Multimodal Imaging of Cotton Wool Spots in Branch Retinal Vein Occlusion

作者：Munk Marion R; Matt Gerlinde; Baratsits Magdalena; Dunayoelgyi Roman; Huf Wolfgang; Montuoro Alessio; Buehl Wolf; Schmidt Erfurth Ursula; Sacu Stefan^*

来源：Ophthalmic Research, 2015, 54(1): 48-56.

DOI：10.1159/000430843

• Ischemia
• Cotton wool spots
• Cystoid bodies
• Argon laser treatment
• Retinal vein occlusion
• Branch retinal vein occlusion
• Hypoperfusion
• Optical coherence tomography
• Fluorescein angiography
• Axoplasmic debris
• Multimodal imaging
• Acute macular neuroretinopathy

Purpose: To describe and follow cotton wool spots (CWS) in branch retinal vein occlusion (BRVO) using multimodal imaging. Methods: In this prospective cohort study including 24 patients with new-onset BRVO, CWS were described and analyzed in color fundus photography (CF), spectral domain optical coherence tomography (SD-OCT), infrared (IR) and fluorescein angiography (FA) every 3 months for 3 years. The CWS area on SD-OCT and CF was evaluated using OCT-Tool-Kit software: CWS were marked in each single OCT B-scan and the software calculated the area by interpolation. Results:29 central CWS lesions were found. 100% of these CWS were visible on SD-OCT, 100% on FA and 86.2% on IR imaging, but only 65.5% on CF imaging. CWS were visible for 12.4 +/- 7.5 months on SD-OCT, for 4.4 +/- 3 months and 4.3 +/- 3.4 months on CF and on IR, respectively, and for 17.5 +/- 7.1 months on FA. The evaluated CWS area on SD-OCT was larger than on CF (0.26 +/- 0.17 mm(2)vs. 0.13 +/- 0.1 mm(2), p < 0.0001). The CWS area on SD-OCT and surrounding pathology such as intraretinal cysts, avascular zones and intraretinal hemorrhage were predictive for how long CWS remained visible (r(2) = 0.497, p <0.002). Conclusions: The lifetime and presentation of CWS in BRVO seem comparable to other diseases. SD-OCT shows a higher sensitivity for detecting CWS compared to CF. The duration of visibility of CWS varies among different image modalities and depends on the surrounding pathology and the CWS size.

• 出版日期2015