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Outer Retinal Tubulation

A Case Series

Rousso, Leticia A.; Rodman, Julie A.; Sutton, Brad; Shechtman, Diana L.

doi: 10.1097/OPX.0000000000001056

Purpose The advent of spectral domain optical coherence tomography has led to superb imaging capabilities in addition to enhanced visualization of the retinal layers. Such advancements have led to the identification of a variety of new retinal conditions, including outer retinal tubulations (ORTs). ORTs are ovoid hyporeflective spaces located in the outer retina. The pathogenesis is unclear but seems to involve sublethal injury to the photoreceptors leading to a compensatory reorganization of the photoreceptor layer with the neighboring ellipsoid zone resulting in a hyperreflective border surrounding a central lumen. Most ORTs have been linked to wet age-related macular degeneration; however, these peculiar structures are now seen in a myriad of retinal disorders.

Case Reports Our cases will highlight the wide variety of clinical presentations associated with outer retinal tubulations. The clinical presentations include two cases of wet age-related macular degeneration, a case of presumed ocular histoplasmosis syndrome, a case of central areolar choroidal dystrophy, and a case of pathological myopia.

Conclusions By correctly differentiating outer retinal tubulations from other masqueraders, unnecessary referrals and interventions can be minimized. Understanding the various disease entities associated with outer retinal tubulation could give further insight into the mechanism and formation of these structures.




Nova Southeastern University College of Optometry, Ft. Lauderdale, Florida (LAR, JAR, BS, DLS); and Indianapolis Eye Care Center, Indianapolis, Indiana (BS).

Leticia Rousso, Nova Southeastern University, College of Optometry, 3200 South University Dr, Ft. Lauderdale, FL 33328-2018, e-mail:

© 2017 American Academy of Optometry