29-year-old female presented with abnormally increased C-reactive protein and erythrocyte sedimentation rate was diagnosed as Takayasu arteritis complicated with severe retinopathy. The scleral vessels in her right eye were observed highly dilated with iris stroma atrophy and irregular pupil as shown in the picture. Both eyes underwent pan-retinal photocoagulation (fig.1).

FFA revealed the few remaining blood vessels in the posterior pole in her right eye in the shape of “a corolla” (fig.2 top). Ultra-wide field full range OCTA revealed the remaining vessels in the right eye with optic disc neovascularization (fig.2 bottom left).

With flexible montage of 4 24mmx20mm images (＞200°), peripheral non-perfusion area and abnormal arteriovenous anastomosis were also observed in the left eye (fig.2 bottom right). With the quantization parameters, it was obvious that the retina and choroid of the right eye were significantly thinner with reduced retinal flow density and 3D-CVI (choroidal vessel index) compared with the left eye (fig.3).

A 400kHz speed full-range swept-source OCTA (BMizar from TowardPi Medical) was used in this case. The ultra-widefield of view and flexible montage make it easy to observe details in the peripheral retina. Quantification parameters for all sizes such as vessel density and thickness are also available.

Case courtesy of: Dr. Jiaxuan Zhang, team of Prof. Ying Xiao from Shandong Provincial Hospital Affiliated to Shandong First Medical University.
Editor: Dr. Chloe Li, TowardPi Medical