Seyeon Park

Purpose: To describe maculopathy diagnosed with high-resolution Fourier-domain optical coherence tomography among eyes with previously unexplained visual loss. Methods: Nine eyes from six patients with previously unexplained vision loss based on funduscopy, fluorescein angiography, and Stratus optical coherence tomography and 32 eyes from 25 asymptomatic age-matched control subjects were imaged with a Fourierdomain optical coherence tomography instrument with axial resolution of 4 mm to 4.5 mm and transverse resolution of 10 mm to 15 mm. Results: Among eyes with unexplained vision loss, visual acuity ranged from 20/20 to 20/80 and central scotoma was noted in all eyes by microperimetry or Amsler grid. Fourierdomain optical coherence tomography showed abnormality in the foveal photoreceptor layer in six eyes from four subjects. These abnormalities include focal loss of the PR layer with microcystoid changes in the macula, focal discontinuity of the PR layer, and focal elevation and blurring of the PR layer associated with a mild epiretinal membrane. Among age-matched control eyes, no foveal PR abnormality was seen. Conclusion: Fourier-domain optical coherence tomography detected subtle changes in the foveal PR layer in some eyes with vision loss and central scotoma unexplained with routine clinical diagnostic tests. © by Ophthalmic Communications Society, Inc.

PURPOSE. To investigate the use of high-resolution Fourierdomain optical coherence tomography to image choroidal neovascular membranes associated with exudative age-related macular degeneration. METHODS. An Fd-OCT instrument with axial resolution of 4 to 4.5 μm and transverse resolution of 10 to 15 μm was used to image 21 eyes with newly diagnosed eAMD. A raster series of 100 B-scans separated by 60 μm was used to study the growth pattern of CNVM and associated morphologic changes. CNVM size was determined using 250 to 300 serial virtual C-scans of reconstructed three-dimensional macular volume. RESULTS. A highly reflective subretinal and/or subretinal pigment epithelial lesion that co-localized with the CNVM seen on fluorescein angiography was detected in all eyes by Fd-OCT. Although a combined subretinal and sub-RPE growth pattern of various degrees was noted in 15 eyes, a statistically significant difference in the distribution of growth pattern was noted when classic CNVM was compared with occult CNVM. CONCLUSIONS. Fd-OCT is a promising potential alternative modality to visualize CNVM with AMD. Angiographic lesion size and type correlated with growth pattern and size of CNVM on Fd-OCT, with correlation being stronger for classic lesions. © Association for Research in Vision and Ophthalmology.

Objective: To evaluate the morphologic changes in the macula of subjects with repaired macula-off retinal detachment using high-resolution Fourier-domain optical coherence tomography and to perform functional correlation in a subset of patients using microperimetry. Design: Prospective observational case series. Participants: Seventeen eyes from 17 subjects who had undergone anatomically successful repair for macula-off, rhegmatogenous RD at least 3 months earlier and without visually significant maculopathy on funduscopy. Methods: FD OCT with axial and transverse resolution of 4.5 μm and 10 to 15 μm, respectively, was used to obtain rapid serial B-scans of the macula, which were compared with that from Stratus OCT. The FD OCT B-scans were used to create a 3-dimensional volume, from which en face C-scans were created. Among 11 patients, MP-1 was performed to correlate morphologic changes with visual function. Main Outcome Measures: Stratus OCT scans, FD OCT scans, and MP-1 data. Results: Stratus OCT and FD OCT images of the macula were obtained 3 to 30 months postoperatively in all eyes. Although Stratus OCT revealed photoreceptor disruption in 2 eyes, FD OCT showed photoreceptor disruption in 13 eyes. This difference was statistically significant. Both imaging modalities revealed persistent subretinal fluid in 2 eyes and lamellar hole in 1 eye. Among 7 subjects who had reliable MP-1 data, areas of abnormal function corresponded to areas of photoreceptor layer disruptions or persistent subretinal fluid in 5 subjects ; one subject had normal FD OCT and MP-1. Conclusions: Photoreceptor disruption after macula-off RD repair is a common abnormality in the macula that is detected better with FD OCT than Stratus OCT. A good correlation between MP-1 abnormality and presence of photoreceptor disruption or subretinal fluid on FD OCT demonstrates that these anatomic abnormalities contribute to decreased visual function after successful repair. Financial Disclosure: The authors have no proprietary or commercial interest in any materials discussed in this article. © 2008 American Academy of Ophthalmology.