ROLE OF OCT-ANGIOGRAPHY IN STUDYING OF PATHOGENESIS, DIAGNOSTICS AND MONITORING THE MACULAR TELANGIECTASIES IN CHILDREN

Abstract

The purpose. to assess the potential of OCT-angiography in studying pathogenesis, diagnosing and monitoring macular telangiectasias of various genesis in children and adolescents. Material and methods. We examined and treated 4 children (5 eyes) aged from 12 to 17 years with idiopathic macular telangiectasias (2), developed against the background of Coat’s disease (1) and diabetic retinopathy (1). The examination included standard ophthalmologic inspection, as well as optical coherence tomography and OCT-angiography (RS-3000 Advance AngioSca, Nidek, Japan). Two children underwent transpupillary laser coagulation of telangiectasias (2 and 3 sessions), two received an intravitreal injection of an inhibitor of angiogenesis. Results. Ophthalmoscopically in all children microaneurysms were localized in the macular and paramacular zones and were accompanied by the development of retinal edema. According to OCT-angiography, all children had pathological structural changes (microaneurysms, vascular artery abnormalities, changes in the density of the vascular pattern) of superficial and to a greater extent deep retinal capillary plexuses. As a result of the treatment, 3 children (4 eyes) had clinically noted decrease in the number of microaneurysms. According to the data of optical coherence tomography, there was positive dynamics in decrease of the height of the retinal edema from 49 to 320 μm, аccording to OCT angiography, showed a decrease in the number of microaneurysms in the superficial and especially in the deep plexus, and in a child with diabetic retinopathy there was also a slight increase in the vascular density of the deep capillary plexus. Сonclusion. According to OCT-angiography, development of macular telangiectasias in children is accompanied by preferential changes in the deep capillary plexus, which indicates the pathogenetic significance of microcirculatory disturbances at this level. The method also reveals its value in monitoring the disease.