located in the optic cup, linear and branching, with an area of less than 1/4 optic disc. In 50 eyes, the positive number of screening retinal neovascularization using FFA was 50 eyes, the positive number of OCTA was 43 eyes. In 43 eyes with detected by OCTA, retinal neovascularization buds were detected in 3 eyes, but not in FFA. The retinal neovascularization not detected by OCTA was located in the mid-peripheral part of the retina, which is beyond the inspection range of multi-directional OCTA.Conclusion:The positive rate of optic disc neovascularization and retinal neovascularization in stage Ⅳ DR by multidirectional OCTA is 100.0% and 86.0%, respectively.