Subretinal Pseudocysts: A Comprehensive Analysis of this Novel OCT Finding.
AMD
Atrophy
Müller cells
Optical coherence tomography
Photoreceptors
Subretinal pseudocysts
Journal
Ophthalmology and therapy
ISSN: 2193-8245
Titre abrégé: Ophthalmol Ther
Pays: England
ID NLM: 101634502
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
31
12
2022
accepted:
27
04
2023
medline:
18
5
2023
pubmed:
18
5
2023
entrez:
17
5
2023
Statut:
ppublish
Résumé
In current clinical practice, several optical coherence tomography (OCT) biomarkers have been proposed for the assessment of severity and prognosis of different retinal diseases. Subretinal pseudocysts are subretinal cystoid spaces with hyperreflective borders and only a few single cases have been reported thus far. The aim of the study was to characterize and investigate this novel OCT finding, exploring its clinical outcome. Patients were evaluated retrospectively across different centers. The inclusion criterion was the presence of subretinal cystoid space on OCT scans, regardless of concurrent retinal diseases. Baseline examination was set as the first time the subretinal pseudocyst was identified by OCT. Medical and ophthalmological histories were collected at baseline. OCT and OCT-angiography were performed at baseline and at each follow-up examination. Twenty-eight eyes were included in the study and 31 subretinal pseudocysts were characterized. Out of 28 eyes, 16 were diagnosed with neovascular age-related macular degeneration (AMD), 7 with central serous chorioretinopathy, 4 with diabetic retinopathy, and 1 with angioid streaks. Subretinal and intraretinal fluid were present in 25 and 13 eyes, respectively. Mean distance of the subretinal pseudocyst from the fovea was 686 µm. The diameter of the pseudocyst was positively associated with the height of the subretinal fluid (r = 0.46; p = 0.018) and central macular thickness (r = 0.612; p = 0.001). At follow-up, subretinal pseudocysts disappeared in most of the reimaged eyes (16 out of 17). Of these, two patients presented retinal atrophy at baseline examination and eight patients (47%) developed retinal atrophy at follow-up. Conversely, seven eyes (41%) did not develop retinal atrophy. Subretinal pseudocysts are precarious OCT findings, usually disclosed in a context of subretinal fluid, and are probably transient alterations within the photoreceptor outer segments and retinal pigment epithelium (RPE) layer. Despite their nature, subretinal pseudocysts have been associated with photoreceptor loss and incomplete RPE definition.
Identifiants
pubmed: 37198519
doi: 10.1007/s40123-023-00727-8
pii: 10.1007/s40123-023-00727-8
pmc: PMC10287866
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2035-2048Informations de copyright
© 2023. The Author(s).
Références
Spaide RF, Jaffe GJ, Sarraf D, et al. Consensus nomenclature for reporting neovascular age-related macular degeneration data: consensus on neovascular age-related macular degeneration nomenclature study group. Ophthalmology. 2020;127:616–36.
doi: 10.1016/j.ophtha.2019.11.004
pubmed: 31864668
Schmidt-Erfurth U, Waldstein SM. A paradigm shift in imaging biomarkers in neovascular age-related macular degeneration. Prog Retin Eye Res. 2016;50:1–24.
doi: 10.1016/j.preteyeres.2015.07.007
pubmed: 26307399
Hilely A, Au A, Freund KB, et al. Non-neovascular age-related macular degeneration with subretinal fluid. Br J Ophthalmol. 2021;105:1415–20.
doi: 10.1136/bjophthalmol-2020-317326
pubmed: 32920528
Gao SS, Jia Y, Zhang M, et al. Optical coherence tomography angiography. Invest Ophthalmol Vis Sci. 2016;57:27–36.
doi: 10.1167/iovs.15-19043
Holz FG, Sadda SVR, Staurenghi G, et al. Imaging protocols in clinical studies in advanced age-related macular degeneration: recommendations from classification of atrophy consensus meetings. Ophthalmology. 2017;124:464–78.
doi: 10.1016/j.ophtha.2016.12.002
pubmed: 28109563
Guymer R, Wu Z. Age-related macular degeneration (AMD): More than meets the eye. The role of multimodal imaging in today’s management of AMD—a review. Clin Exp Ophthalmol. 2020;48:983–95.
doi: 10.1111/ceo.13837
pubmed: 32741052
Sacconi R, Forte P, Tombolini B, et al. OCT predictors of 3-year visual outcome for type 3 macular neovascularization. Ophthalmol Retina. 2022;6:586–94.
doi: 10.1016/j.oret.2022.02.010
pubmed: 35227948
Sacconi R, Brambati M, Miere A, et al. Characterisation of macular neovascularisation in geographic atrophy. Br J Ophthalmol. 2022;106:1282–7.
doi: 10.1136/bjophthalmol-2021-318820
pubmed: 33836986
Borrelli E, Bandello F, Souied EH, et al. Neovascular age-related macular degeneration: advancement in retinal imaging builds a bridge between histopathology and clinical findings. Graefes Arch Clin Exp Ophthalmol. 2022. https://doi.org/10.1007/s00417-022-05577-x .
doi: 10.1007/s00417-022-05577-x
pmcid: 10148775
pubmed: 36477647
Sacconi R, Fragiotta S, Sarraf D, et al. Towards a better understanding of non-exudative choroidal and macular neovascularization. Prog Retin Eye Res. 2022. https://doi.org/10.1016/j.preteyeres.2022.101113 .
doi: 10.1016/j.preteyeres.2022.101113
pubmed: 35970724
Cohen SY, Dubois L, Nghiem-Buff S, et al. Retinal pseudocysts in age-related geographic atrophy. Am J Ophthalmol. 2010;150(2):211–7.
doi: 10.1016/j.ajo.2010.02.019
pubmed: 20537310
Querques G, Coscas F, Forte R, Massamba N, Sterkers M, Souied EH. Cystoid macular degeneration in exudative age-related macular degeneration. Am J Ophthalmol. 2011;152:100–107.e2.
doi: 10.1016/j.ajo.2011.01.027
pubmed: 21570056
Sacconi R, Lutty GA, Mullins RF, Borrelli E, Bandello F, Querques G. Subretinal pseudocysts: a novel OCT finding in diabetic macular edema. Am J Ophthalmol Case Rep. 2019;16:4–6.
Sacconi R, Mullins RF, Lutty GA, Borrelli E, Bandello F, Querques G. Subretinal pseudocyst: a novel optical coherence tomography finding in age-related macular degeneration. Eur J Ophthalmol. 2020;30:24–6.
doi: 10.1177/1120672119846437
Edwards MM, McLeod DS, Bhutto IA, Grebe R, Duffy M, Lutty GA. Subretinal glial membranes in eyes with geographic atrophy. Invest Ophthalmol Vis Sci. 2017;58:1352–67.
doi: 10.1167/iovs.16-21229
pmcid: 5358932
pubmed: 28249091
Hayashi-Mercado R, Pérez-Montaño C, Reyes-Sánchez J, Ramírez-Estudillo A. Findings of uncertain significance by optical coherence tomography (OCT) as prognostic factors in neovascular age-related macular degeneration (nAMD) treated with ranibizumab. Int J Retina Vitreous. 2022;8:1–7.
doi: 10.1186/s40942-022-00379-z
Kashani AH, Green KM, Kwon J, et al. Suspended scattering particles in motion: a novel feature of OCT angiography in exudative maculopathies. Ophthalmol Retina. 2018;2(7):694–770.
doi: 10.1016/j.oret.2017.11.004
pubmed: 30221214
Damasceno NA, Damasceno EF, Silva FQ, Singh RP. Outer retinal tubulation and neovascular age-related macular degeneration: a review of the pathogenesis and clinical implications. Ophthalmic Surg Lasers Imaging Retina. 2018;49(11):870–6.
doi: 10.3928/23258160-20181101-08
pubmed: 30457646
Nagelhus EA, Horio Y, Inanobe A, et al. Immunogold evidence suggests that coupling of K+ siphoning and water transport in rat retinal Muller cells is mediated by a coenrichment of Kir4.1 and AQP4 in specific membrane domains. Glia. 1999;26:47–54.
doi: 10.1002/(SICI)1098-1136(199903)26:1<47::AID-GLIA5>3.0.CO;2-5
pubmed: 10088671
Nagelhus EA, Veruki ML, Torp R, et al. Aquaporin-4 water channel protein in the rat retina and optic nerve: polarized expression in Muller cells and fibrous astrocytes. J Neurosci. 1998;18:2506–19.
doi: 10.1523/JNEUROSCI.18-07-02506.1998
pmcid: 6793100
pubmed: 9502811
Spaide RF. Retinal vascular cystoid macular edema: review and new theory. Retina. 2016;36:1823–42.
doi: 10.1097/IAE.0000000000001158
pubmed: 27328171
Lewis GP, Chapin EA, Luna G, Linberg KA, Fisher SK. The fate of Müller’s glia following experimental retinal detachment: nuclear migration, cell division, and subretinal glial scar formation. Mol Vis. 2010;16:1361.
pmcid: 2905639
pubmed: 20664798
Ho J, Witkin AJ, Liu J, et al. Documentation of intraretinal retinal pigment epithelium migration via high-speed ultrahigh-resolution optical coherence tomography. Ophthalmology. 2011;118:687–93.
doi: 10.1016/j.ophtha.2010.08.010
pubmed: 21093923
Qiu S, Jiang Z, Huang Z, et al. Migration of retinal pigment epithelium cells is regulated by protein kinase Cα in vitro. Invest Ophthalmol Vis Sci. 2013;54:7082–90.
doi: 10.1167/iovs.13-12099
pubmed: 24084091
Jin M, He S, Worpel V, Ryan SJ, Hinton DR. Promotion of adhesion and migration of RPE cells to provisional extracellular matrices by TNF-α. Invest Ophthalmol Vis Sci. 2000;41(13):4324–32.
pubmed: 11095634
Cherepanoff S, Killingsworth MC, Zhu M, et al. Ultrastructural and clinical evidence of subretinal debris accumulation in type 2 macular telangiectasia. Br J Ophthalmol. 2012;96(11):1404–9.
doi: 10.1136/bjophthalmol-2011-301009
pubmed: 22976584
Valter K, Maslim J, Bowers F, Stone J. Photoreceptor dystrophy in the RCS rat: roles of oxygen, debris, and bFGF. Invest Ophthalmol Vis Sci. 1998;39:2427–42.
pubmed: 9804151
Hisatomi T, Sakamoto T, Sonoda KH, et al. Clearance of apoptotic photoreceptors: elimination of apoptotic debris into the subretinal space and macrophage-mediated phagocytosis via phosphatidylserine receptor and integrin αvβ3. Am J Pathol. 2003;162:1869–79.
doi: 10.1016/S0002-9440(10)64321-0
pmcid: 1868143
pubmed: 12759244