Abstract
Purpose :
To describe the imaging characteristics of a distinct abnormality among vitreo-macular interface (VMI) disorders.
Methods :
The included eyes must present an irregular foveal contour not classifiable as lamellar macular hole, pseudohole, epiretinal membrane, vitreo-macular adhesion or traction as imaged with spectral domain optical coherence tomography (SD-OCT) and blue-fundus autofluorescence (B-FAF). Main outcome measures were morphologic evaluation of the imaging features, logMAR best-corrected visual acuity (BCVA), central foveal thickness (CFT) and minimal FT (mFT).
Results :
Two types of FATIAS were identified: (1) the step type characterized by an asymmetric contour of the foveal pit between the temporal and nasal or between the upper and lower aspect with one side more elevated than the other; additionally a tissue of intermediate reflectivity on the inner foveal surface was present; (2) the rail type characterized by a shallow foveal pit and a rail of tissue of intermediate reflectivity in the innermost part of the fovea. An overt epiretinal membrane or lamellar hole-associated epiretinal proliferation were not found in the foveal area in any case. A visible, detached posterior hyaloid was noted 14/28 and 7/19 eyes in the step and rail group, respectively whereas a visible operculum was noted in 8/28 and in 5/19 in the in the step and rail group, respectively. Integrity of the external limiting membrane and ellipsoid zone at the fovea were observed in all cases. Both types were further characterized by an area of increased B-FAF signal, brighter in correspondence of the thinnest part of the foveal pit in the step type and roughly round and centered on the foveal pit in the rail type. LogMAR BCVA was 0.09 ± 0.09 and 0.1 ±0.1 in the step and rail group, respectively. (P=0.91); CFT was 197.82 ±9.70 and 202.21±13.20 in the step and rail group, respectively (P=0.19); mFT was 185.64 ± 9.99 and 197.94 ± 14.97 in the step and rail group ,respectively ( P < 0.0001).
Conclusions :
A distinct VMI disorder is reported. Two types of FATIAS may be appreciated with SD-OCT analysis, the step and the rail type, respectively. FATIAS features absence of overt ERM or LHEP, integrity of external limiting membrane and ellipsoid zone at the fovea, increased B-FAF signal at the fovea, and excellent visual acuity.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.