Retinal Changes in Leber’s Idiopathic Stellate Neuroretinitis Using 3–Dimentional Optical Coherence Tomography

Abstract

Abstract: : Purpose: To report the intraretinal changes in Leber’s idiopathic stellate neuroretinitis using 3–dimentional optical coherence tomography (3D–OCT). Methods: A 50–year–old Japanese woman with Leber’s idiopathic stellate neuroretinitis in her left eye underwent fluorescein angiography and 3D–OCT. 3D–OCT scans in a transverse fashion that creates transverse OCT images (C–scan) that are thin cross sections of retinal and subretinal structures at a chosen depth. The technology also scans laterally along a line to the retina to produce cross–sectional longitudinal OCT images like those of the Humphrey system (B–scan). Results: At the initial examination, funduscopy showed a serous retinal detachment and stellate lesion at the macula and reddish and edematous changes of the optic disc. Fluorescein angiography showed hyperfluorescence at the optic disc, but no remarkable leakage of the macular lesions. 3D–OCT C–scan demonstrated the extent of the edematous retinal changes from the optic disc to the macula and showed a stellate lesion at the macula. 3D–OCT B–scan showed that macular stellate lesions were present in the outer plexiform layer around a foveal lesion. Six weeks after the initial examination, no serous retinal detachment or retinal edema was observed. With the regression of the stellate lesion at the macula, new hard exudates were seen between the optic disc and the macula. 3D–OCT demonstrated that these lesions were in the outer plexiform layer and the outer nuclear layer. Conclusions: 3D–OCT/SLO for the first time enables observation of precise intraretinal changes in Leber’s idiopathic stellate neuroretinitis in living eyes. This system would be useful to evaluate the retinal pathology and follow patients with this disease non–invasively.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retinitis • imaging/image analysis: clinical