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Fig. 3 | International Journal of Retina and Vitreous

Fig. 3

From: Multimodal imaging for paracentral acute maculopathy; the diagnostic role of en face OCT

Fig. 3

Fundus photography of the right eye shows a localized area of retinal whitening and edema corresponding to a cotton-wool spot (green-dashed arrow) and extension of this whitening and retinal edema around the inferotemporal branch retinal artery (a). The foveal B-scan SD-OCT cut (corresponding to the intersecting red line in a) is shown in b. As it can be seen, temporal and more pronounced nasal hyper-reflective bands have involved INL with extension to IPL, consistent with PAMM in the upper margin of the ischemic zone. Vertical and oblique B-scan cuts corresponding to ischemic areas around the involved inferior branch retinal artery are shown in c. The horizontal, vertical, and oblique B-scan images of the cotton-wool spot area are shown in d. e, f show the superficial and deep capillary plexus, outer retinal and choriocapillaris slabs of the OCTA by two different devices (e Topcon DRI OCT Triton SS-OCTA (Topcon, Tokyo, Japan) and f Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA)) respectively. DCP slab shows decreased vascular density in the inferior half of the 6 × 6 image especially in areas closer to the branch retinal artery and unresolved projection artifact of superficial vessels over the deep layer in the inferior part of the image (yellow arrows). Interestingly, the border of the area of flow voids could be better delineated at the choriocapillaris slab (red arrows). Corresponding en face OCT image from the DCP area is shown in g, h. En face OCT at the level of DCP clearly showed a sharp and well-demarcated fern-like whitening as a hyper-reflective area more prominent around the venules around the site of the involved retinal artery

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