Maculopathy diagnosed with high-resolution Fourier-domain optical coherence tomography in eyes with previously unexplained visual loss

Purpose: To describe maculopathy diagnosed with high-resolution Fourier-domain optical coherence tomography among eyes with previously unexplained visual loss. Methods: Nine eyes from six patients with previously unexplained vision loss based on funduscopy, fluorescein angiography, and Stratus optical coherence tomography and 32 eyes from 25 asymptomatic age-matched control subjects were imaged with a Fourierdomain optical coherence tomography instrument with axial resolution of 4 mm to 4.5 mm and transverse resolution of 10 mm to 15 mm. Results: Among eyes with unexplained vision loss, visual acuity ranged from 20/20 to 20/80 and central scotoma was noted in all eyes by microperimetry or Amsler grid. Fourierdomain optical coherence tomography showed abnormality in the foveal photoreceptor (PR) layer in six eyes from four subjects (67%). These abnormalities include focal loss of the PR layer with microcystoid changes in the macula (n = 2), focal discontinuity of the PR layer (n = 3), and focal elevation and blurring of the PR layer associated with a mild epiretinal membrane (n = 1). Among age-matched control eyes, no foveal PR abnormality was seen. Conclusion: Fourier-domain optical coherence tomography detected subtle changes in the foveal PR layer in some eyes with vision loss and central scotoma unexplained with routine clinical diagnostic tests.