ALTERATION OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN A PATIENT WITH OCULAR ISCHEMIC SYNDROME.

ABSTRACT

PURPOSE: To analyze optical coherence tomography angiography images in ocular ischemic syndrome (OIS) before and after carotid artery stenting. METHODS: We report the case of an 80-year-old man with a history of hypertension and diabetes mellitus who developed OIS in the right eye due to right internal carotid artery stenosis 2 years earlier. After visual acuity declined in the left eye 2 years later, a neurosurgeon discovered left internal carotid artery stenosis, which led to the diagnosis of OIS in the left eye as well. After carotid artery stenting, improvements were observed in both visual acuity and blood flow as assessed by laser speckle flowgraphy. The area of the foveal avascular zone and density of the retinal vessel at the level of the superficial and deep retinal layers were analyzed using optical coherence tomography angiography before and after treatment. RESULTS: Mean superficial foveal avascular zone area was 0.29 mm2 before treatment, decreasing by 29.97% to 0.20 mm2 after treatment. Mean deep foveal avascular zone area was 1.72 mm2 before treatment, decreasing by 20.35% to 1.37 mm2 after treatment. Superficial or deep vessel density increased by 33.4% and 34.3% after treatment, respectively. CONCLUSION: Optical coherence tomography angiography confirmed foveal avascular zone area reduction and increased vessel density in all retinal layers after carotid artery stenting for OIS. These findings suggest that optical coherence tomography angiography may be useful for evaluating blood flow and treatment efficacy in OIS.