Wide-field OCT and vitreo-retinal adherence

Abstract

 

Purpose

 

to show the ability of wide-field OCT (montage images of OCT B-scans obtained on the same line) to visualize the relationship between the vitreous and the retina at the posterior pole, optic nerve and the retina till the mid-periphery

 

Methods

 

Consecutive, observational case series. 38 eyes of 36 consecutive patients with macular pucker (3 eyes), macular hole (5), lamellar macular hole (7), vitreo-macular traction (9) and normal (14) were included. Montage images of at least 3 OCT B-scans (Heidelberg Spectralis, Heidelberg Engeneering, Germany) (horizontal and vertical through the fovea) were obtained in each case; montage images were composed using picture editing software (Photoshop Elements version 11; Adobe, San Jose, CA)

 

Results

 

All 76 montage images were created and all had good quality. In 6 eyes vitreous was not visible in both horizontal and vertical montage images (5 lamellar macular hole and 1 pucker). In other 6 eyes vitreous was visible as full adherent to the retina in both horizontal and vertical montage images (5 normal and 1 traumatic macular hole). In the remaining 26 eyes (9 normal, 2 lamellar macular hole, 2 macular pucker, 9 vitreo-macular traction and 4 macular hole) shallows vitreous detachments were visible in different position and with different size showing an incredibly high variability between the same ocular conditions

 

Conclusions

 

Wide-field OCT can clearly show a complete posterior vitreous detachment (when vitreous is not visible), a complete vitreo-retina adhesion (when vitreous is full adherent) and detailed information (including shape and extension) of shallow vitreous detachments. In the era of new therapeutic approach to vitreo-retinal interface diseases, including drugs and small invasive tools for surgery, an in deep knowledge of the vitreo-retinal relation could help ophthalmologists to properly manage patients. Wide-field OCT can show this information. OCT’s manufactures should improve their software including an automatic tool to create montage images

 

 

Macular pucker with a complete posterior vitreous detachment. Vitreous is not visible in the montage image.

 

 

Lamellar macular hole: vitreous is full adherent at the nasal side and optic nerve head, there is a shallow vitreous detachment in the fovea area and a small area of attachment in the temporal side.

 

Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 763 vitreous • 688 retina