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01.03.2020 | Retinal Disorders

Linear and planar reflection artifacts on swept-source and spectral-domain optical coherence tomography due to hyperreflective crystalline deposits

verfasst von: Serena Fragiotta, Pedro Fernández-Avellaneda, Mark P. Breazzano, Lawrence A. Yannuzzi, Christine A. Curcio, K. Bailey Freund

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 3/2020

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Abstract

Purpose

To describe novel spectral-domain (SD) and swept-source (SS) optical coherence tomography (OCT) linear and planar reflection artifacts produced by hyperreflective crystalline deposits (HCD).

Methods

Imaging from 10 eyes with HCD producing linear and planar artifacts on OCT was retrospectively analyzed. All eyes had SD-OCT (Spectralis HRA + OCT, Heidelberg Engineering, Germany) and SS-OCT angiography (PLEX Elite 9000, Carl Zeiss Meditec, Inc., Dublin, CA) acquired on the same day. The horizontal extent of planar artifacts and the corresponding HCD on B-scans was measured using a digital caliper. Artifact features from HCD in eyes with non-neovascular age-related macular degeneration (AMD) were analyzed and compared to those seen in two eyes with the “onion sign,” an OCT signature previously shown to represent cholesterol crystals (CC) in the sub-retinal pigment epithelium-basal laminar space of eyes with neovascular AMD. A third eye with the “onion sign” was imaged with dense B-scan (DB)-OCTA.

Results

Ten eyes of ten patients (77.4 ± 8.7 years) with HCD were analyzed. On SS-OCTA, HCD produced linear artifacts of high signal intensity passing through the HCD and spanning the entire scan depth. On SD-OCT, HCD produced planar artifacts located anterior to both the retina and a hyporeflective space representing normal vitreous signal. The horizontal extent of the artifact did not differ significantly from the corresponding HCD on OCT B-scans (P = 0.62). The OCT artifacts produced by the “onion sign” appeared similar to those of HCD. The additional eye with neovascular AMD imaged with DB-OCTA was characterized by a single, vertical, linear false-flow signal crossing retinal layers.

Conclusions

To the authors’ knowledge, this is the first description of SD- and SS-OCT/OCTA artifacts corresponding to both HCD and the “onion sign.” These artifacts are likely due to highly reflective CC previously shown on histology to correspond to both of these OCT signatures.

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Titel: Linear and planar reflection artifacts on swept-source and spectral-domain optical coherence tomography due to hyperreflective crystalline deposits
verfasst von: Serena Fragiotta
Pedro Fernández-Avellaneda
Mark P. Breazzano
Lawrence A. Yannuzzi
Christine A. Curcio
K. Bailey Freund
Publikationsdatum: 01.03.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 3/2020
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-019-04565-y

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