Highly reflective line in optical coherence tomography images of eyes with macular edema associated with branch retinal vein occlusion

Am J Ophthalmol. 2015 May;159(5):925-33.e1. doi: 10.1016/j.ajo.2015.01.033. Epub 2015 Jan 31.

Abstract

Purpose: To determine whether the highly reflective vertical lines seen in spectral-domain optical coherence tomographic (SD OCT) images, which we have termed track lines, after resolution of macular edema associated with branch retinal vein occlusion are related to the integrity of the photoreceptors.

Design: Retrospective, observational, cross-sectional study.

Methods: We reviewed the medical records of 59 eyes with resolved macular edema associated with branch retinal vein occlusion. The eyes were classified by the presence or absence of the track lines in the SD OCT images after the resolution of macular edema. The correlation between the presence of the track lines and the integrity of the photoreceptors was determined.

Results: Twenty-one of 59 (36%) eyes had track lines in the SD OCT images after a resolution of the macular edema during the follow-up period. At the final visit, 17 (81%) of 21 eyes with the track lines had an interrupted ellipsoid zone at the fovea, whereas 3 eyes (14%) had an intact ellipsoid zone and 1 eye (5%) had an absent ellipsoid zone (P < .0001). The percentage of eyes with a disrupted external limiting membrane at the initial visit was significantly higher in eyes with track lines (90%) than that in eyes without track lines (63%; P = .0324).

Conclusions: The presence of highly reflective vertical lines in the SD OCT image is associated with a disrupted external limiting membrane before the resolution of macular edema and is associated with an interruption of the ellipsoid zone after resolution of macular edema. Thus, the vertical lines are useful markers of damage to the photoreceptors.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Bevacizumab
  • Biomarkers*
  • Cross-Sectional Studies
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use
  • Humans
  • Intravitreal Injections
  • Macular Edema / diagnosis*
  • Macular Edema / drug therapy
  • Macular Edema / etiology
  • Male
  • Photoreceptor Cells, Vertebrate / pathology*
  • Retinal Diseases / diagnosis*
  • Retinal Vein Occlusion / complications
  • Retinal Vein Occlusion / diagnosis*
  • Retinal Vein Occlusion / drug therapy
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Triamcinolone Acetonide / therapeutic use
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Biomarkers
  • Glucocorticoids
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Triamcinolone Acetonide