細胞学および組織学ジャーナル

Diagnostic Procedures and Follow Up of Macular Microstructural Changes in Patients with Uveitis as Seen on Optical Coherence Tomography

Abstract

Jelena Paovic, Predrag Paovic, Anka Stanojevic Paovic and Vojislav Sredovic

The aim of this study was to show how optical coherence tomography (OCT) can provide means for assessing macula and the optic disc, and so can be used to diagnose and follow micro-structural, macular, changes (epiretinal membranes; macular edema; lamellar hole and discontinuity of inner/outer segment line), that occur as complications of a disease (i.e. uveitis). It is a non invasive, non contact method that provides cross-sectional images of retina and its substructures in a real-time mode. High definition cross-sectional images obtained by a commercially available OCT are attained at 1-15 μm and can provide detailed pictures from deep within the retina. Seeing that OCT can be repeated numerous times it is useful for practitioners that need to follow treatment effects and progression of the disease. Spectral-Domain OCT was used to diagnose and follow macular changes in patients with uveitis (intermediate and posterior) and retinal vasculitis. OCT showed an epiretinal membrane (ERM) as intense back-reflective layer on the inner retinal surface. Via this method thickness measurements of ERM as well as the degree of inner retinal surface attachment (focal or diffused) were acquired and precisely defined. OCT showed macular edema as retinal layering followed by presence of intraretinal cavities and absence of back-reflection. It provided means of measuring thickness, localization, as well as size of intraretinal cysts during the evolution of macular edema (ME), and so was utilized in analysis of various factors such as progression of ERM; presence of ME; surface roughness; changes of thickness and layer configuration of retinal tissue. OCT macular scan provides precise and quick diagnosis of delicate microstructural retinal changes in high definition that can’t be obtained during classical clinical examination. Progression of disease, changes and treatment effects, followed via OCT, are of great importance in clinical practice.