Wide field swept source OCT angiography of multifocal retinal and choroidal occlusions from embolic triamcinolone acetonide.

Purpose: Multifocal retinal arterial occlusions and choroidal infarctions due to embolic triamcinolone acetonide (TA) administered during a septoplasty were imaged using swept source OCT angiography (SS-OCTA) to demonstrate the utility of this imaging modality for the diagnosis and longitudinal follow-up of retinal and choroidal vascular diseases.
Observations: A 37-year-old man presented with vision loss in his left eye upon awakening from a left-sided septoplasty during which TA was injected. Examination of the left eye demonstrated retinal whitening in the macula, white material in the distal lumen of retinal arterioles, and multifocal hypopigmented choroidal lesions. SS-OCTA imaging showed the absence of detectable flow in areas of retinal and choroidal whitening. Corresponding B-scans demonstrated hyperreflective material, thought to be embolic TA, within the retinal vessels and inner choroid.
Conclusions: Wide field SS-OCTA was sufficient for the diagnosis and longitudinal evaluation of retinal and choroidal occlusions without the need for dye-based angiography.
Competing Interests: Philip Rosenfeld and Giovanni Gregori received research support from Carl Zeiss Meditec, Inc. and the University of Miami co-owns a patent that is licensed to Carl Zeiss Meditec, Inc. Philip Rosenfeld is a consultant for Apellis, Boehringer-Ingelheim, Carl Zeiss Meditec, Chengdu Kanghong Biotech, Ocunexus Therapeutics, Hemera Biosciences, F. Hoffmann-La Roche Ltd., Isarna Pharmaceuticals, Ocunexus, Ocudyne, and Unity Biotechnology. Philip Rosenfeld has equity interest in Apellis, Verana Health, and Ocudyne. Jayanth Sridhar reports personal fees from Alcon, Alimera, and Oxurion. The following authors have nothing to disclose: HA, JFR, YS, and HWF.
(© 2020 The Authors.)