Hyperreflective Dots in Spectral Domain Optical Coherence Tomography as Phenotypic Marker in Uveitis-Associated Cystoid Macular Edema
Abstract
Purpose
To evaluate the agreement between hyperreflective dots (HRD) in retina layers by spectral domain optical coherence tomography (SD-OCT) and laser flare photometry associated with best-corrected visual acuity (BCVA) results in patients with uveitic cystoid macular edema (CME).
Methods
All patients referred to our tertiary care center for posterior uveitis had full examination including: BCVA, laser flare photometry, SD-OCT, fluorescein and infracyanine angiography. §Causes of uveitis were multiple: infectious, inflammatory and unknown. The characteristics of the HRD were evaluated in all SD-OCT scans. HRD were defined as small focal hyperreflective material scattered mainly in outer retinal layers but also spreading to all retinal layers observed in at least one available scan. Two different ophthalmologists counted HRD using a horizontal B scan cross section through the fovea. They were classified on the basis of quantity (i.e. absent, few if less than 10, moderate if between 10 and 20, or numerous if more than 20). Central macular thickness (CMT) was also evaluated.
Results
24 eyes of 18 patients were included. 8 men and 10 women with posterior uveitis were examined. Mean flare measurement was 25.1 (3–62). Mean BCVA was 20/63. Mean central macular thickness was 463 μm. 2 subgroups were identified. 13 eyes presented decreased BCVA, normal or elevated Flare, numerous HRD and increased CMT, corresponding to active posterior uveitis. Other 11 eyes presented decreased BCVA, increased CMT, normal laser Flare photometry, those results corresponding to chronic posterior uveitis. The difference with the two groups was numerically significant.
Conclusions
HRD are correlated to CMT and BCVA but not with anterior chamber flare in active posterior uveitis. A large prospective study is needed in order to confirm these results.
