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Thomas Gast, Toco Chui, William Swanson, Ann Elsner, Joel Papay, Stephen Burns; A New Retinal Lesion:Characterization of the Gliotic Lesion, or Gli, by Review of AOSLO and SDOCT Images from 851 Subjects. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1507.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the characteristics of a new class of retinal lesions that occur on the surface of the retina, first observed using adaptive optics imaging(Scole ARVO 2012). These lesions were visible with a Heidelberg Spectralis as well, and we determined the age distribution, frequency, retinal distribution, temporal longevity, and association with other retinal conditions for this new retinal lesion.
Methods: SDOCT and SLO images were obtained by review of all 851 SDOCT datasets recorded in the Indiana University School of Optometry research labs. The Indiana adaptive optics scanning laser ophthalmoscope (AOSLO) obtained images on 11 subjects with these lesions. The SDOCT datasets were reviewed after the establishment of gli diagnostic criteria based on comparison to bright, superficial, fibrotic retinal lesions observed on these subjects with the AOSLO.
Results:The lesions seen on AOSLO were bright, fibrotic, and on or embedded into the nerve fiber layer. On SDOCT the diagnostic criteria were a bright lesion on the enface image, that in OCT was a thin, bright line at the vitreoretinal interface in the absence of other retinal lesions. These lesions were found to occur only in subjects over 50 (p<0.01) after a posterior vitreous detachment (PVD) or in the specific area of retina under a partial vitreous detachment (p<0.0001). The incidence in these older individuals with PVD’s was approximately 16%. The lesions are not distinctly mobile but vary somewhat in shape over time, as well as varying greatly in prominence with a tendency to thin over time. There is occurrence only over certain areas of the posterior pole, specifically sparing the macular clivus. The glis are commonly, but not always present in a perivascular fashion. An association with surface wrinkling retinopathy was not seen. Their presence was possibly more common in patients with glaucoma but was certainly not restricted to glaucomatous eyes. Lesions were not visible on standard fundus images.
A new superficial retinal lesion has been identified by AOSLO and had its characteristics further determined by observations on SDOCT. These observations allowed determination of its age related association with PVD and of its somewhat dynamic appearance.
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