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Outer Retinal Hyperreflective Dots: A Potential Imaging Biomarker in Rhegmatogenous Retinal Detachment
Aaditeya Jhaveri1, Isabela Martins Melo2, Aurora Pecaku2
1Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada.
Hyperreflective dots (HRDs) in optical coherence tomography (OCT) scans of rhegmatogenous retinal detachment (RRD) correlate with detachment severity and poorer visual outcomes. HRDs may indicate photoreceptor damage and are linked to postoperative cystoid macular edema, suggesting inflammatory involvement.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Retinal Diseases
Background:
- Hyperreflective dots (HRDs) on optical coherence tomography (OCT) are observed in various retinal conditions.
- Their significance in rhegmatogenous retinal detachment (RRD) requires further investigation.
Purpose of the Study:
- To investigate the presence and significance of hyperreflective dots (HRDs) on baseline OCT scans in patients with rhegmatogenous retinal detachment (RRD).
Main Methods:
- Retrospective cohort study of 351 primary fovea-off RRD cases.
- OCT scans analyzed for HRDs, RRD morphologic stage, and photoreceptor integrity.
- Visual acuity (VA), foveal detachment height, vision loss duration, RRD extent, and postoperative epiretinal membrane (ERM) and cystoid macular edema (CME) were assessed.
Main Results:
- HRDs prevalence increased with RRD morphologic stage (0% in stage 1 to 85% in stage 5).
- HRDs were significantly associated with reduced photoreceptor integrity, worse postoperative VA, greater RRD height, longer vision loss duration, and RRD extent.
- HRDs were associated with postoperative CME but not with ERM formation.
Conclusions:
- HRDs in RRD are linked to RRD severity, photoreceptor degeneration, and poorer visual outcomes.
- The association with CME suggests a role for inflammation in RRD pathogenesis and post-surgical recovery.
- HRDs may serve as a biomarker for RRD severity and prognosis.
