Hsiwei Chung, Lay Leng Seah, Yvonne Chung
Purpose: To describe a novel use of OCTA in imag- ing scleral vasculature of a TED patient with second- ary raised intraocular pressure (IOP) before and after orbital decompression
Method: A 45-year-old patient with active TED and secondary raised IOP was scanned with a commer- cially available AngioVue OCTA system (Optovue, Inc., Fremont, CA) which had an anterior segment lens adapter to delineate increased epsicleral venous ?ow. Scans from superior, inferior, nasal, and temporal quadrants in each eye were obtained by a trained, independent operator before and after orbital decompression. Depth and extent of venous conges- tion, ?ow speed in cross sectional OCTA B-scans were studied.
Results: Increased venous ?ow was conftrmed to be within the congested episcleral network. Extent of venous congestion and cross sectional OCTA ?ow speeds were reduced post orbital decompression.
Conclusion: OCTA scanning has been largely opti- mized for posterior segment imaging. However recent validated applications for anterior segment imaging has opened up possibilities for assessment of in?ammation in TED.
Raised IOP in TED has been attributed to venous out?ow disturbances with resultant increased episcleral venous pressure. This is the ftrst report to describe OCTA features in active TED, conftrming its location in the episcleral venous plexus and showing reduction in ?ow speeds and congestion post decompression.
OCTA?s rapid and non-invasive acquisition of images allows for further studies in correlating in?ammatory scores with venous congestion and in doing so deciphering differences in activity in thy- roid patients and serving as a useful imaging adjunct modality.