PMID- 30221214 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230103 IS - 2468-7219 (Print) IS - 2468-7219 (Electronic) IS - 2468-6530 (Linking) VI - 2 IP - 7 DP - 2018 Jul TI - Suspended Scattering Particles in Motion: A Novel Feature of OCT Angiography in Exudative Maculopathies. PG - 694-702 LID - 10.1016/j.oret.2017.11.004 [doi] AB - OBJECTIVE: To characterize features of extra-vascular optical coherence tomography angiography (OCTA) signals corresponding to hyperreflective intraretinal fluid across various exudative maculopathies. DESIGN: Multicenter, retrospective, observational study. PARTICIPANTS: Eyes with various forms of exudative maculopathy including diabetic retinopathy (DR), retinal vein occlusion (RVO), and neovascular-age related macular degeneration (nvAMD). METHODS: Patients with extra-vascular OCTA signal identified on en face OCTA images were included in this study. This signal was readily distinguishable from projection artifacts. The regions with the extra-vascular motion signal on OCTA were named "Suspended Scattering Particles in Motion (SSPiM)." Depth-encoded, color, en face OCTA images (3mm x 3mm) centered on the fovea and their corresponding structural OCT scans were used to quantify features of SSPiM and its corresponding hyperreflective fluid. Longitudinal data were collected when available. MAIN OUTCOME MEASURES: Anatomic location, the association with hyperreflective material, changes in location and appearance of SSPiM over time, and replication of SSPiM OCTA signal in an in vitro phantom. RESULTS: Seventy-six eyes in 62 patients with various forms of exudative maculopathy were evaluated; 60 eyes with DR, 9 eyes with RVO, and 5 eyes nvAMD, 1 eye with macroaneurysm, and 1 eye with radiation retinopathy. Intraretinal accumulations of fluid with increased OCT signal intensity corresponded to regions of SSPiM in several exudative maculopathies. An in vitro phantom model demonstrates that particulate matter in suspension can generate similar OCTA signal. SSPiM showed an anatomic preference for vascular-avascular junctions. The hyperreflective fluid corresponding to SSPiM appeared more frequently in Henle's fiber layer (HFL) than the inner nuclear layer (INL) and was highly associated with hyperreflective material (HRM) found bordering the fluid. In five of eight longitudinal cases, the resolution of SSPiM resulted in the formation of confluent HRM. Clinically, this appeared as hard exudate on funduscopic images. CONCLUSIONS: Clinical data suggest that SSPiM is a novel imaging feature of retinal vascular diseases that was not appreciated prior to the use of OCTA. We characterized several novel features of SSPiM and demonstrated that at least in some cases it resolves with residual hard exudate. FAU - Kashani, Amir H AU - Kashani AH AD - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California. FAU - Green, Kyle M AU - Green KM AD - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California. FAU - Kwon, Julie AU - Kwon J AD - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California. FAU - Chu, Zhongdi AU - Chu Z AD - Department of Bioengineering, University of Washington, Seattle, Washington. FAU - Zhang, Qinqin AU - Zhang Q AD - Department of Bioengineering, University of Washington, Seattle, Washington. FAU - Wang, Ruikang K AU - Wang RK AD - Department of Bioengineering, University of Washington, Seattle, Washington. AD - Department of Ophthalmology, University of Washington, Seattle, Washington. FAU - Garrity, Sean AU - Garrity S AD - Stein Eye Institute, University of California, Los Angeles, Los Angeles, California. FAU - Sarraf, David AU - Sarraf D AD - Stein Eye Institute, University of California, Los Angeles, Los Angeles, California. FAU - Rebhun, Carl B AU - Rebhun CB AD - New England Eye Center/Tufts University School of Medicine, Boston, Massachusetts. FAU - Waheed, Nadia K AU - Waheed NK AD - New England Eye Center/Tufts University School of Medicine, Boston, Massachusetts. FAU - Schaal, Karen B AU - Schaal KB AD - Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland. FAU - Munk, Marion R AU - Munk MR AD - Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland. AD - Bern Photographic Reading Center, Inselspital, University Clinic Bern, Bern, Switzerland. FAU - Gattoussi, Sarra AU - Gattoussi S AD - Vitreous Retina Macula Consultants of New York, New York. FAU - Freund, K Bailey AU - Freund KB AD - Vitreous Retina Macula Consultants of New York, New York. FAU - Zheng, Fang AU - Zheng F AD - Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. FAU - Liu, Guanghui AU - Liu G AD - Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. FAU - Rosenfeld, Philip J AU - Rosenfeld PJ AD - Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. LA - eng GR - K08 EY027006/EY/NEI NIH HHS/United States GR - R01 EY024158/EY/NEI NIH HHS/United States GR - UH3 NS100614/NS/NINDS NIH HHS/United States PT - Journal Article DEP - 20171215 PL - United States TA - Ophthalmol Retina JT - Ophthalmology. Retina JID - 101695048 PMC - PMC6133252 MID - NIHMS928084 EDAT- 2018/09/18 06:00 MHDA- 2018/09/18 06:01 PMCR- 2019/07/01 CRDT- 2018/09/18 06:00 PHST- 2018/09/18 06:00 [entrez] PHST- 2018/09/18 06:00 [pubmed] PHST- 2018/09/18 06:01 [medline] PHST- 2019/07/01 00:00 [pmc-release] AID - 10.1016/j.oret.2017.11.004 [doi] PST - ppublish SO - Ophthalmol Retina. 2018 Jul;2(7):694-702. doi: 10.1016/j.oret.2017.11.004. Epub 2017 Dec 15.