Bacillary Layer Detachment in Unilateral Acute Idiopathic Maculopathy: A Report of 2 Cases

Venkatesh, Ramesh; Reddy, Nikitha Gurram; Pulipaka, Ram Snehith; Mahendradas, Padmamalini; Yadav, Naresh Kumar; Jayadev, Chaitra

doi:10.1080/09273948.2021.1903934

Cited by 10 publications

(12 citation statements)

References 13 publications

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“…In current studies, BLD is defined as the bacillary layer (MZ, EZ, and outer segments) adjacent to the RPE remaining to the posterior, with separation and anterior displacement of the ELM and other retinal layers. 6,7,8,9,10,11,12,13,14,15,16,18,19 In studies conducted with time-domain OCT, hyperreflective septa that create cystoid spaces by dividing the fluid in SRD into compartments have been reported in acute VKH patients. 22,23 Authors have referred to these hyperreflective structures as subretinal fibrosis, 24 inflammatory fibrin, 5 fibrous strands, 25 or membranous structures.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…This anatomical finding on SD-OCT is referred to using the term "bacillary layer detachment" (BLD). 6 The presence of BLD is not unique to acute VKH and has been reported in many conditions, including acute VKH disease, 7,8 toxoplasmosis retinochoroiditis, 6 peripapillary pachychoroid syndrome, 9 acute posterior multifocal plaque pigment epitheliopathy, 10,11 central serous retinopathy, 12 neovascular age-related macular degeneration, 13 macular telangiectasis type 2, 14 acute idiopathic maculopathy, 15,16 sympathetic ophthalmia, 17 and trauma. 18,19 This study investigated the frequency of BLD in patients with acute VKH disease using SD-OCT and evaluated the relationship between SRD height and choroidal thickness and visual prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Bacillary Layer Detachment in Acute Vogt-Koyanagi-Harada Disease

Atas¹,

Kaya²,

Saatçi³

2022

tjo

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Objectives: To evaluate the frequency and treatment response of eyes with bacillary layer detachment (BLD) in acute Vogt-Koyanagi-Harada (VKH) disease using spectral-domain optical coherence tomography (SD-OCT). Materials and Methods:We retrospectively reviewed the medical records of 58 eyes of acute VKH patients with at least 6 months of follow-up between January 2009 and March 2021. SD-OCT, color fundus photographs, and fluorescein angiography images were analyzed in all patients. Results: The study included 58 eyes of 29 patients. BLD was detected in 33 of the 58 eyes (56.9%) at baseline. Mean serous retinal detachment (SRD) height was 918.50±336.64 µm in the BLD group and 215.33±167.83 µm in the group without BLD (p<0.05). A positive correlation was found between SRD height and the presence of BLD (r=0.783, p<0.05). BLD was significantly more common in patients with a baseline SRD height greater than 500 µm (p<0.05). As subfoveal central choroidal thickness (CCT) could not be measured by enhanced depth imaging-OCT at baseline due to extreme choroidal thickness in all eyes, the earliest post-treatment CCT measurements were analyzed. At the completion of pulse steroid therapy, mean CCT was 425±82.87 µm in the BLD group and 385.58±82.87 µm in the group without BLD (p=0.04). The mean time to BLD resolution was 12.88±6.5 days (range: 2-26). Conclusion: BLD is a common tomographic finding in eyes with acute VKH disease and can be differentiated from the associated SRD through careful SD-OCT analysis. Though it is mostly observed in patients with more serious disease, the presence of BLD has no negative effect on long-term visual function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bacillary Layer Detachment in Acute Vogt-Koyanagi-Harada Disease

Atas¹,

Kaya²,

Saatçi³

2022

tjo

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“…Bridge arch-shaped SRF could be confused with the presence of bacillary layer detachment (BALAD) reported in exudative age-related macular degeneration. 8,9 A recent article by Jung et al described 14 patients with Type-2 macular neovascularization with associated subretinal hemorrhage and BALAD. 10,11 In these cases, the BALAD resolved following therapy with intravitreal anti-VEGF injections.…”

Section: Discussionmentioning

confidence: 99%

Bridge Arch–shaped Subretinal Fluid in Neovascular Age-Related Macular Degeneration

Venkatesh

Mangla

Mishra

et al. 2022

Retina

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Purpose: To study factors leading to bridge arch-shaped subretinal fluid (SRF) on optical coherence tomography in wet age-related macular degeneration and evaluate its anatomical and functional outcomes.Methods: In this single-center, retrospective study, patients with bridge arch-shaped SRF and choroidal neovascular membrane (CNVM) were included.Results: Overall, 623 eyes in 431 patients with chronic CNVM were identified, and 24 eyes (4%) in 21 patients showed bridge arch-shaped SRF. Mean age of patients was 69.19 ± 12.0 years. Type-1 CNVM was noted in 79% cases before development of bridge archshaped SRF. Mean early treatment diabetic retinopathy letters visual acuity was 53.93 ± 32.19. Time interval to develop bridge arch-shaped SRF was 21.9 ± 30.63 months. Mean number of intravitreal anti-vascular endothelial growth factor injections given before developing bridge arch-shaped SRF was 6.5 ± 7.09. During the development of bridge arch-shaped SRF, visual acuity reduced by 220.57 ± 31.13 letters (P = 0.033) and fibrotic Type-2 CNVM (n = 18, 75%) was noted. Retinal pigment epithelium tear was noted in 8 eyes (33%). At the final visit, further reduction in visual acuity of 27.136 ± 13.73 early treatment diabetic retinopathy letters (P = 0.011) after developing bridge arch-shaped SRF was seen. Mean number of injections given after developing bridge arch-shaped SRF was 4.76 ± 3.76.Conclusion: Bridge arch-shaped SRF is an uncommon finding seen in eyes with Type-2 chronic CNVMs. Presence of retinal pigment epithelium breach and tear and nonaggressive treatment regimen with intravitreal anti-vascular endothelial growth factor injections could be responsible for its pathogenesis. It is a marker of fibrotic enlargement, leading to poor visual outcomes despite showing favorable therapeutic response.

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“…It is characterized by a splitting of the photoreceptor layer at the myoid level, resulting in a space posterior to the external limiting membrane (ELM). Several authors have reported BALAD in various ophthalmic conditions as well as ocular trauma, multifocal placoid pigment epitheliopathy, pachychoroid syndrome, tubercular choroidal granuloma, acute idiopathic maculopathy, type 2 macular telangiectasia, Vogt–Koyanagi–Harada disease, choroidal metastasis, osteoma, and age-related macular degeneration (AMD) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. The exact BALAD physiopathology is unknown.…”

Section: Introductionmentioning

confidence: 99%

Bacillary Layer Detachment in Neovascular Age-Related Macular Degeneration: Case Series

et al. 2023

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Purpose: This study seeks to report the clinical and multimodal imaging findings of eight eyes of seven patients with neovascular age-related macular degeneration (nAMD) who developed bacillary layer detachment (BALAD). Setting/Venue: The patients were analysed at the Western Eye Hospital in London, UK. Methods: The approaches of this research include clinical examinations and multimodal imaging-based description of cases of nAMD with BALAD. Results: We report multimodal imaging findings of bacillary layer detachment (BALAD) in patients with nAMD. Conclusions: A bacillary layer detachment was detected in patients with neovascular age-related macular degeneration. This multimodal imaging finding is not commonly described in the literature for this disease.

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Bacillary Layer Detachment in Unilateral Acute Idiopathic Maculopathy: A Report of 2 Cases

Cited by 10 publications

References 13 publications

Bacillary Layer Detachment in Acute Vogt-Koyanagi-Harada Disease

Bacillary Layer Detachment in Acute Vogt-Koyanagi-Harada Disease

Bridge Arch–shaped Subretinal Fluid in Neovascular Age-Related Macular Degeneration

Bacillary Layer Detachment in Neovascular Age-Related Macular Degeneration: Case Series

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