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N. Nigam, M. Brar, I. Kozak, R. M. S. Yuson, W. R. Freeman; Anatomical Basis of Angiographic Leakage of Macular Edema With No Cystic Changes on OCT. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5417.
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© ARVO (1962-2015); The Authors (2016-present)
We have previously found that in some eyes with angiographic macular edema, stratus OCT did not reveal any abnormality. Therefore we wished to study the morphological patterns of macular edema on Spectral domain OCT and correlate them with corresponding angiographic patterns using Spectralis HRA/OCT.
This is a retrospective study from the Jacobs Retina Center, University of California, San Diego. Eyes with macular edema in patients with different etiologies (diabetic macular edema, ERM, vein occlusion, post surgical CME and uveitis) were included in the study. Spectralis HRA/OCT (Heidelberg engineering, Germany) was used which allows simultaneous co-localization of SD-OCT and angiographic images. We studied the morphological patterns of macular edema (cystic/ thickening of retinal layers without cysts/distortion/normal morphology) on SD-OCT images and then correlated with the angiographic patterns in the area of edema (diffuse leakage vs cystoid leakage).
45 eyes with diffuse angiographic leakage either in 1 or more quadrants without cysts were studied. 15 (33.33%) showed microcysts on SD-OCT in the area of edema. 28 eyes (62.22%) had diffuse thickening of 1 or more retinal layers without cyst and or distorted architecture. 4.44% of eyes with FA leakage had no abnormality on SD-OCT. As a control we evaluated OCT scans of 10 consecutive eyes with honeycomb/petalloid pattern of cystoid leakage on FA. All 10 eyes (100%) with a cystic pattern on FA showed cysts in the area of edema by SD-OCT.
Simultaneous FA/OCT using Spectralis provided us valuable information on the retinal morphological changes associated with non-cystoid angiographic macular edema. Diffuse non-cystoid angiographic macular edema may have micro cysts as seen on the Spectral OCT, but is more commonly associated with thickening or distortion of the retinal layers without cyst formation.
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