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Case Reports
. 2022 Jun 28;13(2):517-522.
doi: 10.1159/000525465. eCollection 2022 May-Aug.

Optical Coherence Tomography Angiography in Chiasmitis

Alessandra Cuna  1 , Francesco Pellegrini  2 , Emanuela Interlandi  3 , Erika Mandarà  4 , Marco De Luca  3 , Rocco De Marco  3 , Cristina Ciabattoni  5 , Antonio Zappacosta  2 , Alessandro Papayannis  6
Affiliations
Case Reports

Optical Coherence Tomography Angiography in Chiasmitis

Alessandra Cuna et al. Case Rep Ophthalmol. .

Abstract

A 29-year-old girl presented complaining of acute bilateral visual loss associated with mild headache and retrobulbar pain. She was diagnosed with chiasmal optic neuritis caused by multiple sclerosis. Her visual acuity and visual field defect promptly improved after steroid therapy. However optical coherence tomography angiography showed a progressive reduction of superficial capillary plexus density of the retina and optic nerve consistent with the progressive impairment of the retinal ganglionar cell layer. Contrary to chiasmal compression, in chiasmal optic neuritis, the superficial capillary plexus density reduction is diffuse and does not reflect the peculiar anatomy of the chiasm.

Keywords: Bitemporal hemianopia; Chiasmal optic neuritis; Multimodal imaging; Neuro-ophthalmology; Optical coherence tomography angiography.

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Figures

Fig. 1
Fig. 1
At presentation, fundus (upper left) is normal. Standard computerized perimetry (upper right) shows a bitemporal hemianopia. RNFL (middle right) is normal OU, while ganglion cell complex (GCC) (bottom row) shows mild bilateral perifoveal impairment. Superficial capillary plexus as seen in OCTA of the right eye and left eye. Densitometric map is shown.
Fig. 2
Fig. 2
Brain MRI at presentation shows high signal at the level of the chiasm (arrow).
Fig. 3
Fig. 3
At 3 years, fundus examination (upper left) shows a mild temporal pallor of the optic nerves. Standard computerized perimetry (upper right) is normal. Both RNFL thickness (middle right) as well as GCC (bottom row) studies show a bilateral impairment (more evident in the left eye). OCTA at 3 years show reduction in the capillary density of the superficial capillary plexus of the right eye and left eye also evident in the densitometric map.
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