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T. Kohno, M. Yamamoto, N. Miki, H. Iwami, S. Ataka, M. Kaida, M. Hirabayashi, A. Hamaguchi, K. Shiraki; Spectral Domain OCT Findings in Patients With Angioid Streaks and Peau d’Orange Appearance of Fundus. Invest. Ophthalmol. Vis. Sci. 2010;51(13):322.
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To elucidate the spectral domain optical coherence tomography (SD-OCT) findings in patients with angioid streaks (AS) and peau d’orange appearance of fundus.
12 eyes of 6 patients having AS with peau d’orange appearance were followed for at least one year or more using a Spectralis HRA-OCT (Heidelberg). 5 among the 6 patients were clinically diagnosed as psuedoxanthoma elasticum.
On SD-OCT, breaks, defects and dipping were noted at the outer line of Bruch’s membrane (BM) of the AS sites in all 12 eyes. Retinal pigment epithelium (RPE) overlying AS sites was unaffected, focally detached, or absent. Volume scan images showed some association of the RPE detachment with the breaks in the BM at the AS sites. In 6 eyes with classic choroidal neovascularization (CNV), the CNV was present close to the RPE detachments with occasional defects and dipping of the outer line of the BM.In 6 eyes, uneven reflectivity was noted at the photoreceptor layer with hyper-reflective clumps distributed over several layers of the retina, even at the vitreous side of outer limiging membrane (OLM), at the regions of unaffected or slightly detached RPE.
SD-OCT is good at detecting the changes of the BM at the AS sites and analyzing the relation between abnormalities of BM and development of CNV. In addition, the irregular reflectivity of photoreceptor layer with hyper-reflective clumps suggested that some degenerative changes could be present in the neurosensory retina over disturbed RPE in eyes with AS and peau d’orange appearance of fundus.
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