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Fig. 1 | Journal of Medical Case Reports

Fig. 1

From: Optical coherence tomography angiography in Purtscher-like retinopathy associated with dermatomyositis: a case report

Fig. 1

Composite at time of diagnosis in left eye. a Fundus color picture: multiple confluent cotton-wool spots around the optic nerve head and the macula; some superficial hemorrhages and moderate diffuse venous dilatations are also visible. b Swept source-optical coherence tomography 6 mm scan (arrowheads for directions): severe central macular edema with the presence of serous subretinal fluid is shown. Scans passing through cotton-wool spots show homogeneous hyper-reflective fiber layer as result of ischemic edema of nervous layer (blue arrow). The edema in a few parts also involves the inner nuclear layer (yellow arrows), giving a thickened and hyper-reflective or hypo-reflective appearance. Ganglion cell layer appears hyper-reflective and thickened in a few parts (stars). In the retinal areas affected by cotton-wool spots, inner nuclear and outer plexiform layers appeared wavy (arrowheads). c Fluorescein angiography: vascular walls enhancement, veins dilatation, and capillary occlusion where cotton-wool spots are present. d Optical coherence tomography angiography: superficial (D1) and deep (D2) capillary occlusion in all the areas affected by cotton-wool spots are shown (red arrows)

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