CHARACTERISTICS OF OPTICAL COHERENCE TOMOGRAPHIC HYPERREFLECTIVE FOCI IN RETINAL VEIN OCCLUSION

Purpose: To evaluate the hyperreflective foci in branch retinal vein occlusion and central retinal vein occlusion depicted by spectral-domain optical coherence tomography (OCT). Methods: Consecutive series of 73 eyes of 73 patients with retinal vein occlusion (58 branch retinal vein occlusion and 15 central retinal vein occlusion) who had Spectralis OCT images obtained were retrospectively reviewed, comparing color fundus photographs and fluorescein angiography. Results: Hyperreflective foci were detected in 54 eyes (74.0%) by spectral-domain OCT, and hard exudates were detected in 17 eyes (23.3%) by color fundus photography. Hard exudates on the color photographs corresponded to the confluence of hyperreflective foci mainly around the outer plexiform layer in the unaffected areas on the spectral-domain OCT images, whereas fine hyperreflective foci were scattered in all retinal layers of the affected areas (P < 0.001). Most eyes with hyperreflective foci attached to the inner side of the external limiting membrane also had serous retinal detachment (P < 0.001). Compared with diabetic macular edema, we did not find subfoveal hard exudates in retinal vein occlusion. Conclusion: Hyperreflective foci delineated on spectral-domain OCT suggest the pathogenesis regarding the flow of extravasated blood constituents in retinal vein occlusion. RETINA 32:77-85, 2012