High-Definition Optical Coherence Tomography Feature in Vitelliform Macular Dytrophy Original Reearch Article

Purpoe To correlate high-definition optical coherence tomography (HD OCT) and fundu examination finding at different phae of vitelliform macular dytrophy and to determine the anatomic location of vitelliform material. Deign Propective, noncomparative, obervational cae erie. Method A complete ophthalmologic examination, including fundu biomicrocopy and HD OCT, wa performed in 11 conecutive patient with a diagnoi of vitelliform macular dytrophy. Reult Uing HD OCT, we were able to demontrate for the firt time the preence of previtelliform leion, characterized by a thicker layer between the retinal pigment epithelium (RPE) and the inner egment and outer egment (I/O) interface. At thi tage, a normal-appearing RPE and I/O interface were found in two of four eye. In all progreive tage from the vitelliform to the vitelliruptive, the vitelliform material wa viualized by HD OCT a an highly reflective leion located between the hyporeflective outer nuclear layer and the hyperreflective RPE layer, aociated or not to an optically empty leion. At thee tage, a dirupted I/O interface and an almot normal appearance of all major intraretinal layer wa detected. At the vitelliruptive and atrophic tage, on ome part, the HD OCT can revealed hyperreflective mottling on the RPE layer, probably repreenting area of focal RPE hypertrophy. The atrophic tage and the fibrotic tage were characterized by thinning of all the retinal layer and diffue lo of the I/O interface. In our erie, mean bet-corrected viual acuity impairment howed a tatitically ignificant correlation to the preence of focal diruption or diffue lo of the I/O interface (P = .002), a well a to a more advanced tage of the dieae (P = .01). A more advanced tage of the dieae howed a trong tatitically ignificant correlation to the preence of diffue lo of the I/O interface (P < .001). Concluion Baed on the HD OCT finding, we hypotheize that early change in vitelliform macular dytrophy involve the layer between the RPE and the I/O interface, firt with accumulation of material beneath the enory retina, and then with diruption and attenuation of I and O; late change eem to affect the RPE, which undergoe hypertrophy, diruption, and attenuation.