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Brett King, Kaitlyn Sapoznik, Ann E Elsner, Thomas Gast, Stephen A Burns; Outer Retinal Tubulation observed with SDOCT and AOSLO. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3401. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the characteristics of outer retinal tubulation (ORT) in chronic retinal disease via spectral domain optical coherence tomography (SD-OCT) images and adaptive optics scanning laser ophthalmoscope (AOSLO).
A database search was performed to identify patients with the following diagnoses: presumed ocular histoplasmosis, ocular toxoplasmosis, age-related macular degeneration, hereditary retinal dystrophies, macular scarring, and hereditary choroidal dystrophies. If available, a retrospective review of SD-OCT images was performed and eyes with the presence of ORT were identified. Images were converted to tiff files and uploaded to Photoshop CS6 ™. Greatest width and area of each tubulation was noted as well as other noteworthy characteristics. When available, images were reviewed of eyes that were also scanned with the AOSLO.
ORT was identified in 57 eyes via SD-OCT images. Of the eyes noted with significant retinal atrophy and/or scarring secondary to chronic retinal disease, 47% were found to have ORT. The average in width for tubules was calculated to be 165 um with the minimal and max values to be 70um and 509um respectively. AOSLO demonstrated the tubules to be connected and branching along with a feathery appearance using indirect mode imaging, which may be secondary to the inner retinal structures draping over the tubes as demonstrated on SD-OCT or the appearance of the outer segments. The length of the feathery lines sampled between 18 and 35 um. Atrophy and scarring secondary to age-related macular degeneration accounted for majority of the eyes with ORT with it being present more in patients with moderate to advanced atrophy then from exudative disease. A few patients with had ORT present in peripapillary atrophy. Additional pathologies noted with ORT include exudation secondary to age-related macular degeneration, macular scarring, stargardt’s disease, rod-cone dystrophy, presumed ocular histoplasmosis, central serous choroidopathy, thioridazine retinal toxicity, and unspecified hereditary retinal dystrophy.
While ORT was associated most frequently with atrophy and scarring secondary to age-related macular degeneration in this study, it was also found in a number of other retinal diseases which all cause damage to the outer retinal layers and retinal pigment epithelium including peripapillary atrophy.
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