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William R Freeman - One of the best experts on this subject based on the ideXlab platform.
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the microperimetry of resolved Cotton Wool Spots in eyes of patients with hypertension and diabetes mellitus
Archives of Ophthalmology, 2011Co-Authors: Jae Suk Kim, Anjali S Maheshwary, Dirkuwe Bartsch, Lingyun Cheng, Maria Laura Gomez, Kathrin Hartmann, William R FreemanAbstract:Background Retinal Cotton-Wool Spots (CWSs) are an important manifestation of retinovascular disease in hypertension (HTN) and diabetes mellitus (DM). Conventional automated perimetry data have suggested relative scotomas in resolved CWSs; however, this has not been well delineated using microperimetry. This study evaluates the retinal sensitivity in documented resolved CWSs using microperimetry. Methods Retinal CWSs that resolved after 10 to 119 months (median, 51 months) and normal control areas were photographed to document baseline lesions. Eye-tracking, image-stabilized microperimetry with simultaneous scanning laser ophthalmoscopy was performed over resolved CWSs, adjacent uninvolved areas near the lesion, and in location-matched normal patients (age-matched). Results A total of 16 eyes in patients with DM or HTN (34 resolved CWSs) and 16 normal control eyes (34 areas) were imaged. The mean (SD) sensitivity of resolved CWSs in the eyes of patients with HTN and DM was 11.67 (3.88) dB and 7.21 (5.48) dB, respectively. For adjacent control areas in the eyes of patients with HTN and DM, the mean (SD) sensitivity was 14.00 (2.89) dB and 11.80 (3.45) dB, respectively. Retinal sensitivity was significantly lower in areas of resolved CWSs than in the surrounding controls for patients with HTN (P = .01) and those with DM (P Conclusions Cotton-Wool Spots in patients with DM and HTN leave permanent relative scotomas detected by microperimetry. Scotomas are denser in eyes of patients with DM than in those with HTN. In addition, among patients with DM, adjacent retinas not involved with CWSs have lower retinal sensitivity than in age-matched controls.
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imaging of long term retinal damage after resolved Cotton Wool Spots
Ophthalmology, 2009Co-Authors: Maria Laura Gomez, Dirkuwe Bartsch, Francesca Mojana, William R FreemanAbstract:Purpose Patients infected with the human immunodeficiency virus (HIV) develop noninfectious retinopathy characterized by retinal Cotton Wool Spots (CWS) and microvascular abnormalities. Ophthalmoscopically, CWS fade with time. We hypothesized that structural changes should be permanent and possibly visible well after ophthalmoscopic resolution. We used simultaneous spectral domain optical coherence tomography (SD-OCT)/scanning laser ophthalmoscope (SLO) to allow colocalization of the lesions and determine the extent and location of residual damage after ophthalmoscopic resolution of the lesions. Design Retrospective, noninterventional case series. Participants Eight eyes of 7 HIV patients with 19 resolved retinal CWS. Methods Nineteen retinal CWS were imaged between 2 and 16 years (median, 7.84) after the acute lesions using simultaneous SD-OCT and SLO examinations. The areas of the previous CWS were scanned by overlaying the color retinal image over the SLO image and scanning at high resolution in the horizontal plane through the resolved lesion. Each CWS lesion had a control area taken from the same eye within 2 disc diameters of the lesion. The thickness of each of the retinal layers was compared between lesions and control areas using a paired t -test with multitest correction. Main Outcome Measures Thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and outer nuclear layer (ONL). Results The greatest loss of thickness was seen in the retinal GCL with a 43% reduction in thickness. There was a statistically significant thinning of the RNFL, GCL, IPL, INL, and OPL. The median thickness differences ranged from 5 to 7 microns. This difference was highly significant. Another striking finding was the displacement of the ONL toward the retinal surface resulting in an apparent increase in thickness of the ONL by >15% (median difference, 12 microns). Conclusions Our data, using ultrahigh resolution and high-speed SD-OCT/SLO, show and quantify the presence of permanent retinal destruction associated with retinal CWS in HIV disease. Financial Disclosure(s) The authors have no proprietary or commercial interest in any of the materials discussed in this article.
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hyperreflective sign in resolved Cotton Wool Spots using high resolution optical coherence tomography and optical coherence tomography ophthalmoscopy
Ophthalmology, 2007Co-Authors: Igor Kozak, Dirkuwe Bartsch, Lingyun Cheng, William R FreemanAbstract:Purpose To characterize retinal changes in areas of Cotton Wool Spots (CWSs) using optical coherence tomography (OCT) and to determine the optical density changes of the retina after CWSs have disappeared clinically. Design Prospective, noninterventional, observational study. Participants Thirty-one patients with CWSs who underwent imaging studies. Methods The study groups included patients with CWSs resulting from diabetic retinopathy (n = 12), human immunodeficiency virus (HIV) retinopathy (n = 10), hypertensive retinopathy (n = 3), branch retinal vein occlusion (n = 3), uveitis (n = 2), and radiation retinopathy (n = 1). The single line scan mode of the StratusOCT Model 3000 (Carl Zeiss Meditec, Dublin, CA) was used for imaging of acute CWSs, CWSs 3 months after their resolution, and adjacent normal retina. A fundus photograph served as a template for localization of OCT scanning of CWSs. Retinal tissue reflectivity images were compared across lesion types and time. Additional imaging in 14 patients was performed to localize lesions better and to provide coronal OCT sections using the combined OCT and scanning laser ophthalmoscope. Main Outcome Measures Changes in retinal reflectivity in areas of normal retina and retina with acute and resolved CWSs. Results The average reflectivity of normal retina was 58.4±2.1 dB, the average reflectivity in the area of active CWSs was 62.6±2.5 dB, and the average reflectivity in the same area after CWSs resolved was 61.0±2.4 dB. A significant difference ( P Conclusions Acute CWSs show a hyperreflective pattern on OCT. As they become ophthalmoscopically invisible, the OCT still shows signs of hyperreflectivity in the areas of previous CWSs (hyperreflective sign). The authors observed the same phenomenon using 2 imaging machines.
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in vivo histology of Cotton Wool Spots using high resolution optical coherence tomography
American Journal of Ophthalmology, 2006Co-Authors: Igor Kozak, Dirkuwe Bartsch, Lingyun Cheng, William R FreemanAbstract:Purpose To provide optical characteristics of Cotton-Wool Spots (CWS) on optical coherence tomography (OCT) and scan the retina after CWS have ophthalmoscopically disappeared. Design Observational case reports. Methods We studied four eyes of four patients with retinopathy due to human immunodeficiency virus (HIV) and hypertension. The StratusOCT Model 3000 in single-line mode was used for imaging of acute and resolved CWS and adjacent normal retina. The fundus photography served as a template for OCT scanning in localization of CWS. Retinal tissue reflectivity images were compared. Results There were differences in reflectivity of normal retina, the retina in the area of active CWS, and the retina in the same area after CWS has resolved. Most striking was that the OCT documented a persistent focal area of hyper-reflectivity in the area of the resolved CWS, indicative of retinal gliosis that could be imaged. Conclusions CWS show a hyper-reflective pattern on OCT that persists even after they become ophthalmoscopically invisible.
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the relationship between aids retinal Cotton Wool Spots and neuropsychological impairment in hiv positive individuals in the pre highly active antiretroviral therapy era
Ocular Immunology and Inflammation, 2004Co-Authors: William R Freeman, Allen J Mccutchan, Fernando J Arevalo, Tanya Wolfson, Thomas D Marcotte, Robert K Heaton, Igor GrantAbstract:Purpose: To determine the relationship between AIDS retinal Cotton Wool Spots (CWS) and neuropsychological impairment in HIV-positive individuals in the pre-HAART (highly active antiretroviral therapy) era and the association between AIDS-related retinal CWS and neuropsychological impairment in HIV-positive patients not treated with HAART. Methods: A case-control analysis of prospectively acquired data in HIV-infected individuals who underwent prospective and longitudinal evaluations of retinal findings as well as neuropsychological testing was performed. Individuals underwent prospective retinal ophthalmic examinations with fundus photography of any retinal lesions. They also underwent periodic neuropsychological testing. The occurrence of retinal CWS was analyzed in relationship to neuropsychological impairment. Results: Thirty individuals with CWS were compared to 60 matched control AIDS patients. There was no association between either global clinical neuropsychological impairment or impairment in any...
Dirkuwe Bartsch - One of the best experts on this subject based on the ideXlab platform.
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the microperimetry of resolved Cotton Wool Spots in eyes of patients with hypertension and diabetes mellitus
Archives of Ophthalmology, 2011Co-Authors: Jae Suk Kim, Anjali S Maheshwary, Dirkuwe Bartsch, Lingyun Cheng, Maria Laura Gomez, Kathrin Hartmann, William R FreemanAbstract:Background Retinal Cotton-Wool Spots (CWSs) are an important manifestation of retinovascular disease in hypertension (HTN) and diabetes mellitus (DM). Conventional automated perimetry data have suggested relative scotomas in resolved CWSs; however, this has not been well delineated using microperimetry. This study evaluates the retinal sensitivity in documented resolved CWSs using microperimetry. Methods Retinal CWSs that resolved after 10 to 119 months (median, 51 months) and normal control areas were photographed to document baseline lesions. Eye-tracking, image-stabilized microperimetry with simultaneous scanning laser ophthalmoscopy was performed over resolved CWSs, adjacent uninvolved areas near the lesion, and in location-matched normal patients (age-matched). Results A total of 16 eyes in patients with DM or HTN (34 resolved CWSs) and 16 normal control eyes (34 areas) were imaged. The mean (SD) sensitivity of resolved CWSs in the eyes of patients with HTN and DM was 11.67 (3.88) dB and 7.21 (5.48) dB, respectively. For adjacent control areas in the eyes of patients with HTN and DM, the mean (SD) sensitivity was 14.00 (2.89) dB and 11.80 (3.45) dB, respectively. Retinal sensitivity was significantly lower in areas of resolved CWSs than in the surrounding controls for patients with HTN (P = .01) and those with DM (P Conclusions Cotton-Wool Spots in patients with DM and HTN leave permanent relative scotomas detected by microperimetry. Scotomas are denser in eyes of patients with DM than in those with HTN. In addition, among patients with DM, adjacent retinas not involved with CWSs have lower retinal sensitivity than in age-matched controls.
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imaging of long term retinal damage after resolved Cotton Wool Spots
Ophthalmology, 2009Co-Authors: Maria Laura Gomez, Dirkuwe Bartsch, Francesca Mojana, William R FreemanAbstract:Purpose Patients infected with the human immunodeficiency virus (HIV) develop noninfectious retinopathy characterized by retinal Cotton Wool Spots (CWS) and microvascular abnormalities. Ophthalmoscopically, CWS fade with time. We hypothesized that structural changes should be permanent and possibly visible well after ophthalmoscopic resolution. We used simultaneous spectral domain optical coherence tomography (SD-OCT)/scanning laser ophthalmoscope (SLO) to allow colocalization of the lesions and determine the extent and location of residual damage after ophthalmoscopic resolution of the lesions. Design Retrospective, noninterventional case series. Participants Eight eyes of 7 HIV patients with 19 resolved retinal CWS. Methods Nineteen retinal CWS were imaged between 2 and 16 years (median, 7.84) after the acute lesions using simultaneous SD-OCT and SLO examinations. The areas of the previous CWS were scanned by overlaying the color retinal image over the SLO image and scanning at high resolution in the horizontal plane through the resolved lesion. Each CWS lesion had a control area taken from the same eye within 2 disc diameters of the lesion. The thickness of each of the retinal layers was compared between lesions and control areas using a paired t -test with multitest correction. Main Outcome Measures Thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and outer nuclear layer (ONL). Results The greatest loss of thickness was seen in the retinal GCL with a 43% reduction in thickness. There was a statistically significant thinning of the RNFL, GCL, IPL, INL, and OPL. The median thickness differences ranged from 5 to 7 microns. This difference was highly significant. Another striking finding was the displacement of the ONL toward the retinal surface resulting in an apparent increase in thickness of the ONL by >15% (median difference, 12 microns). Conclusions Our data, using ultrahigh resolution and high-speed SD-OCT/SLO, show and quantify the presence of permanent retinal destruction associated with retinal CWS in HIV disease. Financial Disclosure(s) The authors have no proprietary or commercial interest in any of the materials discussed in this article.
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hyperreflective sign in resolved Cotton Wool Spots using high resolution optical coherence tomography and optical coherence tomography ophthalmoscopy
Ophthalmology, 2007Co-Authors: Igor Kozak, Dirkuwe Bartsch, Lingyun Cheng, William R FreemanAbstract:Purpose To characterize retinal changes in areas of Cotton Wool Spots (CWSs) using optical coherence tomography (OCT) and to determine the optical density changes of the retina after CWSs have disappeared clinically. Design Prospective, noninterventional, observational study. Participants Thirty-one patients with CWSs who underwent imaging studies. Methods The study groups included patients with CWSs resulting from diabetic retinopathy (n = 12), human immunodeficiency virus (HIV) retinopathy (n = 10), hypertensive retinopathy (n = 3), branch retinal vein occlusion (n = 3), uveitis (n = 2), and radiation retinopathy (n = 1). The single line scan mode of the StratusOCT Model 3000 (Carl Zeiss Meditec, Dublin, CA) was used for imaging of acute CWSs, CWSs 3 months after their resolution, and adjacent normal retina. A fundus photograph served as a template for localization of OCT scanning of CWSs. Retinal tissue reflectivity images were compared across lesion types and time. Additional imaging in 14 patients was performed to localize lesions better and to provide coronal OCT sections using the combined OCT and scanning laser ophthalmoscope. Main Outcome Measures Changes in retinal reflectivity in areas of normal retina and retina with acute and resolved CWSs. Results The average reflectivity of normal retina was 58.4±2.1 dB, the average reflectivity in the area of active CWSs was 62.6±2.5 dB, and the average reflectivity in the same area after CWSs resolved was 61.0±2.4 dB. A significant difference ( P Conclusions Acute CWSs show a hyperreflective pattern on OCT. As they become ophthalmoscopically invisible, the OCT still shows signs of hyperreflectivity in the areas of previous CWSs (hyperreflective sign). The authors observed the same phenomenon using 2 imaging machines.
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in vivo histology of Cotton Wool Spots using high resolution optical coherence tomography
American Journal of Ophthalmology, 2006Co-Authors: Igor Kozak, Dirkuwe Bartsch, Lingyun Cheng, William R FreemanAbstract:Purpose To provide optical characteristics of Cotton-Wool Spots (CWS) on optical coherence tomography (OCT) and scan the retina after CWS have ophthalmoscopically disappeared. Design Observational case reports. Methods We studied four eyes of four patients with retinopathy due to human immunodeficiency virus (HIV) and hypertension. The StratusOCT Model 3000 in single-line mode was used for imaging of acute and resolved CWS and adjacent normal retina. The fundus photography served as a template for OCT scanning in localization of CWS. Retinal tissue reflectivity images were compared. Results There were differences in reflectivity of normal retina, the retina in the area of active CWS, and the retina in the same area after CWS has resolved. Most striking was that the OCT documented a persistent focal area of hyper-reflectivity in the area of the resolved CWS, indicative of retinal gliosis that could be imaged. Conclusions CWS show a hyper-reflective pattern on OCT that persists even after they become ophthalmoscopically invisible.
Igor Kozak - One of the best experts on this subject based on the ideXlab platform.
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hyperreflective sign in resolved Cotton Wool Spots using high resolution optical coherence tomography and optical coherence tomography ophthalmoscopy
Ophthalmology, 2007Co-Authors: Igor Kozak, Dirkuwe Bartsch, Lingyun Cheng, William R FreemanAbstract:Purpose To characterize retinal changes in areas of Cotton Wool Spots (CWSs) using optical coherence tomography (OCT) and to determine the optical density changes of the retina after CWSs have disappeared clinically. Design Prospective, noninterventional, observational study. Participants Thirty-one patients with CWSs who underwent imaging studies. Methods The study groups included patients with CWSs resulting from diabetic retinopathy (n = 12), human immunodeficiency virus (HIV) retinopathy (n = 10), hypertensive retinopathy (n = 3), branch retinal vein occlusion (n = 3), uveitis (n = 2), and radiation retinopathy (n = 1). The single line scan mode of the StratusOCT Model 3000 (Carl Zeiss Meditec, Dublin, CA) was used for imaging of acute CWSs, CWSs 3 months after their resolution, and adjacent normal retina. A fundus photograph served as a template for localization of OCT scanning of CWSs. Retinal tissue reflectivity images were compared across lesion types and time. Additional imaging in 14 patients was performed to localize lesions better and to provide coronal OCT sections using the combined OCT and scanning laser ophthalmoscope. Main Outcome Measures Changes in retinal reflectivity in areas of normal retina and retina with acute and resolved CWSs. Results The average reflectivity of normal retina was 58.4±2.1 dB, the average reflectivity in the area of active CWSs was 62.6±2.5 dB, and the average reflectivity in the same area after CWSs resolved was 61.0±2.4 dB. A significant difference ( P Conclusions Acute CWSs show a hyperreflective pattern on OCT. As they become ophthalmoscopically invisible, the OCT still shows signs of hyperreflectivity in the areas of previous CWSs (hyperreflective sign). The authors observed the same phenomenon using 2 imaging machines.
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in vivo histology of Cotton Wool Spots using high resolution optical coherence tomography
American Journal of Ophthalmology, 2006Co-Authors: Igor Kozak, Dirkuwe Bartsch, Lingyun Cheng, William R FreemanAbstract:Purpose To provide optical characteristics of Cotton-Wool Spots (CWS) on optical coherence tomography (OCT) and scan the retina after CWS have ophthalmoscopically disappeared. Design Observational case reports. Methods We studied four eyes of four patients with retinopathy due to human immunodeficiency virus (HIV) and hypertension. The StratusOCT Model 3000 in single-line mode was used for imaging of acute and resolved CWS and adjacent normal retina. The fundus photography served as a template for OCT scanning in localization of CWS. Retinal tissue reflectivity images were compared. Results There were differences in reflectivity of normal retina, the retina in the area of active CWS, and the retina in the same area after CWS has resolved. Most striking was that the OCT documented a persistent focal area of hyper-reflectivity in the area of the resolved CWS, indicative of retinal gliosis that could be imaged. Conclusions CWS show a hyper-reflective pattern on OCT that persists even after they become ophthalmoscopically invisible.
Lingyun Cheng - One of the best experts on this subject based on the ideXlab platform.
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the microperimetry of resolved Cotton Wool Spots in eyes of patients with hypertension and diabetes mellitus
Archives of Ophthalmology, 2011Co-Authors: Jae Suk Kim, Anjali S Maheshwary, Dirkuwe Bartsch, Lingyun Cheng, Maria Laura Gomez, Kathrin Hartmann, William R FreemanAbstract:Background Retinal Cotton-Wool Spots (CWSs) are an important manifestation of retinovascular disease in hypertension (HTN) and diabetes mellitus (DM). Conventional automated perimetry data have suggested relative scotomas in resolved CWSs; however, this has not been well delineated using microperimetry. This study evaluates the retinal sensitivity in documented resolved CWSs using microperimetry. Methods Retinal CWSs that resolved after 10 to 119 months (median, 51 months) and normal control areas were photographed to document baseline lesions. Eye-tracking, image-stabilized microperimetry with simultaneous scanning laser ophthalmoscopy was performed over resolved CWSs, adjacent uninvolved areas near the lesion, and in location-matched normal patients (age-matched). Results A total of 16 eyes in patients with DM or HTN (34 resolved CWSs) and 16 normal control eyes (34 areas) were imaged. The mean (SD) sensitivity of resolved CWSs in the eyes of patients with HTN and DM was 11.67 (3.88) dB and 7.21 (5.48) dB, respectively. For adjacent control areas in the eyes of patients with HTN and DM, the mean (SD) sensitivity was 14.00 (2.89) dB and 11.80 (3.45) dB, respectively. Retinal sensitivity was significantly lower in areas of resolved CWSs than in the surrounding controls for patients with HTN (P = .01) and those with DM (P Conclusions Cotton-Wool Spots in patients with DM and HTN leave permanent relative scotomas detected by microperimetry. Scotomas are denser in eyes of patients with DM than in those with HTN. In addition, among patients with DM, adjacent retinas not involved with CWSs have lower retinal sensitivity than in age-matched controls.
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hyperreflective sign in resolved Cotton Wool Spots using high resolution optical coherence tomography and optical coherence tomography ophthalmoscopy
Ophthalmology, 2007Co-Authors: Igor Kozak, Dirkuwe Bartsch, Lingyun Cheng, William R FreemanAbstract:Purpose To characterize retinal changes in areas of Cotton Wool Spots (CWSs) using optical coherence tomography (OCT) and to determine the optical density changes of the retina after CWSs have disappeared clinically. Design Prospective, noninterventional, observational study. Participants Thirty-one patients with CWSs who underwent imaging studies. Methods The study groups included patients with CWSs resulting from diabetic retinopathy (n = 12), human immunodeficiency virus (HIV) retinopathy (n = 10), hypertensive retinopathy (n = 3), branch retinal vein occlusion (n = 3), uveitis (n = 2), and radiation retinopathy (n = 1). The single line scan mode of the StratusOCT Model 3000 (Carl Zeiss Meditec, Dublin, CA) was used for imaging of acute CWSs, CWSs 3 months after their resolution, and adjacent normal retina. A fundus photograph served as a template for localization of OCT scanning of CWSs. Retinal tissue reflectivity images were compared across lesion types and time. Additional imaging in 14 patients was performed to localize lesions better and to provide coronal OCT sections using the combined OCT and scanning laser ophthalmoscope. Main Outcome Measures Changes in retinal reflectivity in areas of normal retina and retina with acute and resolved CWSs. Results The average reflectivity of normal retina was 58.4±2.1 dB, the average reflectivity in the area of active CWSs was 62.6±2.5 dB, and the average reflectivity in the same area after CWSs resolved was 61.0±2.4 dB. A significant difference ( P Conclusions Acute CWSs show a hyperreflective pattern on OCT. As they become ophthalmoscopically invisible, the OCT still shows signs of hyperreflectivity in the areas of previous CWSs (hyperreflective sign). The authors observed the same phenomenon using 2 imaging machines.
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in vivo histology of Cotton Wool Spots using high resolution optical coherence tomography
American Journal of Ophthalmology, 2006Co-Authors: Igor Kozak, Dirkuwe Bartsch, Lingyun Cheng, William R FreemanAbstract:Purpose To provide optical characteristics of Cotton-Wool Spots (CWS) on optical coherence tomography (OCT) and scan the retina after CWS have ophthalmoscopically disappeared. Design Observational case reports. Methods We studied four eyes of four patients with retinopathy due to human immunodeficiency virus (HIV) and hypertension. The StratusOCT Model 3000 in single-line mode was used for imaging of acute and resolved CWS and adjacent normal retina. The fundus photography served as a template for OCT scanning in localization of CWS. Retinal tissue reflectivity images were compared. Results There were differences in reflectivity of normal retina, the retina in the area of active CWS, and the retina in the same area after CWS has resolved. Most striking was that the OCT documented a persistent focal area of hyper-reflectivity in the area of the resolved CWS, indicative of retinal gliosis that could be imaged. Conclusions CWS show a hyper-reflective pattern on OCT that persists even after they become ophthalmoscopically invisible.
Amina Ghezzaz - One of the best experts on this subject based on the ideXlab platform.
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features of Cotton Wool Spots in diabetic retinopathy a spectral domain optical coherence tomography angiography study
International Ophthalmology, 2020Co-Authors: Amir Mahdjoubi, Youcef Bousnina, Gaelle Barrande, Faiza Bensmaine, Sadri Chahed, Amina GhezzazAbstract:To describe the features of Cotton Wool Spots (CWSs) in diabetic retinopathy (DR) by using spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCT angiography). We retrospectively studied patients with DR who presented CWSs and had been imaged by SD-OCT angiography. The retinal layer localisation and dimensions of the CWSs were assessed on SD-OCT, while the decorrelation signal generated by the CWSs and the vascular density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus around the CWSs and in the macula were assessed on OCT angiography. A total of 87 eyes of 57 DR patients were included. All CWSs were located in the retinal nerve fibre layer and exhibited a decorrelation signal on OCT angiography. In 68 eyes (78.1%), hyporeflective cavities appearing as cysts in the CWS were noted, especially when were peripheral and large (P < 0.0001). The thickness averaged 211.8 ± 80.02 mm and was positively influenced by recent diabetes history, glycaemic dysregulation, posterior pole localisation and a high VD of the SCP around the CWS, while the surface area averaged 0.33 ± 0.24 mm2 and was influenced only by a low VD of the SCP around the CWS (P < 0.001). In 72 eyes (82.7%), the non-perfused areas were predominant in the periphery of the CWS. The features of CWSs are influenced by systemic factors, such as history and severity of diabetes, in association with local factors, such as localisation and retinal ischaemia. The peripheral localisation of ischaemia confirms the hypothesis that CWSs are sentinel lesions.
