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2017 Agenda and Abstracts | < Previous Next >


2017 OMIG Abstract 5

Evaluation of Inflammatory Vascular Responses to Regressing Cytomegalovirus Retinitis by Optical Coherence Tomography Angiography
Nitish Mehta, MD, Edmund Tsui, MD, Yasha Modi, MD
Department of Ophthalmology, New York University, New York, New York

Purpose: To describe post-inflammatory vascular changes associated with treatment-resistant cytomegalovirus (CMV) retinitis.

Methods: A 40-year-old HIV negative gentleman with IgA nephropathy on chronic high-dose steroids and azathioprine presented with floaters and blurry vision for two weeks and was found to have a large area of sectoral retinal whitening and hemorrhage supero-temporally crossing the superior arcade consistent with macula-threatening CMV retinitis.  An AC tap was positive for CMV.  Oral valganciclovir, a steroid taper and a series of intravitreal foscarnet injections over a three-month period were administered. Optical coherence tomography angiography (OCTA) was longitudinally conducted to follow vascular changes in areas of prior retinitis and at the retinitis margin. 

Results: Spectral-domain structural OCT revealed full thickness retinal atrophy in areas of prior retinitis. OCTA revealed the complete absence of the retinal capillary network with preservation of large arterioles and venules. The progressive development of retinal venous to venous and retinal venous to choriocapillaris anastomoses was noted.

Conclusion: To our knowledge, this is the first case of CMV retinitis analyzed by OCT angiography with the identification of retinal venous-to-venous and chorioretinal anastomoses. Inflammatory retinitis with loss of the retinal capillary network may have resulted in high levels of ischemia, increased levels of angiogenic factors, and the development of anastomotic networks. Commonly seen in retinal vein occlusion, we suspect such vascular remodeling may be also be present in prior areas of retinal inflammation.

Disclosure: N


2017 Agenda and Abstracts | < Previous Next >