Severe systemic lupus erythematosus (SLE)

25-year-old female, severe systemic lupus erythematosus (SLE) related occlusive vasculitis. This neovascularisation was managed with repeated intravitreal anti-VEGF injections.

Courtesy Prof. Tariq Aslam

Right eye 17x17-mm mosaic. There are multiple areas of capillary drop out visible superiorly and inferiorly. Foveal avascular zone appears enlarged and distorted. A large secondary frond of neovascular tissue is apparent at the temporal aspect of the inferior arcade.

B scan angiogram showing at this location an area of vascular tissue (flow is apparent) that is anterior to the internal limiting membrane and therefore confirms that it is neovascular.

10x10mm Superficial capillary plexus right eye macula scan. Enlarged view of same patient macular showing ischaemic damage.

Left eye mosaic 17.5mm OCT-A1 scan. Alternate eye of same patient demonstrates widespread retinal ischaemia.

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Behcet's disease

Male teenager with severe longstanding ocular involvement from Behcet's disease presenting with left eye visual loss.

Courtesy Prof. Tariq Aslam

10x10mm OCTA of left macula. Superficial capillary plexus imaging shows significant capillary drop out, most pertinently at macula, secondary to Behcet’s occlusive vasculitis

Enlarged 3x3 mm image of deep capillary plexus confirms extensive macular ischaemia explaining central visual loss.

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Proliferative diabetic retinopathy

54-year-old male, 17-year history of type two diabetes. He has proliferative diabetic retinopathy.

Courtesy Prof. Tariq Aslam

17.5mm mosaic OCT-A1 left eye. This mosaic image of the superficial plexus reveals extensive signs of ischaemia, including capillary dropout and intraretinal microvascular abnormalities. Most importantly there are areas of abnormal vasculature at disc and superior to macula and at the superior arcade. B scan images from the OCT-A in these locations demonstrate the tissue to be vascular with flow and anterior to the internal limiting membrane, confirming them as areas of active neovascularisation, requiring treatment. He was treated with anti-VEGF injections and pan-retinal photocoagulation (PRP).

This 10x10mm scan of the superficial capillary plexus provides a closer view of neovascularisation at disc and new vessels superior to fovea.

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Ischaemic maculopathy

This patient attended with right reduced vision of unknown origin. Further investigation and historical fundus images suggested possible prior venous occlusion but current OCT did not show macular oedema as a cause of the vision loss.

Courtesy Prof. Tariq Aslam

OCT -A confirmed ischaemic maculopathy, likely secondary to the previous occlusive event.

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Branch retinal vein occlusion

This patient was known to have had previous branch retinal vein occlusion and attended for review.

Courtesy Prof. Tariq Aslam

10x10mm Superficial capillary plexus. OCT-A showed left inferior branch retinal vein occlusion with large areas of ischaemia, collaterals and telangiectatic vessels. However, the B scan did not show any projection of abnormal vessels anterior to internal limiting membrane indicating neovascularisation.

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Coats disease

Male University student, with previous diagnosis of treated right Coats disease, presented with decreasing vision and visual acuity right eye 6/15. Patient was treated with laser and anti-vegf injection and the non-invasive OCT-A was further used for monitoring.

Courtesy Prof. Tariq Aslam

Widefield OCT A shows typical vascular anomalies of Coats in temporal retina; dilated telangiectic vessels, aneurysms, and loops as well as hypoperfusion areas.

OCT of macula with overlying B scan demonstrates macular oedema, haemorrhage, lipid deposits and hard exudates.

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