Abstract
Purpose:
Microcystic macular edema (MME) is detected as an arcuate-shaped low reflectance area in the macula in the infrared fundus photographs and in the adaptive optics scanning laser ophthalmoscopic (AO-SLO) images. The low reflectance area corresponds to the area of microcystic changes in the inner nuclear layer (INL) detected by optical coherence tomography (OCT), and they have been reported in a variety of optic nerve diseases. The purpose of this study was to determine whether MME was present in eyes with optic neuropathy and to determine their characteristics.
Methods:
This was a retrospective study of 41 eyes of 25 patients with optic neuropathy or glaucoma. There were 7 eyes with traumatic optic neuropathy, 3 eyes with ischemic optic neuropathy, 4 eyes with ethambutol optic neuropathy, 4 eyes with Leber’s optic neuropathy, 5 eyes with optic neuritis, 6 eyes with optic nerve atrophy and 12 eyes with glaucoma. All of the patients were examined by AO-SLO and OCT at the Osaka University Hospital between August 2013 and October 2014. The visual acuity and incidence of MME were determined in these patients.
Results:
Low-reflectance areas in the AO-SLO image with microcysts in the OCT images were observed in 11 eyes (26.8%). The visual acuity was significantly poorer in eyes with MME (1.9±1.2 logMAR units) than in eyes without MME (0.42±0.73 log units; P<0.0). Eight of the 11 eyes with MME had arcuate low reflectance area but 3 eyes with glaucoma had a nerve fiber layer defect (NFLD)-like low reflectance area by AO-SLO. This NFLD-like low reflectance area did not correspond to the scotoma in the Humphery visual fields, which were different from the ordinal NFLD.
Conclusions:
The presence of MME may be related to an advanced stage of optic neuropathy. The shape of the MME in the AO-SLO images is not only arcuate but can also be NFLD-like.