Shields Gray Crescents Masquerading as Glaucomatous Cupping of the Optic Nerve Head.
Ophthalmol Glaucoma
; 1(2): 99-107, 2018.
Article
em En
| MEDLINE
| ID: mdl-32677615
ABSTRACT
PURPOSE:
Gray crescents characterized by darkly pigmented regions on the optic nerve head could make assessment of cupping difficult by obscuring the true anatomic disc border. On slit-lamp examination, 2 morphologically distinct types of gray crescents at the curved disc boundary exist. The in vivo histologic characteristics differentiating these 2 types are described using spectral-domain (SD) OCT.METHODS:
A prospective interventional case series in a single tertiary referral center. Sixteen eyes of 10 patients with gray crescents determined through clinical examination and fundus photography underwent cross-sectional optic nerve head and parapapillary imaging using high-resolution SD OCT. In vivo histology of gray crescents was characterized.RESULTS:
In SD OCT images across the areas of gray crescent, type A gray crescents represent regions where the retinal pigment epithelium (RPE)-Bruch's membrane complex is absent and the dark underlying choroid is directly visible. In contrast, type B gray crescents represent regions of the retina where the RPE is clumped or thickened, typically appearing to be folded upon itself, revealing the embryonic continuity of the RPE and neuroretina.CONCLUSIONS:
Shields type A and B gray crescents appear different clinically because histologically they represent differences in RPE. Type A grey crescents lack RPE, whereas type B crescents have thickened, folded RPE. Gray crescents can obscure the true disc border and result in pseudo-cupping of the optic nerve head. Identification of gray crescents is clinically important because failure to recognize pseudo-cupping can contribute to overdiagnosis of glaucoma.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Disco Óptico
/
Glaucoma
/
Tomografia de Coerência Óptica
/
Epitélio Pigmentado da Retina
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Ophthalmol Glaucoma
Ano de publicação:
2018
Tipo de documento:
Article