September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Volume Rendered Optical Coherence Tomography of Retinal Vascular Cystoid Macular Edema
Author Affiliations & Notes
  • Richard F Spaide
    Ophthalmology, Vitreous Retina Macula Consultants NY, New York, New York, United States
  • Footnotes
    Commercial Relationships   Richard Spaide, Bausch and Lomb (C), Genentech (C), Topcon Medical Systems (C), Topcon Medical Systems (P)
  • Footnotes
    Support  Macula Foundation
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Richard F Spaide; Volume Rendered Optical Coherence Tomography of Retinal Vascular Cystoid Macular Edema. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate the retinal vascular findings and associated anatomic abnormalities in the central macula of eyes with retinal vascular cystoid macular edema using volume rendered angiographic and structural optical coherence tomography.

Methods : Patients were imaged using optical coherence tomography (OCT) using split-spectrum amplitude decorrelation. The structural OCT data was segmented for cystoid spaces, and integrated into the angiographic data for subsequent volume rendering. These images were evaluated to assess the inner and deep vascular plexus in relation to cystoid spaces. The retinal vascular diseases investigated were diabetic retinopathy, 25 eyes, retinal vein occlusion, 12 eyes, Type 1 macular telangiectasis, 2 eyes, and radiation retinopathy, 2 eyes.

Results : Retinal vascular flow abnormalities were demonstrated by flow voids with abnormal vascular morphology in the inner vascular layer and varying flow loss in the deep vascular plexus in all affected eyes. Areas of cystoid edema were associated with topographically colocalizing flow voids in the deep vascular layer. Treatment with intravitreous anti-vascular endothelial growth factor injections resulted in resolution of edema but no change in flow patterns in either the inner or deep plexus. With resolution of edema, particularly in diabetics, a thinner featureless retina consistent with disorganization of retinal inner layers was seen. Recurrence of edema happened in the same areas of altered inner and absent deep vascular plexus flow signal.

Conclusions : Cystoid macular edema in retinal vascular disease occurred in relation to altered inner plexus and absent deep vascular plexus flow. These findings suggest functions for the deep vascular plexus may exist in addition to oxygen and metabolite delivery to the retina.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Left panel. View of the retinal vessels, as visualized by volume rendered optical coherence tomography angiography, of an eye with cystoid macular edema secondary to diabetic retinopathy. The inner vascular plexus is blue, the deep plexus is red, and cystoid spaces are cyan. Middle panel. The retina viewed from the underside of the retina. Right panel. When the cystoid spaces were taken from view the cystoid spaces are seen to have occurred in the context of decreased or absent flow in the deep vascular plexus.

Left panel. View of the retinal vessels, as visualized by volume rendered optical coherence tomography angiography, of an eye with cystoid macular edema secondary to diabetic retinopathy. The inner vascular plexus is blue, the deep plexus is red, and cystoid spaces are cyan. Middle panel. The retina viewed from the underside of the retina. Right panel. When the cystoid spaces were taken from view the cystoid spaces are seen to have occurred in the context of decreased or absent flow in the deep vascular plexus.

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