OCTA in macular intraretinal microvascular abnormalities: Retinal vascular density remodeling after panretinal photocoagulation

Eur J Ophthalmol. 2022 Jul;32(4):NP123-NP126. doi: 10.1177/11206721211059014. Epub 2021 Nov 9.


Purpose: To describe a case of macular intraretinal microvascular abnormality (IRMA) detected with Optical Coherence Tomography Angiography (OCTA) and to show its remodeling and vascular density changes after panretinal photocoagulation (PRP) during an 18-month follow-up.

Methods: Case report.

Results: A 22-year-old female patient with proliferative diabetic retinopathy was found to have a small hyperreflective formation with posterior shadow cone and signal flow, located at the temporal margin of the fovea avascular zone (FAZ), identified as macular IRMA with OCTA. Her best-corrected-visual acuity was 20/20. Four months later the macular IRMA was larger and, in its context, there was also an increase in the flow area in B-scan. The patient underwent PRP and after 18 months we observed a regression of macular IRMA and an increase in the superficial capillary plexus vessel density in all sectors in comparison to baseline.

Conclusion: OCTA is a non-invasive tool that recognize macular IRMA in diabetic retinopathy patient and it could be helpful to follow their qualitative and quantitative vascular evolution over time.

Keywords: Macular IRMA; OCTA; panretinal photocoagulation; vessel density.

Publication types

  • Case Reports

MeSH terms

  • Computed Tomography Angiography / methods
  • Diabetic Retinopathy* / physiopathology
  • Diabetic Retinopathy* / therapy
  • Female
  • Humans
  • Laser Coagulation*
  • Microvascular Density / physiology
  • Retinal Vessels* / diagnostic imaging
  • Retinal Vessels* / pathology
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Young Adult