Abstract
Purpose. “En face” is an emerging imaging technique derived from spectral domain optical coherence tomography (OCT). It produces frontal sections of retinal layers, also called “C-scan OCT.” Outer retinal tubulations (ORTs) in age-related macular degeneration (AMD) are a recent finding evidenced by spectral-domain OCT. The aim of this study is to characterize the morphology of ORT according to the form of AMD, using “en-face” spectral domain OCT. Methods. “En face” OCT imaging was prospectively performed in 26 consecutive eyes with AMD that also had ORT. Results. There were 15 neovascular, 8 atrophic, and 3 eyes with a mixed (fibrotic and atrophic) form of AMD. Among the neovascular group, the most frequent tubulation pattern on “en-face” OCT was a branching network emanating from a fibrovascular scar; we term this pattern as “pseudodendritic.” It did not require treatment when observed as an isolated finding. In all cases of atrophic AMD, the tubular network was located at the edge of the geographic atrophy area, and formed a “perilesional” pattern. Six atrophic cases showed tubular invaginations inside this area. Conclusion. “En face” OCT is a valuable technique in the diagnosis and followup of macular disease. It revealed the main characteristic patterns of ORT associated with neovascular and atrophic AMD.
Highlights
Outer retinal tubulations (ORT) have been recently identified in age-related macular degeneration (AMD) thanks to technological improvements in Spectral-Domain Optical Coherence Tomography (SD-optical coherence tomography (OCT)) [1]
This study aims to differentiate between the ORT presentations observed by “en face” OCT in exudative and atrophic AMD
Neovascular AMD with a neovascular fibrotic scar was identified in 15 eyes, geographic atrophy in 8 eyes and “mixed” exudative and atrophic AMD form in 3 eyes
Summary
Outer retinal tubulations (ORT) have been recently identified in age-related macular degeneration (AMD) thanks to technological improvements in Spectral-Domain Optical Coherence Tomography (SD-OCT) [1]. On B-scans ORT are round hyporeflective lesions, which may contain a few focal hyperreflective spots, and are always delineated by an hyperreflective ring, in contrast to the completely hyporeflective retinal cystoid lesions. They are always located at the level of the outer nuclear layer, and in AMD are classically found very close to areas of neovascular fibrosis or retinal atrophy. These lesions have been named “tubulations” because they exhibit a tubular morphology when observed in frontal sections using “en face” OCT scans, called C-scans
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