PURPOSE: To evaluate the macular choroidal and scleral changes in tilted disc syndrome (TDS) with staphyloma using optical coherence tomography (OCT) to determine the mechanism of serous retinal detachment (SRD) formation. METHODS: All eyes underwent fluorescein (FA) and indocyanine green angiography (ICGA) in this retrospective, observational study. Enhanced-depth imaging (EDI) OCT and prototype high-penetration (HP) OCT were used to examine the choroid and sclera, respectively, at the upper and lower optical areas and the subfovea on vertical OCT sections. RESULTS: Twenty-four eyes with TDS with inferior staphyloma were included. FA showed the macular area with the superior edge of staphyloma had a granular hyperfluorescent pattern and ICGA showed belt-like hypofluorescence. OCT showed SRDs in seven eyes. The mean EDI-OCT choroidal thicknesses in 19 eyes were: upper area, 211 ± 79 μm; subfovea, 153 ± 70 μm; and lower area, 158 ± 42 μm. The mean subfoveal and lower choroid were significantly (P < 0.01 for both) thinner than the upper area. The mean HP-OCT scleral thicknesses in 14 eyes were: upper area, 414 ± 36 μm; subfovea, 493 ± 40 μm; and lower area, 398 ± 83 μm. The subfoveal sclera was significantly (P < 0.01) thicker than the others. CONCLUSIONS: The subfoveal choroid was relatively thin and the subfoveal sclera thickened in TDS with a staphyloma edge at the macula. The area with retinal pigment epithelial (RPE) atrophy was hyperfluorescent on FA; choriocapillaris occlusion was hypofluorescent on ICGA. Characteristic anatomic subfoveal scleral alterations might lead to a thinner choroid and inhibit chorioscleral outflow; a secondary RPE disorder subsequently could cause SRDs.
PURPOSE: To evaluate the macular choroidal and scleral changes in tilted disc syndrome (TDS) with staphyloma using optical coherence tomography (OCT) to determine the mechanism of serous retinal detachment (SRD) formation. METHODS: All eyes underwent fluorescein (FA) and indocyanine green angiography (ICGA) in this retrospective, observational study. Enhanced-depth imaging (EDI) OCT and prototype high-penetration (HP) OCT were used to examine the choroid and sclera, respectively, at the upper and lower optical areas and the subfovea on vertical OCT sections. RESULTS: Twenty-four eyes with TDS with inferior staphyloma were included. FA showed the macular area with the superior edge of staphyloma had a granular hyperfluorescent pattern and ICGA showed belt-like hypofluorescence. OCT showed SRDs in seven eyes. The mean EDI-OCT choroidal thicknesses in 19 eyes were: upper area, 211 ± 79 μm; subfovea, 153 ± 70 μm; and lower area, 158 ± 42 μm. The mean subfoveal and lower choroid were significantly (P < 0.01 for both) thinner than the upper area. The mean HP-OCT scleral thicknesses in 14 eyes were: upper area, 414 ± 36 μm; subfovea, 493 ± 40 μm; and lower area, 398 ± 83 μm. The subfoveal sclera was significantly (P < 0.01) thicker than the others. CONCLUSIONS: The subfoveal choroid was relatively thin and the subfoveal sclera thickened in TDS with a staphyloma edge at the macula. The area with retinal pigment epithelial (RPE) atrophy was hyperfluorescent on FA; choriocapillaris occlusion was hypofluorescent on ICGA. Characteristic anatomic subfoveal scleral alterations might lead to a thinner choroid and inhibit chorioscleral outflow; a secondary RPE disorder subsequently could cause SRDs.
Authors: Antonio García-Ben; Radua Kamal-Salah; Ignacio García-Basterra; Ana Gonzalez Gómez; María José Morillo Sanchez; Jose Manuel García-Campos Journal: Graefes Arch Clin Exp Ophthalmol Date: 2017-01-17 Impact factor: 3.117
Authors: Jaclyn Chiang; Michael Yapp; Angelica Ly; Michael P Hennessy; Michael Kalloniatis; Barbara Zangerl Journal: Optom Vis Sci Date: 2018-03 Impact factor: 1.973