Cystoid macular edema in polypoidal choroidal vasculopathy viewed by a scanning laser ophthalmoscope

Abstract

Visual prognosis for polypoidal choroidal vasculopathy (PCV) is reported to be relatively good. However, some eyes in the end-stage of PCV show cystoid macular edema (CME) with severe loss of vision. We examined two eyes with CME in the end-stage of PCV. The fundus of each of these eyes was examined noninvasively with a new commercially available scanning laser ophthalmoscope (SLO) in the retro-mode with an infrared laser. In the retro-mode, scattered light that passed the aperture deviated laterally, giving a shadow to the silhouetted cystoid spaces, enabled visualisation of the CME. In each eye, although no cystoid spaces were detected on fundus photographs, monochromatic images obtained with an SLO in the retro-mode showed numerous cystoid spaces on the disciform scar. SLO in the retro-mode can show each cystoid space located in any layer of the retina, and allows us to detect the extent of the CME.

The Noninvasive Retro-Mode Imaging Modality of Confocal Scanning Laser Ophthalmoscopy in Polypoidal Choroidal Vasculopathy: A Preliminary Application

“…In previous studies, retro-mode imaging was used to characterize the CME associated with different diseases, including diabetic retinopathy [21,24,26], retinal vein occlusion [21,26], uveitis [21,26], age-related macular degeneration (AMD) [21,25,26], PCV [27] and retinitis pigmentosa [26]. Shin et al reported comprehensive topographic descriptions of RPE alterations in central serous chorioretinopathy using the retro-mode imaging [17].…”

Comparing Different Imaging Modalities in Harada Disease: A Case Report

“…Previous studies on cystoid macular edema and age-related macular degeneration have reported good visualization of lesions using IR imaging 4,5 ; however, further studies are needed to determine the specificity of its features.…”

Scanning laser ophthalmoscopy in the retromode in diabetic macular oedema

“…Although OCT has added relevant information in quantitative and qualitative evaluation of DME, it fails to give immediate information about the extension of oedema (Ohkoshi et al 2010 (Browning et al 2008). Scanning laser ophthalmoscopy in the retromode [Retromode Scanning Laser Ophthalmoscopy (RM-SLO)] is a non-invasive imaging tool, which enables an easy visualization of deep retinal structures by using an infrared laser light (Yamamoto et al 2008(Yamamoto et al , 2010Ohkoshi et al 2010;Acton et al 2011). It uses a central stop, which blocks directly reflected light, while collecting laterally oriented scattered light.…”

“…As a consequence, pseudo-3-dimensional images of the retina are obtained. Retromode Scanning Laser Ophthalmoscopy has been used for the visualization of cystoid macular oedema of different origin, and drusen in age-related maculopathy (Yamamoto et al 2008(Yamamoto et al , 2010Ohkoshi et al 2010;Acton et al 2011). In DME, it has been recently used for the visualization of subthreshold micropulse diode laser treatment spots (Ohkoshi et al 2010).…”