Andrea Govetto1, David Sarraf2, Jean-Pierre Hubschman3, Ramin Tadayoni4, Aude Couturier4, Ismael Chehaibou3, Adrian Au5, Christelle Grondin5, Gianni Virgili6, Mario R Romano7. 1. Ophthalmology Department, Fatebenefratelli and Ophthalmic Hospital, ASST-Fatebenefratelli-Sacco, Milan, Italy. Electronic address: a.govetto@gmail.com. 2. Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA; Greater Los Angeles VA Healthcare Center, Los Angeles, California, USA. 3. Retina Division, Stein Eye Institute, University of California, Los Angeles, California, USA. 4. Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université Paris Diderot, Sorbonne Paris Citè, France. 5. Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA. 6. Ophthalmology Department, Careggi University Hospital, University of Florence, Florence, Italy. 7. Humanitas University, Eye Unit, Humanitas-Gavazzeni Hospital, Bergamo, Italy.
Abstract
PURPOSE: To determine clear-cut distinctions between tractional and exudative intraretinal cystoid spaces subtypes. DESIGN: Retrospective, multicenter, observational case series. METHODS: A cohort of patients diagnosed with intraretinal cystoid spaces and imaged with optical coherence tomography (OCT), fluorescein angiography (FA), blue fundus autofluorescence (BFAF), en face OCT, and OCT angiography (OCT-A) was included in the study. All images were qualitatively and quantitatively evaluated. RESULTS: In this study were included 72 eyes of 69 patients. Exudative intraretinal cystoid spaces (36/72 eyes, 50%) displayed a "petaloid" morphology as seen with en face OCT, FA, and BFAF. Tractional intraretinal cystoid spaces (24/72 eyes, 33.3%), displayed a radial "spoke-wheel" en face OCT pattern. There was no leakage with FA and BFAF did not reveal specific patterns. Eyes with full-thickness macular hole (FTMH, 12/72 eyes, 16.7%) displayed a "sunflower" en face OCT appearance. FTMH showed OCT, OCT-A, and BFAF features of both exudative and tractional cystoid spaces, but without any FA leakage. Inner nuclear layer (INL) thickness was significantly lower in tractional cystoid spaces (P < .001). There were a greater number of INL cystoid spaces in both the exudative and FTMH subgroups (P = .001). The surface area of INL cystoid spaces was significantly lower in the tractional subgroup (P < .001). There was a significant reduction of the microvascular density in eyes with exudative vs tractional (P = .002) and FTMH (P < .001) subgroups. CONCLUSIONS: Exudative and tractional intraretinal cystoid spaces displayed characteristic multimodal imaging features and they may represent 2 different pathologic conditions with equally different clinical implications.
PURPOSE: To determine clear-cut distinctions between tractional and exudative intraretinal cystoid spaces subtypes. DESIGN: Retrospective, multicenter, observational case series. METHODS: A cohort of patients diagnosed with intraretinal cystoid spaces and imaged with optical coherence tomography (OCT), fluorescein angiography (FA), blue fundus autofluorescence (BFAF), en face OCT, and OCT angiography (OCT-A) was included in the study. All images were qualitatively and quantitatively evaluated. RESULTS: In this study were included 72 eyes of 69 patients. Exudative intraretinal cystoid spaces (36/72 eyes, 50%) displayed a "petaloid" morphology as seen with en face OCT, FA, and BFAF. Tractional intraretinal cystoid spaces (24/72 eyes, 33.3%), displayed a radial "spoke-wheel" en face OCT pattern. There was no leakage with FA and BFAF did not reveal specific patterns. Eyes with full-thickness macular hole (FTMH, 12/72 eyes, 16.7%) displayed a "sunflower" en face OCT appearance. FTMH showed OCT, OCT-A, and BFAF features of both exudative and tractional cystoid spaces, but without any FA leakage. Inner nuclear layer (INL) thickness was significantly lower in tractional cystoid spaces (P < .001). There were a greater number of INL cystoid spaces in both the exudative and FTMH subgroups (P = .001). The surface area of INL cystoid spaces was significantly lower in the tractional subgroup (P < .001). There was a significant reduction of the microvascular density in eyes with exudative vs tractional (P = .002) and FTMH (P < .001) subgroups. CONCLUSIONS: Exudative and tractional intraretinal cystoid spaces displayed characteristic multimodal imaging features and they may represent 2 different pathologic conditions with equally different clinical implications.
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