title: Highly reflective foveal region in optical coherence tomography in eyes with vitreomacular traction or epiretinal membrane.
abstract: OBJECTIVE
  To report the optical coherence tomography (OCT) findings in eyes with vitreomacular traction (VMT) or with an epiretinal membrane (ERM).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Fifty-four eyes of 45 consecutive patients with subjective visual disturbances resulting from VMT or idiopathic ERM were studied.
  
  
  METHODS
  The morphologic features of the photoreceptor layer at the foveal center were determined and the central foveal thickness (CFT) was measured by spectral-domain (SD) OCT.
  
  
  METHODS
  The morphologic characteristics of the foveal region observed by SD OCT.
  
  
  RESULTS
  A roundish or diffuse highly reflective region was observed between the photoreceptor inner segment/outer segment junction line and the cone outer segment tip line at the center of the fovea. This highly reflective region was present in 7 of 7 cases of VMT and 30 of 47 cases of ERM. In the ERM cases, the mean CFT of the cases with the highly reflective region was significantly thicker than that in cases without it. The highly reflective region disappeared when the inward traction on the fovea was released surgically or spontaneously.
  
  
  CONCLUSIONS
  The highly reflective region is a characteristic sign observed in the OCT images of eyes with VMT and ERM, and it has been termed the cotton ball sign after its appearance. The presence of the cotton ball sign indicates an inward traction on the fovea and may be a predictor of visual impairment.
authors: Laboratory of Visual Physiology, National Institute of Sensory Organs, Tokyo, Japan. tsunodakazushige@kankakuki.go.jp
authors: Kazushige
authors: K
authors: Tsunoda
authors: Ken
authors: K
authors: Watanabe
authors: Kunihiko
authors: K
authors: Akiyama
authors: Tomoaki
authors: T
authors: Usui
authors: Toru
authors: T
authors: Noda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019773:Epiretinal Membrane / Q000175:diagnosis* / Q000601:surgery; D005128:Eye Diseases / Q000175:diagnosis* / Q000601:surgery; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000473:pathology; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000175:diagnosis*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology*