Clinical OCT Angiography Atlas Bruno Lumbroso, Marco Rispoli, Maria Cristina Savastano, Yali Jia, David Huang
INDEX
ABCDEFGHILMNOPQRSTUVWZ
Note: Page numbers in bold or italic refer to tables, box or figures respectively.
A
Alzheimer's disease 151, 152, 154
Angioid streaks 54
Anterior segment optical coherence tomography angiography 31
Arteries 28
Atrophy 63, 64, 112, 133
Autosomal-dominant neurodegenerative disorder 156
B
Behçet's disease 97, 118, 129
Best disease, color retinal fundus of 58
Best macular dystrophy 55
Birdshot chorioretinopathy 95, 97, 118, 125
Blood flow
velocity 7
visualization of 141
Brain 151, 152
Branch retinal artery occlusion 112, 114, 115
Branch retinal vein occlusion 42, 113
Bruch's membrane 51, 54, 71, 133
B-scan 31
optical coherence tomography 54
C
Central nervous system 151, 152
Central retinal artery occlusion 112
Central retinal vein occlusion 119
Central serous chorioretinopathy 51, 51, 93, 95, 96, 97
Central serous retinopathy 97
Chorioretinitis 125
macular serpiginous 129
scars 66
Chorioretinopathy, chronic central serous 51
Choroid, visualization of 17
Choroidal disorders 17
Choroidal hemangioma 142, 142
Choroidal melanoma 97, 141
Choroidal metastasis 143
Choroidal neovascularization 9, 17, 45, 46, 52, 55, 56–58, 60, 61, 63, 64, 97, 126, 129, 133, 136, 139
Choroidal nevus 97, 141
Choroidal nonexudative neovascular membrane, optical coherence tomography angiography of 45
Choroidal osteoma 142
Choroiditis 95, 97, 117
multifocal 59, 95, 97
Circle of Zinn–Haller 133
Classic choroidal neovascularization, fluorescein angiography of 59
Coats’ disease 19, 20
Conjunctiva 32
Conjunctival vasculatures 31
Corneal adapter module 31
Coronavirus disease 2019 118
COVID-19 117, 118
Cross-section optical coherence tomography 93, 115
angiography 9
Cushing's syndrome 93
Cystic spaces 101
Cystoid edema 111, 125
D
Deep vascular complex 14, 15, 38, 42, 116
Deep vascular plexus 22, 27, 29, 110, 154
Dermatomyositis, juvenile 118
Diabetic fibrovascular membrane 66
Diabetic macular edema 81, 119
Diabetic maculopathy, ischemic 85
Diabetic retinopathy 19, 21, 81, 83, 84, 119
advanced 22
nonproliferative 11, 22, 23, 82, 84, 84–86, 121
proliferative 22, 23, 85, 88, 89–91, 118
Diffuse retinal pigment epitheliopathy 93, 96
Disk, neovascularization of 81
Dye angiography 46
E
Edematous branch vein occlusion 109, 110
En-face optical coherence tomography 93, 94, 99
angiography 47, 134, 145, 146
sequence of 107
Epiretinal membranes 17, 18
Epitheliopathy, chronic 93, 95–97
Epstein–Barr infection 99
Expanded disability status scale 151
F
Fibrosis 63
Fibrotic neovascularization 66
Fibrotic punctate inner choroidopathy macular lesion 128
Fibrous scars 64
Fibrovascular pigment epithelium detachment 46
Fluid reaccumulation 61, 62
Fluorescein angiography 17, 27, 27, 39, 45, 56, 59, 81, 83, 93, 102, 109, 109, 110, 110, 111, 112, 113, 119, 133, 137, 141, 142
examinations 101
Fluorescein diffusion leakage 20
Focal choroidal excavation 95, 97, 98, 99
Foveal avascular zone 30, 81, 154
Fuchs’ lesion 54
Fuchs’ spot 133
Fundus
autofluorescence 118
fluorescein angiography 126
G
Ganglion cell 155
combined 14
complex 145, 152, 156
layer 27, 28, 81
plexus 14, 15
Geographic atrophy 48, 73
Giant cell arteritis 112
Glaucoma 145
H
Haller's layer 93, 95
Haller's vessel dilatation 97
Hemorrhage 65
intraretinal 119
macular 135, 136
subretinal 40
High myopia 133
Highly active antiretroviral therapy 125
Huntington's disease 152, 156, 156
Hypertension 118
Hyporeflective cavities 101
Hypotony 97
I
Idiopathic macular telangiectasia 101
Indocyanine green 17, 51
angiography 31, 45, 46, 53, 56, 66, 93, 117, 133, 142, 143
phases of 46
Inflammatory disorders 97, 125
Inflammatory vein occlusion 110
Inner nuclear layer 14, 28, 81
Inner plexiform layer 14, 29, 81
Inner retinal disorders 17, 18
Inner retinal layer
atrophy of 112
complex 155
Intermediate capillary plexus 14, 15, 27, 29
Iris 32
optical coherence tomography 32
angiography 31
Ischemia, retinal 22
Ischemic branch vein occlusion 109
Isolated retinal capillary ischemia 115
L
Lacquer cracks 133
Laser scars 66
Leber–Coats’ disease 19
Locus minoris resistentiae 133
Lymphoma 97
M
Macroaneurysm 19, 21
Macular degeneration
advanced 66
age-related 23, 45, 71, 74, 94, 97, 161
Macular geographical atrophy 84
Macular hole 133
Macular hole classification of Gass 45
Macular neovascularization 37, 41, 42, 45, 162
Macular neuroretinopathy, acute 113, 115, 117, 117
Macular vessel density, quantification of 147
Magnetic resonance angiography 151
Microphthalmia 97
Microvascular occlusions 117
Mixed edematous ischemic occlusions 109
Müller cell depletion 101
Multiple evanescent white dot syndrome 95, 97, 127, 129, 131
Multiple sclerosis 151, 152, 154
Myopia 133
degenerative 133
Myopic choroidal neovascularization 133, 136–138
recurrence of 138
Myopic eye 25, 26
Myopic fibrous scars 66
Myopic maculopathy 133
atrophy, traction, and neovascularization classification system of 133
N
Neovascular age-related macular degeneration, pathogenic sequence of 37
Neovascular membranes 26
Neovascularization 64, 81
angioflow evolution sequence of 62
chronic 65
nonexudative 93, 94
vessel area of 15
Nerve fiber layer 14, 115
infarction 115
plexus 14, 15
Neurodegenerative diseases 151, 152
Nonexudative choroidal neovascularization, multimodal imaging of 46
Nonneovascular age-related macular degeneration 71
O
Obstruction, extent of 109
Ocular toxoplasmosis, bilateral 127
Ocular tumors 141
diagnosis of 141
management of 141
Ophthalmia, sympathetic 97, 125
Optic disk 28
Optic nerve
head 145, 151
optical coherence tomography angiography of 109
Optic neuritis 109, 151
Optical coherence tomography 3, 4, 10, 31, 45, 56, 65, 95, 101, 111, 111, 112, 114, 115, 117, 117, 125, 133, 145, 151, 161
angiography 3, 7, 8, 13, 17, 19, 23, 27, 32, 37, 46, 51, 52–55, 57–59, 66, 67, 72, 73, 73–78, 81, 82, 83–86, 88, 88–91, 94, 96–98, 103, 105, 106, 109–111, 112–114, 116, 117, 118, 121, 128, 135–138, 141, 148, 151, 153–156, 161
advantages of 17
applications 17
clinical use of 13
disadvantages of 17
examination 101, 133, 145, 151
features 94, 110
future developments in 159
interpretation of 7
principles of 3
ratio analysis 3
signal generation 4
study 35
terminology 13
visualization 8
scans 3
system 82, 86, 87
techniques 46, 125
Optical microangiography 4, 31
Outer retinal atrophy 162
Outer retinal disorders 23
P
Pachychoroid
disorders 93
neovasculopathy 95, 98
pigment epitheliopathy 95, 98
spectrum 93, 95, 97
Paracentral acute middle maculopathy 17, 23, 113, 115, 116, 118, 143
Parkinson's disease 151–153, 155
Pathologic myopia 54, 133
choroidal neovascularization of 54
Pearson test 147, 147
Peripapillary pachychoroid syndrome 95, 97
Peripapillary retinal flow index and vessel density, quantification of 145
Peripapillary retinal nerve fiber layer 145
Pigment epithelial detachment 38, 51, 93
Polypoidal choroidal vasculopathy 51, 52, 95, 97, 98
Projection-resolved optical coherence tomography angiography 14
Punctate outer retinal toxoplasmosis 126
Q
Quiescent choroidal neovascularization 45
R
Radial peripapillary capillary plexus 15
Ranibizumab, intravitreal injection of 55
Relapsing-remitting multiple sclerosis 151
Retina 145, 151
neovascularization of 81
Retinal angiomatous proliferation 9
Retinal anomalies 19
Retinal capillary ischemia, levels of 115
Retinal choroidal anastomosis, development of 104
Retinal detachment 94
serous 97
Retinal diseases 128
Retinal disorders study 17
Retinal edema 110
areas of 111
Retinal folds 18
Retinal ganglion cells 152
Retinal hemorrhages 110, 111
Retinal inner layers, disorganization of 113, 115, 119
Retinal microcirculation, pathology of 113
Retinal nerve fiber layer 27, 81, 146, 147, 147, 151, 152
Retinal pigment epithelium 24, 25, 29, 38, 51, 54, 56, 57, 64, 65, 71, 93, 95, 96, 117, 126, 127, 133, 161
Retinal vascular plexus 14, 28
Retinal vein 28
occlusion 42, 109
Retinitis, infectious 125
Retinopathy 17
acute central serous 94
S
Sarcoidosis 97, 125
Scaffold vessels 61
Sclera 32
Scleral optical coherence tomography angiography 31
Scleritis, posterior 97
Serpiginous 129
Sickle cell disease 117, 118
Signal-to-noise ratio 14
Spectral-domain optical coherence tomography 39, 40, 102, 103, 127, 142
angiography 41, 42, 152, 156
scan 135
Split-spectrum amplitude-decorrelation angiography 3, 14, 31
Subretinal macular neovascularization 85, 101
Subretinal pigment epithelium 45, 98
Superficial capillary plexus 27, 105
Superficial plexus 18, 29, 111
Superficial retinal optical coherence tomography angiography 154
Superficial vascular complex 10, 14, 15
Superficial vascular plexus 22, 27, 28, 29, 29, 110, 112, 112
angioflow of 113
T
Telangiectasia 19
macular serpiginous 19, 20, 101
Trauma 66
Tumors 97
U
Ultrahigh sensitive optical microangiography 5
Uveal effusion syndrome 97
Uveitis 95, 97, 125
V
Vascular endothelial growth factor 11, 37, 46, 54, 57, 60, 66, 67, 104, 106, 136, 138
Vascular plexuses 15
Vein occlusions 109
Vessel
arterialization 61
densities 15
metrics 15
Visual acuity 126
loss of 37, 38
Visual field damage 145
Vitrectomy 118
Vogt–Koyanagi–Harada
disease 95, 97, 100, 125
W
White dot syndromes 125
Z
Zinn–Haller ring 134
×
Chapter Notes

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CLINICAL OCT ANGIOGRAPHY ATLAS
CLINICAL OCT ANGIOGRAPHY ATLAS
SECOND EDITION
Marco Rispoli MD(Italy) Surgery and Emergency Unit, Rome Eye Hospital Centro Italiano Macula, Rome, Italy Bruno Lumbroso MD(Italy) Centro Italiano Macula, Rome, Italy David Huang MD PhD(USA) Associate Director & Director of Research, Casey Eye Institute Peterson Professor of Ophthalmology Professor of Biomedical Engineering Oregon Health & Science University Portland, USA Yali Jia PhD(USA) Jennie P Weeks Professor of Ophthalmology Associate Professor of Biomedical Engineering Casey Eye Institute, Oregon Health & Science University Portland, USA Maria Cristina Savastano MD PhD(Italy) Clinical Research Coordinator, Ophthalmology Unit Policlinico Universitario A Gemelli (IRCS), Catholic University, Rome Centro Italiano Macula, Rome, Italy Foreword by James Fujimoto
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Clinical OCT Angiography Atlas / Marco Rispoli, Bruno Lumbroso, David Huang, Yali Jia, Maria Cristina Savastano
First Edition: 2015
Second Edition: 2022
9789354655036
Printed at:
Foreword
The first edition of the Clinical OCT Angiography Atlas was a landmark in the clinical and scientific development of optical coherence tomography angiography (OCTA). It is published in 2015, only one year after the commercial introduction of OCT angiography, the Atlas led international awareness and acceptance of OCTA, providing a reference not only for interpreting this new imaging modality, but also mapping the range of possible clinical applications, and predicting its future potential. Since that time, clinical and fundamental science research groups have performed extensive studies on a broad range of ocular pathologies and all major commercial ophthalmic manufacturers have introduced OCTA instruments. OCTA is performed at points of care ranging from retinal, glaucoma, and neuro-ophthalmology to comprehensive ophthalmology, and optometry.
OCT angiography provides critical new information on three-dimensional microvascular structure in the retina, choriocapillaris, and optic nerve head. It enables visualization and quantification of pathology such as capillary nonperfusion and neovascularization with a clarity and accuracy that was previously unachievable. The ability to image on every patient visit, where fluorescein or indocyanine green angiography would not be indicated, has enabled powerful studies of disease progression and treatment response. At the same time, OCTA is inherently more complicated than structural OCT and special care is required to clinically interpret OCTA image data. The scope, complexity, and promise of this new imaging modality have attracted a diverse community researchers in fundamental science, engineering, and image analysis to clinical ophthalmology.
The second edition of the Clinical OCT Angiography Atlas is edited by Marco Rispoli, David Huang, Yali Jia, Maria Cristina Savastano, and Bruno Lumbroso provides a comprehensive view of the state of the art in OCTA clinical applications, research, and technology. Extensive new material has been added to reflect key advances. The contributing authors are international leaders in clinical medicine, fundamental science, and technology, providing complementary perspectives on the exciting and impactful developments in this field.
James G Fujimoto
Elihu Thomson Professor of Electrical Engineering and Computer Science
Massachusetts Institute of Technology
Preface to the second edition
The first edition of this OCT Angiography Atlas was published in 2015, when optical coherence tomographic angiography (OCTA) was a fairly new imaging modality. It was one of the first books in the world about the clinical use of this new noninvasive technology.
OCT angiography offers precise and separate visualization of blood flow in the four retinal vascular plexuses, showing the complexity of its networks. It has introduced revolutionary new understanding of retinal vascular anatomy.
OCT angiography is today widely available to eye practitioners. Since the first edition of this Atlas, it has seen shattering new developments and exponential adoption. OCTA is recognized all over the world as an indispensable device for study, diagnosis, and follow-up of retinal diseases and glaucoma in everyday clinical work and research. OCT angiography has replaced, in most fields, the more invasive dye-based angiography. Fluorescein angiography is no longer the gold standard of retinal vascular imaging.
This new edition of the Clinical OCT Angiography Atlas wishes to show the innovative principles of clinical OCTA imaging. As in the first edition, the key word is “clinical”, helping users to interpret OCTA images, guiding clinicians to understand the features of angiographic images. This Atlas edition has been deeply transformed and developed. All chapters have been completely rewritten; some are entirely new and groundbreaking. We report the great advances OCTA has obtained in the clinical field. OCTA allowed us to identify new pathologies, recognize new syndromes, and organize disorders in new classifications. Known diseases are now better understood and new diseases are described. In this book, the operating principles, clinical applications, and future promises of OCTA are clearly explained by world-renowned original developers of the technology.
Optical coherence tomographic angiography holds an immense practical interest for clinical ophthalmology and its importance will continue to grow in the coming years. We trust this handbook will help ophthalmologists, optometrists, residents, and ophthalmic technicians to understand and appreciate the new possibilities offered by the use of OCTA in everyday clinical practice.
Marco Rispoli
Bruno Lumbroso
David Huang
Yali Jia
Maria Cristina Savastano
Preface to the first edition
OCT angiography is a new high resolution imaging method for visualizing the retinal and choroidal circulation without the injection of any dye. By rapidly detecting intravascular flow when needed and being able to repeat the images, as often as necessary, at no risk to the patient, clinicians will come to appreciate OCT angiography as one of the most important applications of en face OCT imaging because of its ability to offer precise visualization of intravascular flow in the inner and outer retinal layers, as well as the inner choroid. An added advantage of this imaging strategy is that the same images acquired during OCT angiography can also be viewed as typical OCT B-scans. While it is no longer the domain of just a few privileged researchers and retina specialists, OCT angiography is now widely available to eye practitioners. As the quality of OCT angiography imaging improves and its availability becomes even more widespread, we predict that this noninvasive technology will become a new standard for imaging both the retinal and choroidal vasculature and anatomy.
The aim of this Clinical OCT Angiography Atlas is to show OCT users the utility of clinical OCT angiography imaging. The keyword is ‘clinical’. We hope to develop interest in the use of OCT angiography in everyday clinical activities and help users interpret OCT angiographic images. The operating principles and the future of OCT angiography are explained by some of the original developers of the technology, and well-known authors from around the world wrote the clinical chapters. This atlas should guide the general ophthalmologists to select the best OCT angiographic views and to be able to identify the typical and atypical features of the OCT angiographic images.
The everyday use of OCT angiographic imaging in the clinics has already generated enormous interest and its importance will grow rapidly in the next few years. Our atlas is designed to appeal a wide audience with interest in a variety disorders. We hope that this atlas fulfills a huge unmet clinical need to learn more about OCT angiography.
Bruno Lumbroso
David Huang
Ching J Chen
Yali Jia
Marco Rispoli
André Romano
Nadia K Waheed
Contributors