Optical coherence tomographic relationships of neovascular complexes and posterior vitreous spaces in proliferative diabetic retinopathy

Abstract

Purpose : To describe anatomic relationships of retinal neovascular complexes (NVC) and posterior vitreous spaces in proliferative diabetic retinopathy using spectral-domain optical coherence tomography (OCT).

Methods : Cross-sectional study. NVCs were imaged using spectral-domain OCT in 51 eyes of 37 patients. The relationship of NVCs to posterior vitreous spaces, such as the premacular bursa, prevascular vitreous fissures (PVF) and perimacular cisterns (PC), were analyzed.

Results : In the 77 NVCs evaluated the premacular bursa and PVF/PC were invaded in 15% and 38%, respectively (p=0.137). When no invasion of the PVF/PC was documented, these spaces were usually aligned and centered over the associated NVC. Neovascular complexes arising from the arcades and proliferating along the posterior hyaloid formed a “wolf’s jaw” configuration in 9%. By contrast, NVCs that invaded the bursa originated from smaller venous tributaries more distant from the arcades.

Conclusions : Diabetic NVCs interact with posterior vitreous interfaces and spaces. The PVF/PCs may have a greater role than the premacular bursa in PDR, because of their proximity to the vascular arcades, and may represent either pre-existing or newly formed cavities. The “wolf’s jaw” configuration seems to result from neovascularization along the posterior hyaloid in proximity to the arcades, rather than invasion of the bursa, as previously suggested.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.