Dr. RAMESH VENKATESH

DR. RUBBLE MANGLA, Dr.NARESH KUMAR YADAV, Dr.Jay Kumar Chhablani

Abstract

Purpose: To report evolution and outcomes of hyperreflective crystalline deposit (HCD) on OCT in DME. Methods: Patients with DME showing HCD on OCT were included. Factors leading to HCD development and effect on VA were analysed. Results: 60 HCD cases in 45 (33 males) patients were noted. Mean age was 61.53 yrs & DM duration was 13.82 yrs. Mean VA was 0.902 logMAR. Patients with HCD showed subretinal hard exudates, were on anti-cholesterol medications (36, 80%) and reduced VA (20/160) if the HCD involved the fovea. The median time taken for HCD development was 28 months. Mean follow-up duration was 26.19 mths. All cases showed HCD persistence till last visit. Conclusion: Horizontal, single or multi-layered HCDs on OCT in DME represent intraretinal or subretinal cholesterol crystal precipitates evolving from the hard exudates identical to the “onion ring sign” seen in nAMD. HCDs can lead to substantial visual impairment if the fovea gets involved.

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