Abstract
Purpose: :
Case study. To assess morphological differences in pigment epithelium detachments (PEDs) observed with en face optical coherence tomography in central serous retinopathy (CSC), diffuse retinal pigment epitheliopathy (DRPE) and age-related macular degeneration (AMD)
Methods: :
We assessed 36 eyes of 28 consecutive patients with PED. Clinical diagnosis of recruited eyes were: 9 with CSC, 6 with DRPE and 21 affected by AMD. All patients were evaluated with en face optical coherence tomography (OCT) (Ophthalmic Technologies Inc, Toronto, Canada). Morphological PEDs aspects were estimated on C-scans and classified according to: shape, inner silhouette, contents, wall aspects, wall thickness and size.
Results: :
In CSC, PED shape was predominantly circular (90%) and never showed irregular aspects; irregular and multilobular features were the mainly characteristics (77%) in AMD and, intermediate distributions between CSC and AMD was found in DRPE. PED inner silhouette had mostly smooth aspect (89%) in rare cases light granular features (11%) and did not reveal granular features in CSC; light granular (38%) and granular figures (62%) were the exclusive representations in AMD; smooth profile were absent and midway distribution between light granular and granular aspect were evident in DRPE. Clear PED contents were the most frequent representations in CSC (89%); alternatively clear (67%) and flare contents (33%) were observed in DRPE. Not univocal data were found in AMD. Morphological PED wall aspects were regular (56%) or lightly irregular (44%) in CSC and never presented irregular features. In DRPE and in AMD they were lightly irregular (67% and 52% respectively) or irregular (33% and 48% respectively). PED wall thickness and PED dimensions were always larger in AMD than in CSC and DRPE. Pearson’s correlation coefficient and Fisher’s exact in PED morphological aspects were statistically significant (p<0.01) between CSC and AMD in inner silhouette, contents and wall aspects. A relation, not statistically significant (p>0.01), was observed between DRPE and AMD. Statistically significant correlation (p<0.01) between CSC and DRPE in PED inner silhouette only was found.
Conclusions: :
En face OCT was revealed useful imaging technique to detect tiny PED morphological differences in CSC, DRPE and AMD.
Keywords: retinal pigment epithelium • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • age-related macular degeneration