Spectral-domain optical coherence tomography characteristics of cystic retinal tuft

Abstract

Objective To investigate the characteristics of cystic retinal tufts (CRTs) with 55° widefield spectral-domain optical coherence tomography. Methods This was a retrospective study. All subjects underwent a complete ocular examination, ultra-widefield (UWF) pseudocolor fundus photography and Spectral domain optical coherence tomography (SD-OCT) with a 55° widefield lens. The SD-OCT characteristics were analyzed in subjects with CRT. Results Twenty-six eyes of 25 subjects were scanned and 29 CRTs were analyzed for SD-OCT characteristics. On SD-OCT images, the CRTs exhibited hyperreflective irregular elevated lesions with internal hyporeflective cystoid cavities. Normal layers of the neuroepithelium could not be distinguished. The mean diameter of CRTs was 1022 microns (range, 117–3711 microns; standard deviation, 815 microns). There was vitreoretinal traction at the apex of CRTs. Among them, retinal tears in 24.14% (7/29), suspected retinal tears in 27.59% (8/29), and shallow neuroepithelium detachment in 31.03% (9/29). Conclusions The widefield SD-OCT imaging can provide detailed cross-sectional anatomic information of CRT and may guide clinical treatment.

Peripheral retinal degenerations: multimodal imaging–guided risk stratification and clinical decision-making

“…PVD remains the dominant pathophysiological event linking PRD to RT and subsequent RRD. During acute or incomplete PVD, traction is concentrated at focal points of strong vitreoretinal adhesion, most commonly at the posterior margins of lattice and snail track degeneration, where horseshoe RT frequently originate ( 20 , 23 ). In clinical practice, the temporal association between acute PVD symptoms and localized tractional changes often carries greater decision making value than lesion morphology alone.…”

“…In clinical practice, the temporal association between acute PVD symptoms and localized tractional changes often carries greater decision making value than lesion morphology alone. SS-OCT has refined this concept by enabling in vivo visualization of microtraction, vitreoretinal strands, bridging structures, and focal outer retinal disruption, thereby improving biomechanical risk stratification beyond conventional ophthalmoscopy ( 20 , 22 ).…”

“…UWF systems, especially those based on scanning laser ophthalmoscopy (SLO), allow visualization of up to 200° of the peripheral retina in a single image, significantly increasing the detection rate of lattice degeneration, snail-track lesions, and retinal tufts. Contemporary UWF studies have demonstrated that these lesions are identified more reliably than with conventional fundus photography and that UWF imaging enables more consistent longitudinal follow-up ( 20 , 21 ). UWF imaging is particularly useful for documenting morphologic changes that evolve over time and for identifying multiple peripheral lesions that may be difficult to detect during routine examination without scleral depression.…”

“…Compared with spectral-domain OCT (SD-OCT), SS-OCT provides deeper tissue penetration and a more stable signal in peripheral regions, allowing visualization of retinal layers far beyond the macular area. Recent studies have described detailed microstructural features of lattice degeneration using SS-OCT, including thinning of the outer retinal layers, fragmentation of photoreceptor segments, subclinical microhemorrhagic points, and bridging vitreoretinal strands ( 20 ). Snail-track degeneration, which was previously identified exclusively on clinical grounds, can now be clearly differentiated using SS-OCT based on its characteristic hyporeflective and granular reflective pattern ( 22 ).…”

Peripheral retinal degenerations: multimodal imaging–guided risk stratification and clinical decision-making

“…PVD remains the dominant pathophysiological event linking PRD to RT and subsequent RRD. During acute or incomplete PVD, traction is concentrated at focal points of strong vitreoretinal adhesion, most commonly at the posterior margins of lattice and snail track degeneration, where horseshoe RT frequently originate ( 20 , 23 ). In clinical practice, the temporal association between acute PVD symptoms and localized tractional changes often carries greater decision making value than lesion morphology alone.…”

“…In clinical practice, the temporal association between acute PVD symptoms and localized tractional changes often carries greater decision making value than lesion morphology alone. SS-OCT has refined this concept by enabling in vivo visualization of microtraction, vitreoretinal strands, bridging structures, and focal outer retinal disruption, thereby improving biomechanical risk stratification beyond conventional ophthalmoscopy ( 20 , 22 ).…”

“…UWF systems, especially those based on scanning laser ophthalmoscopy (SLO), allow visualization of up to 200° of the peripheral retina in a single image, significantly increasing the detection rate of lattice degeneration, snail-track lesions, and retinal tufts. Contemporary UWF studies have demonstrated that these lesions are identified more reliably than with conventional fundus photography and that UWF imaging enables more consistent longitudinal follow-up ( 20 , 21 ). UWF imaging is particularly useful for documenting morphologic changes that evolve over time and for identifying multiple peripheral lesions that may be difficult to detect during routine examination without scleral depression.…”

“…Compared with spectral-domain OCT (SD-OCT), SS-OCT provides deeper tissue penetration and a more stable signal in peripheral regions, allowing visualization of retinal layers far beyond the macular area. Recent studies have described detailed microstructural features of lattice degeneration using SS-OCT, including thinning of the outer retinal layers, fragmentation of photoreceptor segments, subclinical microhemorrhagic points, and bridging vitreoretinal strands ( 20 ). Snail-track degeneration, which was previously identified exclusively on clinical grounds, can now be clearly differentiated using SS-OCT based on its characteristic hyporeflective and granular reflective pattern ( 22 ).…”

The role of ultra-widefield imaging with navigated central and peripheral cross-sectional and three-dimensional swept source optical coherence tomography in ophthalmology: Clinical applications

“…Persistent vitreous traction may lead to retinal tears and detachment. [ 44 45 ] The combination of UWF imaging with OCT allows to better assess these lesions and establish the risk factors for lesions to progress to become vision-threatening complications thus enabling necessary treatments while avoiding unnecessary ones.…”

Peripheral retinal degenerations: multimodal imaging–guided risk stratification and clinical decision-making

“…PVD remains the dominant pathophysiological event linking PRD to RT and subsequent RRD. During acute or incomplete PVD, traction is concentrated at focal points of strong vitreoretinal adhesion, most commonly at the posterior margins of lattice and snail track degeneration, where horseshoe RT frequently originate ( 20 , 23 ). In clinical practice, the temporal association between acute PVD symptoms and localized tractional changes often carries greater decision making value than lesion morphology alone.…”

“…In clinical practice, the temporal association between acute PVD symptoms and localized tractional changes often carries greater decision making value than lesion morphology alone. SS-OCT has refined this concept by enabling in vivo visualization of microtraction, vitreoretinal strands, bridging structures, and focal outer retinal disruption, thereby improving biomechanical risk stratification beyond conventional ophthalmoscopy ( 20 , 22 ).…”

“…UWF systems, especially those based on scanning laser ophthalmoscopy (SLO), allow visualization of up to 200° of the peripheral retina in a single image, significantly increasing the detection rate of lattice degeneration, snail-track lesions, and retinal tufts. Contemporary UWF studies have demonstrated that these lesions are identified more reliably than with conventional fundus photography and that UWF imaging enables more consistent longitudinal follow-up ( 20 , 21 ). UWF imaging is particularly useful for documenting morphologic changes that evolve over time and for identifying multiple peripheral lesions that may be difficult to detect during routine examination without scleral depression.…”

“…Compared with spectral-domain OCT (SD-OCT), SS-OCT provides deeper tissue penetration and a more stable signal in peripheral regions, allowing visualization of retinal layers far beyond the macular area. Recent studies have described detailed microstructural features of lattice degeneration using SS-OCT, including thinning of the outer retinal layers, fragmentation of photoreceptor segments, subclinical microhemorrhagic points, and bridging vitreoretinal strands ( 20 ). Snail-track degeneration, which was previously identified exclusively on clinical grounds, can now be clearly differentiated using SS-OCT based on its characteristic hyporeflective and granular reflective pattern ( 22 ).…”

The role of ultra-widefield imaging with navigated central and peripheral cross-sectional and three-dimensional swept source optical coherence tomography in ophthalmology: Clinical applications

“…Persistent vitreous traction may lead to retinal tears and detachment. [ 44 45 ] The combination of UWF imaging with OCT allows to better assess these lesions and establish the risk factors for lesions to progress to become vision-threatening complications thus enabling necessary treatments while avoiding unnecessary ones.…”

Peripheral retinal degenerations: multimodal imaging–guided risk stratification and clinical decision-making

“…PVD remains the dominant pathophysiological event linking PRD to RT and subsequent RRD. During acute or incomplete PVD, traction is concentrated at focal points of strong vitreoretinal adhesion, most commonly at the posterior margins of lattice and snail track degeneration, where horseshoe RT frequently originate ( 20 , 23 ). In clinical practice, the temporal association between acute PVD symptoms and localized tractional changes often carries greater decision making value than lesion morphology alone.…”

“…In clinical practice, the temporal association between acute PVD symptoms and localized tractional changes often carries greater decision making value than lesion morphology alone. SS-OCT has refined this concept by enabling in vivo visualization of microtraction, vitreoretinal strands, bridging structures, and focal outer retinal disruption, thereby improving biomechanical risk stratification beyond conventional ophthalmoscopy ( 20 , 22 ).…”

“…UWF systems, especially those based on scanning laser ophthalmoscopy (SLO), allow visualization of up to 200° of the peripheral retina in a single image, significantly increasing the detection rate of lattice degeneration, snail-track lesions, and retinal tufts. Contemporary UWF studies have demonstrated that these lesions are identified more reliably than with conventional fundus photography and that UWF imaging enables more consistent longitudinal follow-up ( 20 , 21 ). UWF imaging is particularly useful for documenting morphologic changes that evolve over time and for identifying multiple peripheral lesions that may be difficult to detect during routine examination without scleral depression.…”

“…Compared with spectral-domain OCT (SD-OCT), SS-OCT provides deeper tissue penetration and a more stable signal in peripheral regions, allowing visualization of retinal layers far beyond the macular area. Recent studies have described detailed microstructural features of lattice degeneration using SS-OCT, including thinning of the outer retinal layers, fragmentation of photoreceptor segments, subclinical microhemorrhagic points, and bridging vitreoretinal strands ( 20 ). Snail-track degeneration, which was previously identified exclusively on clinical grounds, can now be clearly differentiated using SS-OCT based on its characteristic hyporeflective and granular reflective pattern ( 22 ).…”

The role of ultra-widefield imaging with navigated central and peripheral cross-sectional and three-dimensional swept source optical coherence tomography in ophthalmology: Clinical applications

“…Persistent vitreous traction may lead to retinal tears and detachment. [ 44 45 ] The combination of UWF imaging with OCT allows to better assess these lesions and establish the risk factors for lesions to progress to become vision-threatening complications thus enabling necessary treatments while avoiding unnecessary ones.…”