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OPHTHALMIC IMAGE
Year : 2023  |  Volume : 3  |  Issue : 1  |  Page : 255

Foveal neovascularization on optical coherence tomography angiography: An uncommon manifestation of proliferative diabetic retinopathy


Department of Medical Retina and Vitreoretina and Ocular Oncology, Sankara Eye Hospital, Bengaluru, Karnataka, India

Date of Web Publication20-Jan-2023

Correspondence Address:
Deepika Makam
Sankara Eye Hopsital, Varthur Road, Kundalahalli Gate, Bengaluru - 560 037, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1418_22

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How to cite this article:
Makam D, Shanmugam MP, Minija C K, Dubey N. Foveal neovascularization on optical coherence tomography angiography: An uncommon manifestation of proliferative diabetic retinopathy. Indian J Ophthalmol Case Rep 2023;3:255

How to cite this URL:
Makam D, Shanmugam MP, Minija C K, Dubey N. Foveal neovascularization on optical coherence tomography angiography: An uncommon manifestation of proliferative diabetic retinopathy. Indian J Ophthalmol Case Rep [serial online] 2023 [cited 2023 Jun 9];3:255. Available from: https://www.ijoreports.in/text.asp?2023/3/1/255/368142



Neovascularization is a hallmark of proliferative diabetic retinopathy (PDR) and is mostly seen at the disc or around major vascular arcades. Neovascularization at fovea (NVF) does not usually occur because of its dense vascular supply by the choriocapillaris beneath the macula which yields high oxygen concentration to the fovea. However, the decreased choroidal blood flow and choroidal vessel density in diabetics[1] is presumed to be responsible for NVF along with perifoveal retinal ischemia.[2] We report an image of unilateral NVF with vitreomacular traction [Figure 1]. Optical coherence tomography angiography (OCTA) being a non-invasive and dye-less imaging modality helps in identifying subtle NVF which may be missed due to the leakage of the dye in FFA.
Figure 1: Macular optical coherence tomography angiography (OCTA) showing (a) altered foveal avascular zone with irregular vessels arising from perifoveal capillaries in superficial capillary plexus (yellow circle). (b) No new vessels in deep capillary plexus. (c) Vascular density and flow index map indicating low blood flow in perifoveal area with high blood flow in neovascular lesion (red circle). (d) Structural OCT shows homogenous moderate reflective lesion with flow signal arising from superficial retina and being pulled by the vitreomacular traction

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Statement of informed consent

Informed consent was obtained prior to performing the procedure, including permission for publication of all photographs and images included herein.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Nagaoka T, Kitaya N, Sugawara R, Yokota H, Mori F, Hikichi T, et al. Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes. Br J Ophthalmol 2004;88:1060-3.  Back to cited text no. 1
    
2.
Rajagopal J, Kamath AG, Kamath GG, Solanki N. Foveal neovascularisation in diabetic retinopathy: Case report and review of literature. Int Ophthalmol 2010;30:311-4.  Back to cited text no. 2
    


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