Clinical features of three-layer’s impairment of capillary plexuses’ perfusion at follow-up in patients with Purcher retinopathy and Purcher-like retinopathy

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Abstract

In Purcher retinopathy and Purcher-like retinopathy, ischemic lesions occur at the level of all three retina capillary plexuses. Recognition of characteristic ischemic patterns by optical coherence tomography helps to predict the degree of visual functions’ recovery. The aim of this study is to present clinical cases of patients with Purcher retinopathy and Purcher-like retinopathy and to observe the dynamics of visual rehabilitation of patients with retinal vascular conditions. Two patients with complaints of central vision loss and skotomata in the visual field were examined. The complex of multimodal visualization included fundus photoregistration with fundus camera, optical coherence tomography and optical coherence tomography-angiography, and microperimetry. Paracentral acute middle maculopathy and acute macular neuroretinopathy are the manifestations of the same ischemic process on different levels of retinal vascular plexuses. The “diffuse” pattern damages in paracentral acute middle maculopathy lead to more permanent structural and functional impairments opposed to the “skip” pattern. The optical coherence tomography allows to predict the possibilities of visual and functional rehabilitation in patients with ischemic damage of retinal vessels.

About the authors

Mariya A. Poroshina

S. Fyodorov Eye Microsurgery Federal State Institution

Email: doctor_poroshina@mail.ru
ORCID iD: 0000-0002-3110-4772
SPIN-code: 8654-8948
Russian Federation, 59a Beskudnikovskii bulvar, Moscow, 27486

Elena K. Pedanova

S. Fyodorov Eye Microsurgery Federal State Institution

Email: elenamntk@mail.ru
ORCID iD: 0000-0001-5191-3385
SPIN-code: 1409-0712

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Azad Kh. Samedov

S. Fyodorov Eye Microsurgery Federal State Institution

Email: shakatak65@mail.ru
ORCID iD: 0009-0005-9187-1980
Russian Federation, Moscow

Angelina D. Matyaeva

S. Fyodorov Eye Microsurgery Federal State Institution

Email: matyaeva.lina@yandex.ru
ORCID iD: 0000-0001-7543-619X
SPIN-code: 3302-0808
Russian Federation, Moscow

Neilya I. Kalinich

O.M. Filatov City Clinical Hospital No. 15 of the Moscow Department of Health

Author for correspondence.
Email: nkalinich.lazer@mail.ru
ORCID iD: 0009-0007-8456-8064

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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2. Fig. 1. Follow-up fundus photos of the right and left eye: a — at the initial visit 2 weeks after the onset of the disease; b — after 1 month; c — after 3 months; d — after 6 months. White arrow — cotton-wool spot, black arrow — paracentral acute middle maculopathy

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3. Fig. 2. Dynamics of cotton-wool spot’s regression in the right eye (arrow): а — at the initial visit 2 weeks after the onset of the disease; b — after 1 month; c — after 3 months; d — after 6 months

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4. Fig. 3. Dynamics of paracentral acute middle maculopathy “skip” pattern regression in the left eye (arrow): а — at the initial visit 2 weeks after the onset of the disease; b — after 1 month; c — after 3 months; d — after 6 months

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5. Fig. 4. Regression dynamics of changes in external retinal layers by the type of acute macular neuroretinopathy (arrow) а — at the initial visit 2 weeks after the onset of the disease; b — after 1 month; с — after 3 months; d — after 6 months

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6. Fig. 5. Dynamics of changes in photosensitivity according to microperimetry in the right eye (a, c, e) and left eye (b, d, f): а, b — at the initial visit; c, d — after 1 month; e, f — after 6 months

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7. Fig. 6. Dynamics of deep capillary plexus damages on OCTA: а — at the initial visit 2 weeks after the onset of the disease, b — after 1 month; c — after 3 months; d — after 6 months

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8. Fig. 7. OCT-scans of the right eye (a) and of the left eye (b) after injury

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9. Fig. 8. Fundus photos of the right eye (a) and of the left eye (b) after 6 months of the disease’s onset

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10. Fig. 9. OCT-scans of the right eye (a) and of the left eye (b)

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11. Fig. 10. Dynamics of the photosensitivity changes according to microperimetry in the right (a, c) and of the left eye (b, d): а, с — at the initial visit, 6 months after the injury; b, d — in 1 month after the initial visit

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12. Fig. 11. Damage to the deep capillary plexus in the right eye (a) and left eye (b) on OCT after 6 months of the disease’s onset

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