Abstract
Purpose:
To describe the prevalence of macular and paravascular retinal cysts in a population-based study of older adults.
Methods:
There were 1913 participants aged 63 to 102 years at the 20-year Beaver Dam Eye Study examination phase, of which 1547 persons (3075 eyes) had gradable 3D-OCT scans of the macula. The presence of retinal cysts was determined by standardized grading of the macular scans. Height, weight, blood pressure, visual acuity, ocular biometry, and intraocular pressure were measured, and a detailed medical history was obtained. Stereoscopic photos of 3 standard fields (7 fields in people with diabetes) were graded according to a standard protocol for retinal diseases.
Results:
At least 1 macular cyst was found in 102 eyes (92 participants) for a prevalence rate of 6%. Of these, 86% had more than 1 cyst. Cysts were found most often in the center circle (81%) and ranged in size from 28 to 498 µm (mean 130 µm). Age (p<0.001), but not gender was associated with the presence of a macular cyst. Adjusting for age and gender, the presence of late stage age-related macular degeneration, epiretinal membrane (ERM), macular holes, increasing diabetic retinopathy severity, macular edema, retinal vein occlusions and history or cataract surgery were all associated (p<0.05) with prevalent macular cysts. Visual acuity (p<0.0001) and contrast sensitivity (p<0.0001) decreased in the presence of a greater number and larger-sized macular cysts. Paravascular cysts were more common with a prevalence rate of 20% (360 eyes in 308 people). They were not related to age, gender, visual acuity or any of the ocular diseases associated with macular cysts, except for presence of ERM (p=0.004). Paravascular cysts were associated with a longer axial length (p=0.002) and a more myopic refraction (p=0.0006).
Conclusions:
Macular cysts are associated with decreased visual acuity and many age-related retinal diseases. While paravascular cysts do not have an impact on vision, they are related to longer axial length. Further follow-up of this population will allow better understanding of the natural history of cysts and their associations with retinal diseases.
Keywords: 463 clinical (human) or epidemiologic studies: prevalence/incidence •
585 macula/fovea •
688 retina