Hyperreflective dots detected in the retina using spectral domain optical coherence tomography

Abstract

Purpose to investigate morphologic changes in posterior segment diseases using spectral‐domain optical coherence tomography (SD‐OCT). To discuss the role and characteristics of hyperreflective dots (HRD) in retinal inflammatory diseases and choroidal neovascularization (CNV). Methods 3 patients (3 eyes) with posterior segment diseases (Lyme disease, Cat scratch disease, and suspected Best vitelliform macular dystrophy with CNV) were retrospectively reviewed. Thorough ophthalmologic examination and SD‐OCT were performed during the first visit and follow‐up. HRD behavior was evaluated in the retina with SD‐OCT pre‐ and post‐treatment. Results in all three eyes, various amounts of HRD were detected in the foveal or parafoveal area and, in one case, near the optic disc prior to the treatment. Hyperreflective dots accumulated densely, especially surrounding the area of fluid accumulation. During follow‐up, progressive resolution of the hyperreflective dots was observed with SD‐OCT. HRD reduction was observed mainly in cases of complete macular edema resolution and correlated greatly with visual acuity (VA) improvement. Conclusion HRD seen with SD‐OCT in retinal inflammatory diseases behave similarly as in wet age‐related macular degeneration and diabetic maculopathy. The association between VA improvement and a decrease in the amounts of HRD could be used as a helpful treatment indicator in both inflammatory posterior segment diseases and choroidal neovascularization.