March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Cystoid Macular Edema Of Different Origins Can Be Distinguished Based On Very Characteristic And Specific Morphologic Alterations In Sd-oct.
Author Affiliations & Notes
  • Marion R. Munk
    Dept of Ophthalmology,
    Medical University Vienna, Vienna, Austria
  • christopher G. Kiss
    Dept of Ophthalmology,
    Medical University Vienna, Vienna, Austria
  • Stefan Sacu
    Dept of Ophthalmology,
    Medical University Vienna, Vienna, Austria
  • Florian Sulzbacher
    Dept of Ophthalmology,
    Medical University Vienna, Vienna, Austria
  • Tamara J. Mittermüller
    Dept of Ophthalmology,
    Medical University Vienna, Vienna, Austria
  • Philip Roberts
    Dept of Ophthalmology,
    Medical University Vienna, Vienna, Austria
  • Wolfgang Huf
    Department of Medical Physics and Biomedical Technics,
    Medical University Vienna, Vienna, Austria
  • Rene Rückert
    Novartis Pharma AG, Basel, Switzerland
  • Matthias Bolz
    Dept of Ophthalmology,
    Medical University Vienna, Vienna, Austria
  • Ursula Schmidt-Erfurth
    Dept of Ophthalmology,
    Medical University Vienna, Vienna, Austria
  • Footnotes
    Commercial Relationships  Marion R. Munk, None; christopher G. Kiss, None; Stefan Sacu, None; Florian Sulzbacher, None; Tamara J. Mittermüller, None; Philip Roberts, None; Wolfgang Huf, None; Rene Rückert, None; Matthias Bolz, None; Ursula Schmidt-Erfurth, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 2273. doi:
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    • Get Citation

      Marion R. Munk, christopher G. Kiss, Stefan Sacu, Florian Sulzbacher, Tamara J. Mittermüller, Philip Roberts, Wolfgang Huf, Rene Rückert, Matthias Bolz, Ursula Schmidt-Erfurth; Cystoid Macular Edema Of Different Origins Can Be Distinguished Based On Very Characteristic And Specific Morphologic Alterations In Sd-oct.. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2273.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate whether specific morphologic characteristics can be defined to distinguish cystoid macular edema (CME) of different origins by SD-OCT

Methods: : 85 eyes with CME were included; 29 with untreated CME due to uveitis (uvCME), 24 with treatment-naive branch retinal vein occlusion (BRVO) and 32 with (at least 3 months untreated) diabetic macular edema (DME). Fourteen healthy subjects formed the control group. HD-OCT central line (horizontal/ vertical) and section scans were performed using Spectralis OCT. Scans were graded by two independent masked readers for CME-pattern in every particular ETDRS subgrid, CME distribution,-symmetry, layer cyst-location, subretinal detachment (SRD), epiretinal membrane (ERM), intraretinal blood, microaneurysms, cotton wool spots (CWS), microfoci, hard exudates, hyperreflective SRD deposits, preserved foveal depression, integrity and individual layer thicknesses (measured central, foveal, parafoveal and extrafoveal) and retinal thickness.

Results: : UvCME showed the thickest inner nuclear layer (INL), DME the thickest outer nuclear layer (ONL) and BRVO the thickest ganglion cell layer. Cysts restricted to the INL defined uvCME, cysts restricted to the ONL defined DME, whereas cysts in BRVO were never confined to a single layer. UvCME showed a symmetric, central distribution with the cyst maximum in the central subfield, unless an ERM was present. BRVO manifested with hemi (= generalized CME either only nasal or temporal) or generalized edema, asymmetric distribution and a cone shaped CME pattern in the EDTRS grid with CME maximum in the inner superior or inferior subgrid. Diffuse and focal CME were specific for DME (DME:42%,others:0%). Preserved foveal depression (DME:64%,BRVO:30%,uvCME:24%), microaneurysms in INL (DME:97%,others:0%), microfoci (DME:97%,BRVO:65%,uvCME:0%) and hard exudates (DME:81%,BRVO:13%, uvCME:0%) were indicatory for DME, CWS (BRVO:88%,DME:6%, uvCME:0%), widespread shadowing by light attenuation (BRVO:92%,DME:6%,uvCME:3%), hyperreflective SRD deposits (BRVO:95%,DME:6%,uvCME:31%) and neuronal layer cysts for BRVO and intact hyperreflective bands(uvCME:97%,others:25%) for uvCME.

Conclusions: : Differences in layer thicknesses and characteristic, specific morphologic alterations characterize CMEs of different origin and make them distinguishable based on SD-OCT analysis.

Keywords: edema • imaging/image analysis: clinical • macula/fovea 
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