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Takao Endo, Takashi Fujikado, Masakazu Hirota, Hiroyuki Kanda, Takeshi Morimoto, Shinichi Usui, Kohji Nishida; Characteristics of microcystic macular edema determined by adaptive optics scanning laser ophthalmoscopy (AO-SLO) in eyes with optic neuropathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3876.
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© ARVO (1962-2015); The Authors (2016-present)
Microcystic macular edema (MME) is detected as an arcuate-shaped low reflectance area in the macula in the infrared fundus photographs and in the adaptive optics scanning laser ophthalmoscopic (AO-SLO) images. The low reflectance area corresponds to the area of microcystic changes in the inner nuclear layer (INL) detected by optical coherence tomography (OCT), and they have been reported in a variety of optic nerve diseases. The purpose of this study was to determine whether MME was present in eyes with optic neuropathy and to determine their characteristics.
This was a retrospective study of 41 eyes of 25 patients with optic neuropathy or glaucoma. There were 7 eyes with traumatic optic neuropathy, 3 eyes with ischemic optic neuropathy, 4 eyes with ethambutol optic neuropathy, 4 eyes with Leber’s optic neuropathy, 5 eyes with optic neuritis, 6 eyes with optic nerve atrophy and 12 eyes with glaucoma. All of the patients were examined by AO-SLO and OCT at the Osaka University Hospital between August 2013 and October 2014. The visual acuity and incidence of MME were determined in these patients.
Low-reflectance areas in the AO-SLO image with microcysts in the OCT images were observed in 11 eyes (26.8%). The visual acuity was significantly poorer in eyes with MME (1.9±1.2 logMAR units) than in eyes without MME (0.42±0.73 log units; P<0.0). Eight of the 11 eyes with MME had arcuate low reflectance area but 3 eyes with glaucoma had a nerve fiber layer defect (NFLD)-like low reflectance area by AO-SLO. This NFLD-like low reflectance area did not correspond to the scotoma in the Humphery visual fields, which were different from the ordinal NFLD.
The presence of MME may be related to an advanced stage of optic neuropathy. The shape of the MME in the AO-SLO images is not only arcuate but can also be NFLD-like.
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