Purchase this article with an account.
F. Prager, E. Goetzinger, C. Ahlers, M. Pircher, B. Baumann, W. Geitzenauer, C. Schütze, C. Hitzenberger, U. Schmidt-Erfurth; Polarization-Sensitive Optical Coherence Tomography in Adult-Onset Foveomacular Vitelliform Dystrophy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):762.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To visualize and evaluate changes of retinal pigment epithelium (RPE) in patients with adult-onset foveomacular vitelliform dystrophy by polarisation-sensitive optical coherence tomography (PS-OCT).
20 eyes of 14 patients with adult-onset foveomacular vitelliform dystrophy were evaluated using ophthalmic examination, best corrected Snellen visual acuity testing, conventional TD- and SD-OCT (Stratus OCT/Cirrus OCT - Carl Zeiss Meditec), fluorescein angiography (Heidelberg Engineering-HRA II) and PS-OCT. The SD PS-OCT system is able to record intensity, retardation, optic axis orientation simultaneously and allows to measure the degree of polarization uniformity (DOPU). The instrument is operated at a center wavelength of 840 nm, a bandwith of 50 nm and a scanning speed of 20000 A-scans per second. The depth resolution within the retina is ~4.5 microns.
Mean visual acuity was 20/50 (ranging from 20/400 to 20/25+2). TD- and SD-OCT imaging showed a diverse subretinal accumulation of highly reflective material. Fluorescein angiography presented central hyperfluorescence, RPE window defects or a central nonfluorescent spot with a surrounding irregular ring of hyperfluorescence. PS-OCT revealed within DOPU images a central accumulation of depolarizing tissue surrounded by atrophic areas at the lesion border in all patients. However, the RPE next to the lesion appeared unaffected. The nature of the accumulated depolarizing tissue is still unclear, but potentially could be caused by an accumulation or hypertrophy of pigmented tissue. In contrast to conventional TD- and SD-OCT systems SD PS-OCT allowed to differentiate hypperreflective tissue according to its depolarizing properties.
PS-OCT provides new insight into RPE changes in patients with adult-onset foveomacular vitelliform dystrophy and appears to be a promising tool for diagnosis and follow-up of this disease, especially in indistinct cases.
This PDF is available to Subscribers Only