Optical coherence tomography angiography (OCT-A) is a new non-invasive technology for imaging of retinal and choroidal vasculature of the macular area with resolution comparable to histological sections. OCT-A does not require usage of intravenous dye, contrary to fluorescein angiography, the current gold standard for imaging of retinal vessels, and indocyanine-green angiography, which is important for imaging of choroidal vessels. With the advancements in optical coherence tomography (OCT) scanning speeds and creation of powerful algorithms for improvement of image quality in recent years, OCT-A imaging of macular vasculature, superficial, deep and avascular retinal complex, as well as choriocapillaris and deep choroid has become available in everyday clinical practice. This review covers aspects important for understanding choroidal and retinal blood supply, as well as the development, mechanisms and clinical application of OCT and OCT-A technology.

Background: Central retinal artery occlusion (CRAO) is an ophthalmic emergency attributed to a vessel occlusion with an embolus or a thrombus and may occur during the hypercoagulable state, inflammation, or vasculitis. CRAO may occur in children; however its incidence is very rare. Most pediatric cases have detectable etiologies. Case Presentation: We describe the case of an otherwise-healthy six-year-old female, who presented with the sudden and complete vision loss of the left eye lasting over twelve hours after a six-day chickenpox exanthema, followed by a high fever. All the ophthalmological, laboratory, and instrumental investigations led to the diagnosis of a left CRAO. Laboratory testing was unremarkable except for the transient elevation of D dimers (1363 µg/L), IgM anticardiolipin antibodies (238.5 CU), and IgG anti-beta-2 glycoprotein-1 antibodies (76.1 CU) on admission. Thrombolytic treatment was not exerted because of late presentation to the hospital. Treatment with steroids, antiviral medications, antibiotics, and anticoagulants was obtained, but the visual outcome was poor during the hospitalization and at the last follow-up. We could not ascribe features of this case to any etiological condition apart from the documented ongoing chickenpox infection. Conclusions: This is the first case report of CRAO in a child with transient aPL elevation and acute chickenpox infection.

Background/Objectives: To describe the presentation, diagnostic evaluation, management, and clinical outcome of unilateral corneal ulcer in an otherwise healthy infant without identifiable predisposing factors. Methods: We report a case of a 2-month-old infant who presented with a visible white corneal lesion. Initial examination revealed a 2 × 1 mm fluorescein-positive corneal ulcer with a surrounding stromal infiltrate. There was mild conjunctival injection without ocular discharge. The anterior chamber was deep, without cells or flare. Corneal scraping was deferred because specimen collection would have required sedation or general anesthesia. Consequently, the microbial etiology remained unconfirmed, and empirical antimicrobial treatment was initiated. Results: The patient was treated with topical azithromycin, tobramycin, moxifloxacin, and aciclovir, as well as liposomal ozonized oil eye drops. During empirical treatment and close clinical monitoring, the corneal epithelial defect resolved within seven days, and the surrounding stromal infiltrate progressively decreased in size and opacity. At the one-month follow-up, a small residual stromal scar remained outside the visual axis. Conclusions: This case illustrates the diagnostic and therapeutic challenges of managing corneal ulcer in early infancy when microbiological confirmation is unavailable. The favorable clinical course observed during empirical treatment and close monitoring does not establish an infectious etiology or demonstrate a causal effect of antimicrobial therapy.