The Causes of Hyperreflective Dots in Optical Coherence Tomography Excluding Diabetic Macular Edema and Retinal Venous Occlusion§§

Burak Turgut*, Hakan Yildirim
Fırat University, School of Medicine, Department of Ophthalmology, Elazığ, Turkey

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Creative Commons License
© Turgut and Yildirim; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Fırat University, School of Medicine, Department of Ophthalmology, 23119, Elazığ, Turkey; Tel: +90 424 2333555; Fax: +90 424 2388096; E-mail:
§ Presented at the 14th ESASO Retina Academy, Istanbul, Turkey, November 2014.


Purpose :

To investigate the causes of hyperreflective dots (HRDs) in spectral domain optical coherence tomography (OCT) excluding diabetic macular edema (DME) and RVO (retinal vein occlusion).

Patients and Methods :

The medical records of 56 patients with HRDs documented by OCT were reviewed retrospectively. The patients with DME and RVO were excluded from the study in order to prevent misdiagnosing hard exudates or HRDs. The causes, unilaterality or bilaterality of HRD and demographic properties of the patients with HRD were evaluated.

Results :

Sixty four eyes of 56 patients having HRDs were included in this study. Of the patients with HRD, 17 (30.36%) were women and 39 (69.64%) were men. The ages of patients were between 13 to 84 years (median 60.18 years). The causes of HRD were as follows: papilledema in 4 eyes (6.25%), active neovascular age related macular degeneration (AMD) in 33 eyes (51.56%), familial dominant drusen in 2 eyes (3.13%), central serous chorioretinopathy in 19 eyes (29.69%) and commotio retina in 2 eyes (3.13%), choroidal folds in one eye (1.56%), branch retinal artery occlusion in one eye (1.56%), central retinal artery occlusion in one patient (1.56%) and Best vitelliform macular dystrophy in one eye (1.56%). The most common cause of HRD was AMD. The causes of HRDs in both eyes were AMD and papilledema.

Conclusion :

The most common causes of HRDs excluding DME and RVO seem as active exudative AMD. The presence of HRDs in retinal diseases might affect the decisions and the results of the treatment and the prognosis of diseases.

Keywords: Hyperreflective dots, causes, optical coherence tomography.