Characterization of Hyperreflective Dots by Structural and Angiographic Optical Coherence Tomography in Patients with Diabetic Retinopathy and Healthy Subjects

Abstract

Hyperreflective dots are a common but highly variable feature of optical coherence tomography (OCT) scans of the retina. We studied the spatial characteristics and perfusion of hyperreflective dots using both structural and angiographic OCT B-scans of the macula in 16 eyes in 8 healthy subjects and 8 patients with diabetic retinopathy without macular edema. Hyperreflective dots were manually graded in a 1000 µm parafoveal area by number, diameter, location and perfusion status and traced through adjacent B-scans at 11 µm intervals to determine their length. Thereby, this study defined a procedure to identify granular and elongated hyperreflective elements and differentiate between presumably perfused and occluded capillaries. The latter were only found in the diabetic patients. This classification can potentially be automated to non-invasively identify capillary non-perfusion in vivo.

Detection of capillary abnormalities in early diabetic retinopathy using scanning laser ophthalmoscopy and optical coherence tomography combined with adaptive optics

“…The combination of methods used in this study could be valuable in the early and precise detection of retinopathy and the close monitoring of retinopathy progression or regression, especially by moving from suspicion of capillary perfusion loss to detailed positive identification of such loss 37 . In vivo correlation of structural and angiographic OCT for positive identification of capillary non-perfusion has only, to the best of our knowledge, been done in a manual analysis of quiescent diabetic retinopathy 38 . This will be of particular value in early stages of diabetic retinopathy, providing an opportunity for optimizing early diabetes treatment and for defining an early endpoint for clinical trials.…”