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Kevin C Chen, Tiezhu Lin, William R Freeman; Retinal pseudocysts in geographic atrophy secondary to non-exudative age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2017;58(8):44.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal pseudocysts have been observed in geographic atrophy from non-exudative age-related macular degeneration (AMD) with time-domain optical coherence tomography. These cavitary spaces are not associated with choroidal neovascularization (CNV) but rather are thought to be a result of Müller cell degeneration leading to structural weakness. With the higher resolution of spectral-domain optical coherence tomography (SD-OCT), we report the incidence of intraretinal pseudocysts in geographic atrophy secondary to AMD and evaluate their effect on visual acuity.
A retrospective chart review was performed of patients presenting to a tertiary referral center with geographic atrophy at baseline due to non-exudative AMD. Best corrected visual acuity was recorded from presentation and last follow-up. All patients underwent imaging with SD-OCT and intravenous fluorescein angiography (FA). A two-tailed t-test was used to compare best corrected visual acuity of eyes with pseudocysts to those without. Statistical significance was defined as p≤0.05.
77 eyes from 47 patients (38.3% male) were followed for an average of 38.5 ± 31.1 months. Retinal pseudocysts were found in 15 eyes (19.5%) at baseline, of which zero showed leakage on FA. No eyes developed CNV during follow up. Baseline and final visual acuity were logMAR 0.577 ± 0.425 (Snellen 20/75) and logMAR 0.791 ± 0.371 (Snellen 20/120), respectively. The presence of retinal pseudocysts did not affect baseline (p=0.78) or final (p=0.88) visual acuity.
Retinal pseudocysts can be observed in patients with geographic atrophy secondary to non-exudative AMD, often overlying areas of retinal atrophy. Unlike cystoid spaces from CNV, retinal pseudocysts are not associated with leakage on FA and do not have a significant effect on baseline or final visual acuity at last follow up.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
A. Fundus autofluorescence of the left eye of a patient with non-exudative age-related macular degeneration showing hypoautofluorescence at the area of geographic atrophy. B. Early and C. late fluorescein angiography revealing a window defect corresponding to the geographic atrophy without leakage. D. Spectral-domain optical coherence tomography through the geographic atrophy showing intraretinal pseudocysts in the inner nuclear layer (red arrowhead).
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