Nodular Epiretinal Mϋller Cell Gliosis in the Fovea.

Abstract

To report the findings of a hyperreflective nodular epiretinal gliosis observed with optical coherence tomography (OCT) presumed to be due to subclinical hyaloidal traction causing Mϋller cell cone gliosis. Retrospective, observational case series. Six eyes of 6 patients (mean age: 57, range 35-81 years) presented with a nodular epiretinal gliosis and had an average follow-up interval of 26 months (range 1-82 months). Mean baseline best corrected visual acuity was 0.25±0.17 (Snellen equivalent 20/38.3±16.9). Fundus photography demonstrated a yellowish lesion overlying the fovea. OCT imaging revealed a hyperreflective preretinal lesion with a mean vertical length of 267-microns (µm) (range 185-497) and a mean greatest linear diameter of 312-µm (range 124-640). There was no vitreoretinal abnormality including vitreomacular traction or epiretinal membrane noted in any eye, and 2 of 6 eyes displayed a definitive posterior vitreous detachment (PVD). These nodules may have occurred prior to and persisted even after a PVD or may have been acquired after the PVD. The nodules typically remained stable with minimal change although in one eye, a PVD occurred 6 months after initial presentation and lifted the gliosis off of the retinal surface where it remained attached to the posterior hyaloid. Foveal nodular epiretinal gliosis may occur due to subclinical hyaloidal traction on the Müller cell cone even without obvious vitreoretinal interface abnormality on OCT.