Retinal tubulations in geographic atrophy associated with age-related macular degeneration

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Abstract

Purpose

To describe the presence of retinal tubulations at the boundaries and within areas of retinal atrophy in patients with geographic atrophy (GA) associated with age-related macular degeneration (AMD) by spectral-domain optical coherence tomography (SD-OCT).

Methods

82 consecutive patients, 50 years or older with GA associated with AMD were examined between January 2012 and July 2012. Patients were evaluated by SD-OCT and fundus autofluorescence (FAF). Patients with single or multiple and well-defined areas of atrophy in whom retinal layers could be visualized were included. FAF was performed at the same time that OCT (Spectralis, Heidelberg Eng). Three acquisition protocols were performed: high-resolution horizontal B-scan for foveal study and two macular cubes to evaluate the whole macular surface (19 horizontal and 19 vertical B-scans centred on the fovea). Main Outcomes Measures: Presence of spherules/tubulations within the atrophic area in patients with GA associated with AMD.

Results

50/82 patients with GA presented with single or multiple areas of atrophy with identifiable retinal layers. Clearly visible and slightly hyper/hyporeflective round, rosette-like, spherule-shaped structures were localized in the outer nuclear layer (ONL). These structures occasionally contacted the external limiting membrane. They were adjacent to the margin between preserved retina and atrophic area and within the atrophic area. In these cases, uniformly hypereflective, hyporeflective and isoreflective spherules surrounded by hyperreflective halo that might correspond with retinal tubulation were present in the same eye.

Conclusion

Retinal tubulations can be observed in the ONL in patients with GA associated with AMD.

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