Microcystic macular edema: retrograde maculopathy caused by optic neuropathy

Abegg, Mathias; Dysli, Denise-Muriel; Wolf, Sebastian; Kowal, Horst Jens; Dufour, Pascal André; Zinkernagel, Martin (2014). Microcystic macular edema: retrograde maculopathy caused by optic neuropathy. Ophthalmology, 121(1), pp. 142-149. Elsevier 10.1016/j.ophtha.2013.08.045

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PURPOSE To investigate retrograde axonal degeneration for its potential to cause microcystic macular edema (MME), a maculopathy that has been previously described in patients with demyelinating disease. To identify risk factors for MME and to expand the anatomic knowledge on MME. DESIGN Retrospective case series. PARTICIPANTS We included 117 consecutive patients and 180 eyes with confirmed optic neuropathy of variable etiology. Patients with glaucoma were excluded. METHODS We determined age, sex, visual acuity, etiology of optic neuropathy, and the temporal and spatial characteristics of MME. Eyes with MME were compared with eyes with optic neuropathy alone and to healthy fellow eyes. With retinal layer segmentation we quantitatively measured the intraretinal anatomy. MAIN OUTCOME MEASURES Demographic data, distribution of MME in the retina, and thickness of retinal layers were analyzed. RESULTS We found MME in 16 eyes (8.8%) from 9 patients, none of whom had multiple sclerosis or neuromyelitis optica. The MME was restricted to the inner nuclear layer (INL) and had a characteristic perifoveal circular distribution. Compared with healthy controls, MME was associated with significant thinning of the ganglion cell layer and nerve fiber layer, as well as a thickening of the INL and the deeper retinal layers. Youth is a significant risk factor for MME. CONCLUSIONS Microcystic macular edema is not specific for demyelinating disease. It is a sign of optic neuropathy irrespective of its etiology. The distinctive intraretinal anatomy suggests that MME is caused by retrograde degeneration of the inner retinal layers, resulting in impaired fluid resorption in the macula.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Ophthalmic Technology Lab

UniBE Contributor:

Abegg, Mathias; Dysli, Denise-Muriel; Wolf, Sebastian; Kowal, Horst Jens; Dufour, Pascal André and Zinkernagel, Martin

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0161-6420

Publisher:

Elsevier

Language:

English

Submitter:

Christina Rust

Date Deposited:

09 Jul 2014 14:46

Last Modified:

25 Nov 2015 09:51

Publisher DOI:

10.1016/j.ophtha.2013.08.045

PubMed ID:

24139122

BORIS DOI:

10.7892/boris.44355

URI:

https://boris.unibe.ch/id/eprint/44355

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