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Alexandre Sellam, Nathalie Massamba, Audrey Fel, Phuc Lehoang, Bahram Bodaghi; Hyperreflective Dots in Spectral Domain Optical Coherence Tomography as Phenotypic Marker in Uveitis-Associated Cystoid Macular Edema. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3138.
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To evaluate agreement between hyperreflective dots (HRD) in retina layers by spectral domain optical coherence tomography (SD-OCT), laser flare photometry associated with best-corrected visual acuity (BCVA) results in patients with uveitis-associated cystoid macular edema (CME). Thus, the aim of the study was to demonstrate that the HRD in SD-OCT could be a phenotypic marker in CME-associated posterior uveitis.
All patients referred to our tertiary care center for posterior uveitis had full examination including: BCVA, laser flare photometry, SD-OCT, fluorescein and infracyanine angiography. Causes of uveitis were multiple: infectious, inflammatory and unknown. The characteristics of the HRD were evaluated in all SD-OCT scans. HRD were defined as small focal hyperreflective material scattered mainly in outer retinal layers but also spreading to all retinal layers observed in at least one available scan. Two different ophthalmologists counted HRD using a horizontal B scan cross section through the fovea. The eyes were divided into three groups according to the location of HRD on SD-OCT : RNFL + ILM, INL + OPL and ONL. They were classified on the basis of quantity (i.e. absent, few if less than 10, moderate if between 10 and 20, or numerous if more than 20). Central macular thickness (CMT) was also evaluated.
Thirty eyes of 22 patients were included. Twelve men and 10 women with posterior uveitis were examined. HRD were present in all patients with CME in the outer and inner retinal layers. Overall, 22 HRD were found in the RNFL and ILM, 24 in INL and OPL and 13 in ONL.<br /> Mean flare measurement was 13 +/- 11.5. Mean BCVA was 20/200. Mean central macular thickness was 420 μm.<br /> Two subgroups were identified. Nineteen eyes presented decreased BCVA, normal or elevated Flare, numerous HRD and increased CMT, corresponding to active posterior uveitis. Other 11 eyes presented decreased BCVA, increased CMT, normal laser Flare photometry, those results corresponding to inactive posterior uveitis. The difference with the two groups was numerically significant.
HRD are correlated to CMT and BCVA but not to the Flare. Flare is not predictive of inflammation for posterior uveitis.<br /> HRD in posterior uveitis associated with CME could be an early marker of inflammation corresponding to the activation of microglial cells.
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