Idiopathic Juxtafoveal Retinal Telangiectasis: New Findings by Ultrahigh-Resolution Optical Coherence Tomography
Received 26 April 2005; accepted 19 August 2005. published online 12 December 2005.
Objective
To investigate the capabilities of ultrahigh-resolution optical coherence tomography (UHR OCT); to compare with the commercially available OCT standard-resolution system, StratusOCT, for imaging of idiopathic juxtafoveal retinal telangiectasis (IJT); and to demonstrate that UHR OCT provides additional information on disease morphology, pathogenesis, and management.
Design
Retrospective, observational, interventional case series.
Participants
Nineteen eyes of 10 patients diagnosed with IJT in at least one eye.
Method
All patients were imaged with UHR OCT and StratusOCT at the same visit. A subset of patients was also imaged before and after treatment of IJT.
Main Outcome Measures
Ultrahigh- and standard-resolution cross-sectional tomograms of IJT pathology.
Results
Using both standard- and ultrahigh-resolution OCT, we identified the following features of IJT: (1) a lack of correlation between retinal thickening on OCT and leakage on fluorescein angiography, (2) loss and disruption of the photoreceptor layer, (3) cystlike structures in the foveola and within internal retinal layers such as the inner nuclear or ganglion cell layers, (4) a unique internal limiting membrane draping across the foveola related to an underlying loss of tissue, (5) intraretinal neovascularization near the fovea, and (6) central intraretinal deposits and plaques. In 63% of cases, the presence of abnormal vessels and a discontinuity of the photoreceptor layer correlated with visual acuity.
Conclusions
Ultrahigh-resolution OCT improves visualization of the retinal pathology associated with IJT and allows identification of new features associated with it. Some of these features, such as discontinuity of the photoreceptor layer, are revealed only by UHR OCT.
1New England Eye Center, Tufts–New England Medical Center, Tufts University, Boston, Massachusetts.
2Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.
3Institute of Medical Physics, University of Vienna, Christian Doppler Laboratory, Vienna, Austria.
4UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Correspondence to Jay S. Duker, MD, New England Eye Center, Tufts–New England Medical Center, 750 Washington Street, Boston, MA 02111.
Manuscript no. 2005-357.
Supported in part by the National Institutes of Health, Bethesda, Maryland (contract nos.: RO1-EY11289-16, R01-EY13178, P30-EY13078); National Science Foundation, Arlington, Virginia (contract no.: ECS-0119452); Air Force Office of Scientific Research, Arlington, Virginia (contract no.: F49620-98-1-0139); Medical Free Electron Laser Program, Arlington, Virginia (contract nos.: F49620-01-1-0186, FWF P14218-PSY, FWF Y159-PAT, CRAF-1999-70549); Massachusetts Lions Eye Research Fund Inc., New Bedford, Massachusetts; Research to Prevent Blindness, New York, New York; and Carl Zeiss Meditec, Dublin, California.
Drs Fujimoto and Schuman receive royalties from intellectual property licensed to Carl Zeiss Meditec.
ABSTRACT