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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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© 2017 Association for Research in Vision and Ophthalmology.
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.
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.
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.
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.
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