En Face Optical Coherence Tomography Imaging Ellipsoid Zone Regeneration in Laser-Induced and Solar Maculopathies

Figure 3

Regeneration of the ellipsoid zone in a patient with laser-induced maculopathy. (a) Fundus photography on day 1 after the accident showing small central lesion in both eyes of patient 1. (b) B‐scan OCT images through the fovea of the right and left eye depicts a hyperreflective band reaching from the retinal pigment epithelium (RPE) to the outer plexiform layer extending slightly to the perifoveal region (assumingly following the Henle fibers) and a hyporeflective zone expanding from the ellipsoid zone (EZ) to the external limiting membrane (ELM) in both eyes on day 1. It also showed thickened subfoveal outer retinal layers and a hyporeflective zone expanding from the EZ to the ELM. These findings diminish over follow-up (day 11, 46, and 249). Last follow-up on day 249 showed only a distinct hyporeflective zone in the outer retinal layers, boarded by intact ELM and RPE layers. (c) En face OCT images on the level of the EZ demonstrating a regeneration of the EZ alterations over time in both eyes. Early images show a central hyporeflective oval zone surrounded by a distinct hyperreflective ring and again a faint, fuzzily bounded hyporeflective zone. Late images show a pronounced hyporeflective defect in the EZ, decreasing in size over follow-up. Note the inhomogeneous choroidal hypertransmission as an indirect sign of incomplete RPE and outer retina damage visible on days 11 and 46 in both eyes [10].