The vascular flow remodeling induced by recurrent anti-vascular endothelial growth factor treatment can be assessed by OCTA. Optical coherence tomography angiography may help to accurately evaluate treatment response and to recognize patterns usually associated with recurrent exudative activity.

Summary. The anatomy of the pancreatic veins has become the object of renewed interest due to the advent of pancreatic phlebography coupled with selective blood sampling to diagnose the site of endocrine tumors of this organ.This study, based on the examination of 50 postmortem glands prepared by the technique of injection-corrosion, was undertaken to identify the veins of the pancreas and establish anatomicosurgical correlations.The right pancreas is drained by four relatively constant veins of unequal importance. The two superior pancreaticoduodenal veins (posterosuperior and anterosuperior) join with the portal vein and gastrocolic venous trunk. Due to their large drainage territory these veins are the main routes of cephalic pancreatic venous return. The inferior pancreaticoduodenal veins (posteroinferior and anteroinferior) most often run into the jejunal veins and less frequently end in the superior mesenteric vein.A part of the right pancreas can be referred to as the retrovenous segment. Drainage of this territory is via the anteroinferior and both posterior pancreaticoduodenal veins as well as by one or two small veins (veins of the retrovenous pancreas) which merge with the posterior surface of the superior mesenteric vein.The left part of the pancreas is drained by numerous small venous tributaries of the vena lienalis. A second drainage axis, present in half of the cases studied, is the inferior pancreatic vein. The left gastric, inferior mesenteric and middle colic veins afford an accessory route of drainage of the left pancreas.The anatomical and surgical junction between the right and left parts of the pancreas can be referred to as the prevenous segment. The drainage of this segment is most often via the neighboring veins, although in some cases may be via true isthmic veins, which join the anterior surface of the mesentericoportal trunk.A protocol for the phlebographic exploration of the pancreas is proposed, based on these anatomical findings. Taking multiple selective samples of venous blood for hormone determinations should allow reduction of the error of tumor localization related to the rich network of venous anastomoses in the pancreas. Le drainage veineux du paner6as. Application ~ la phl6bographie pancr6atiqueR6sum& L'anatomie des veines du pancr6as b6n6fi-cie d'un regain d'int6r6t depuis que la phl6bogra-phie pancr6atique avec pr61~vements sanguins s6-lectifs est venue enrichir les moyens de localisation des tmneurs endocrines du pancr6as. Bas6e sur l'6-tude de 50 pi6ces d'injection-corrosion, leur description permet de retrouver la ~tualit6 anatomochirurgicale de la glande.Le pancr6as droit est drain6 par 4 veines relativement constantes mais dont l'importance est in6gale. Les veines pancr6atico-duod6nales sup~rieu-res (PDPS et PDAS) reioignent la veine porte et le syst~me du tronc gastrocolique; par l'6tendue de leur territoire de drainage, elles repr6sentent les p6dicules c6phaliques principaux. Les veines pancr6atico-duod6nales inf6rieures (PDPI et PDAI) gagnent le plus souvent les v...

BackgroundThe early diagnosis of cancer is of crucial importance and a key prognostic factor. Cancer-associated retinopathy (CAR) can be symptomatic prior to other manifestations directly related to malignant tumors. The aim of this study was to show that, in selected cases, ophthalmic findings are consistent enough with the diagnosis of CAR to trigger investigations aimed at detecting a previously unknown malignancy.MethodsThis was a monocentric retrospective case series performed in a tertiary referral center. Patients with a diagnosis of CAR were included. Diagnosis was based on the clinical presentation, the visual field and electroretinogram alterations. The clinical presentation, visual field testing and electroretinographic results were analyzed as well as the malignancies identified following the diagnosis of CAR. Follow-up data was collected.ResultsFour patients (two men, two women, median age 65.5 years) were included. All patients presented with posterior segment inflammation at initial presentation as well as advanced visual field loss and an extinguished electroretinogram. The best corrected decimal visual acuity was 0.8 or better in both eyes of three patients and decreased to 0.3 OD and O.2 OS in one patient due to a bilateral macular edema. No patient had a previously known history of cancer. Once the diagnosis of CAR was made, investigations aimed at identifying a malignant tumors subsequently led to the diagnosis of two cases of small cell lung tumors, of one prostate carcinoma and of a uterine sarcoma. The treatment of CAR included plasmapheresis, systemic corticosteroids, azathioprine, cyclosporine and periocular or intraocular corticosteroid injections. In all cases the intraocular inflammation resolved, but pigment mottling, diffuse retinal atrophy, optic disc pallor and arterial narrowing were among manifestations observed during the follow-up of the patients.ConclusionIn selected patients, findings suggestive of CAR can be useful for the early detection of a cancer.Electronic supplementary materialThe online version of this article (10.1186/s12886-018-0948-2) contains supplementary material, which is available to authorized users.

Purpose To compare the qualitative and quantitative choroidal neovascularization (CNV) changes after antivascular endothelial growth factor (anti-VEGF) therapy in treatment-naïve and treated eyes with age-related macular degeneration (AMD) using optical coherence tomography angiography (OCTA). Methods Consecutive patients with neovascular AMD underwent multimodal imaging, including OCTA (AngioPlex, CIRRUS HD-OCT model 5000; Carl Zeiss Meditec, Inc., Dublin, OH) at baseline and at three monthly follow-up visits. Treatment-naive AMD patients undergoing anti-VEGF loading phase were included in group A, while treated patients were included in group B. Qualitative and quantitative OCTA analyses were performed on outer retina to choriocapillaris (ORCC) slab. CNV size was measured using a free image analysis software (ImageJ, open-source imaging processing software, 2.0.0). Results Twenty-five eyes of 25 patients were enrolled in our study (mean age 78.32 ± 6.8 years): 13 treatment-naïve eyes in group A and 12 treated eyes in group B. While qualitative analysis revealed no significant differences from baseline to follow-up in the two groups, quantitative analysis showed in group A a significant decrease in lesion area (P = 0.023); in group B, no significant change in the lesion area was observed during anti-VEGF therapy (P = 0.93). Conclusion Treatment-naïve and treated eyes with CNV secondary to neovascular AMD respond differently to anti-VEGF therapy. This should be taken into account when using OCTA for CNV follow-up or planning therapeutic strategies.

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