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T. Leng, O. Punjabi, G. Gregori, C. A. Puliafito, P. J. Rosenfeld; Spectral Domain Optical Coherence Tomography Characteristics of Vitelliform Macular Detachments in Patients With Basal Laminar Drusen. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2160. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the characteristics of high-resolution spectral domain optical coherence tomography (SDOCT) retinal images in patients who developed vitelliform macular detachments in the presence of basal laminar drusen (BLD).
The data from a prototype 8 µm axial resolution SDOCT instrument was reviewed from 8 patients who had the characteristic fundus appearance of BLD combined with vitelliform retinal detachment. With an aquisition time of approximately 2.6 seconds, the SDOCT, produced datasets consisting of 128 B-scans covering an area of 6 x 6 mm. Each B-scan was composed of 512 A-scans, each of which had 1024 samples taken over a depth of 2 mm. This data was compared to the data gathered from a time domain OCT3 machine. Specifically, we concentrated our analysis on the retinal pigment epithelium-Bruch’s membrane complex, the subretinal space, and the photoreceptor layer.
SDOCT allowed for accurate image registration. Higher density and improved resolution of B-scans allowed for better visualization of retinal architecture. All of the eyes studied demonstrated an intact inner retina. Within the subretinal space, the material from the exudative detachment demonstrated a medium reflectivity. There was a characteristic "saw-toothed" appearance of the retinal pigment epithelium (RPE). This finding most likely correlated to the focal nodular thickening of the RPE basement membrane seen in previous histopathological studies of BLD. Additionally, we found that the RPE in between the lesions was attenuated and that the outer reflective band representing the photoreceptor outer segments was also attenuated in many areas.
SDOCT analysis provided for high-quality images of the retina in BLD with vitelliform detachments. The involvement of the outer retinal layers was clearly defined and may be clinically useful for determining progression or regression of patients' disease state during follow-up, as well as for monitoring the effects of treatment.
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