Dataset Information

Orbital arteriovenous fistula presenting with choroidal pulsations on optical coherence tomography.

ABSTRACT:

Purpose

To describe a case of orbital arteriovenous fistula diagnosed based on choroidal pulsations on optical coherence tomography (OCT).

Observations

A 69-year-old female originally referred for evaluation of macular degeneration. During acquisition of OCT images, choroidal pulsations of the right eye were noted on the B-scan on the instrument display. The pulsations were not noted on gross or funduscopic examination. Fluorescein angiography was unremarkable. Indocyanine green angiography revealed engorged choroidal vasculature in the right eye. OCT angiography revealed relative tortuosity and dilation of the superficial and deep vascular complexes respectively. B-scan ultrasonography revealed orbital pulsations on the right. MRI imaging of the brain and orbits was unremarkable. Findings were attributed to a low-flow orbital arteriovenous fistula. The patient subsequently developed mild stasis retinopathy for which anti-VEGF therapy was initiated.

Conclusions and importance

Arteriovenous fistulas of the brain and orbit classically present with gross pulsatile proptosis among other clinical features. Low flow orbital fistulas may present with subtle choroidal pulsations only detectable on OCT.

SUBMITTER: Thomas AS

PROVIDER: S-EPMC6111050 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

Orbital arteriovenous fistula presenting with choroidal pulsations on optical coherence tomography.

Thomas Akshay S AS Hsu S Tammy ST Vajzovic Lejla L

American journal of ophthalmology case reports 20180819

<h4>Purpose</h4>To describe a case of orbital arteriovenous fistula diagnosed based on choroidal pulsations on optical coherence tomography (OCT).<h4>Observations</h4>A 69-year-old female originally referred for evaluation of macular degeneration. During acquisition of OCT images, choroidal pulsations of the right eye were noted on the B-scan on the instrument display. The pulsations were not noted on gross or funduscopic examination. Fluorescein angiography was unremarkable. Indocyanine green a ...[more]

PMID: 30167502

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Project description:Background To evaluate choroidal vascular changes, including choriocapillaris (CC) and middle/large choroidal vessels, in retinitis pigmentosa (RP) patients using wide-angle optical coherence tomography angiography (OCTA) and to determine whether changes in the choroidal vascularity have a relationship with visual function and retinal structural changes. Methods 34 patients with a confirmed diagnosis of RP and 48 controls were recruited. All patients underwent detailed ophthalmologic and imaging examinations, including two types of OCTA (Optovue, 3?×?3?mm, 6?×?6?mm; VG-200, 12?×?12?mm). CC defects were defined according to the choroidal vascular structure in five degrees. To evaluate middle and large choroidal vascular changes, the choroidal vascularity index (CVI), which was the luminance volume to the total choroidal volume, was used. Results Defects of choroidal vascularity of RP eyes were detected in comparison to control eyes. The defects were observed in the CC layer with a concentric or lobular pattern at different degrees. CVI, which was used to reflect middle/large choroidal vascularity, decreased in the perifoveal, pararetinal and periretinal regions in the RP eyes. CC defects degree were correlated with the BCVA (p?=?0.001, r?=???0.556), the Humphrey indexes (mean deviation, MD, p?<?0.001, r?=???0.673; PVF, p?=?0.003, r?=???0.639; 10° mean sensitivity, 10° MS, p?=?0.002, r?=???0.651) and microperimetry index (mean sensitivity, MS, p?<?0.001, r?=???0.807). The preserved CC area (mean value: 28.65?±?12.50?mm2) was negatively correlated with MS measured by microperimetry (p?=?0.005, r?=???0.449). Ordinary regression analysis revealed that the CC defect degree was associated with the CVI of perifovea (p?=?0.002, 95% CI: ??102.14 to ??24.01), the EZ length (p?=?0.006, 95% CI: ??0.006 to ??0.001) and the VAD (vascular area density) of the DCP (deep capillary plexus) in the fovea (p?=?0.022, 95% CI: 0.038–0.478). No correlations were detected between BCVA and CVI in any retinal regions. No correlations were found between the CVI and the VAD in any retinal regions. Conclusion The choroidal vascularity was widely defected in RP. Choriocapillaris and middle/large choroidal vascularity defects were correlated with each other. Visual function and retinal structural changes were found to be associated with choriocapillaris defects but not with middle/large choroidal vascular defects.

Dataset Information

Orbital arteriovenous fistula presenting with choroidal pulsations on optical coherence tomography.

Purpose

Observations

Conclusions and importance

Publications

Orbital arteriovenous fistula presenting with choroidal pulsations on optical coherence tomography.

Similar Datasets

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