Macular thickness profile and diabetic retinopathy: the Singapore Epidemiology of Eye Diseases Study

2017 ◽  
Vol 102 (8) ◽  
pp. 1072-1076 ◽  
Author(s):  
Wei Dai ◽  
Yih Chung Tham ◽  
Ning Cheung ◽  
Masayuki Yasuda ◽  
Nicholas Y Q Tan ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Oedema ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Glycated Haemoglobin ◽  
Eye Diseases ◽  
Inner Plexiform Layer ◽  
Outer Retina ◽  
Sd Oct

BackgroundTo evaluate retinal thickness profiles in eyes with and without diabetic retinopathy (DR) using spectral-domain optical coherence tomography (SD-OCT) among individuals with diabetes.MethodsParticipants were recruited from the Singapore Epidemiology of Eye Diseases Study, a population-based study among Chinese, Malays and Indians aged 40 years or older residing in Singapore. All participants underwent standardised systemic and ophthalmic examinations. Average thickness of the macula, ganglion cell-inner plexiform layer and outer retina layer (from the outer plexiform layer to the retinal pigment epithelium layer) were measured using SD-OCT. DR status and severity were graded based on fundus photographs using the modified Airlie House classification system. Participants with macular oedema were excluded.Results2240 eyes from 1280 participants were included. Of these, 1764 (78.7%) eyes had no DR, 351 (15.7%) eyes had minimal or mild DR and 125 (5.6%) eyes had moderate or worse DR. After adjusting for age, gender, ethnicity, axial length, hypertension, glycated haemoglobin, body mass index, total cholesterol and diabetes duration, eyes with DR had thicker macula (245.44 µm vs 243.04 µm, P=0.03) and outer retina (124.26 µm vs 123.08 µm, P=0.01) than eyes without DR. When stratified by DR severity, thicker macula (250.24 µm vs 242.88 µm, P=0.011) and outer retina (126.4 µm vs 123.0 μm, P=0.006) were observed in eyes with moderate or worse, but not minimal or mild DR, compared with eyes without DR.ConclusionsEven in the absence of macular oedema, eyes with DR, particularly those with more severe DR, had thicker macular and outer retinal layers than eyes without DR.

Normative pattern and determinants of outer retinal thickness in an Asian population: the Singapore Epidemiology of Eye Diseases Study

2019 ◽  
Vol 103 (10) ◽  
pp. 1406-1412 ◽  
Author(s):  
Wei Dai ◽  
Yih-Chung Tham ◽  
Miao-Li Chee ◽  
Shivani Majithia ◽  
Nicholas Y Q Tan ◽  
...  
Keyword(s):  
Retinal Thickness ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Asian Population ◽  
Final Analysis ◽  
Population Based ◽  
Eye Diseases ◽  
Retinal Diseases ◽  
Sd Oct

Background/aimsTo evaluate the distribution and determinants of outer retinal thickness in eyes without retinal diseases, using spectral-domain optical coherence tomography (SD-OCT).MethodsParticipants were recruited from the Singapore Epidemiology of Eye Diseases Study, a population-based study among Chinese, Malays and Indians in Singapore. A total of 5333 participants underwent SD-OCT imaging in which a 6×6 mm2 measurement area centred at the fovea. Outer retinal thickness was defined as the distance from the outer plexiform layer to the retinal pigment epithelium layer boundary.Results7444 eyes from 4454 participants were included in final analysis. Of them, mean age was 58.4 years (SD 8.3), and 2294 (51.5%) were women. Women (121.0±8.1 µm) had thinner average outer retinal thickness than men (125.6±8.2 µm) (p<0.001). Malays (121.4±8.7 µm) had thinner average outer retinal thickness than Indians (124.3±8.6 µm) and Chinese (123.7±7.9 µm) (both p<0.001). In multivariable models, thinner average outer retinal thickness was associated with older age (per decade, β=−1.02, p<0.001), hypertension (β=−0.59, p=0.029), diabetes (β=−0.73, p=0.013), chronic kidney disease (β=−1.25, p=0.017), longer axial length (per mm, β=−0.76, p<0.001), flatter corneal curvature (per mm, β=−2.00, p<0.001) and higher signal strength (β=−1.46, p<0.001).ConclusionIn this large sample of Asian population, we provided normative SD-OCT data on outer retinal thickness in eyes without retinal diseases. Women had thinner outer retina than men. For the first time, these findings provide fundamental knowledge on normative profile of outer retinal thickness in Asians.

Multiple cell targets for melatonin action in Xenopus laevis retina: Distribution of melatonin receptor immunoreactivity

2001 ◽  
Vol 18 (5) ◽  
pp. 695-702 ◽  
Author(s):  
ALLAN F. WIECHMANN ◽  
CELESTE R. WIRSIG-WIECHMANN
Keyword(s):  
Xenopus Laevis ◽  
Direct Action ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Amacrine Cells ◽  
Receptor Protein ◽  
Inner Plexiform Layer ◽  
Melatonin Receptor ◽  
Multiple Cell

In the retina of the African clawed frog (Xenopus laevis), melatonin is synthesized by the photoreceptors at night, and binds to receptors that likely mediate paracrine responses. Melatonin appears to alter the sensitivity of the retinal cells to light, and may play a key role in regulating important circadian events that occur in the eye. A polyclonal antibody was raised against a 13 amino acid peptide corresponding to a region of the third cytoplasmic loop of the Xenopus laevis Mel1c melatonin receptor. Western blot analysis revealed a major immunoreactive band of approximately 60 kD in neural retina and retinal pigment epithelium (RPE) membranes. Immunocytochemical labeling of sections of Xenopus eyes demonstrated intense melatonin receptor-like immunoreactivity in the inner plexiform layer (IPL). Immunolabeling with antibodies to glutamate decarboxylase (GAD) or tyrosine hydroxylase (TOH) appeared to co-localize with the melatonin receptor immunoreactivity in different sublaminas of the IPL. This suggests that both GABAergic and dopaminergic amacrine cells express melatonin receptor protein. There were also some melatonin receptor immunoreactive varicose fibers in the IPL that did not co-localize with either TOH or GAD, and may represent efferent fibers, since they could be followed into the optic nerve. Melatonin receptor immunoreactivity was also present on cell soma in the ganglion cell layer. Furthermore, a moderate level of melatonin receptor immunoreactivity was observed in the RPE and rod and cone photoreceptor cells. The presence of melatonin receptor immunoreactivity in these cells supports previous observations of melatonin receptor RNA expression in multiple cell types in the Xenopus retina. Expression of melatonin receptor protein in the photoreceptors suggests that melatonin may have a direct action on these cells.

Calcium gradients and light-evoked calcium changes outside rods in the intact cat retina

1994 ◽  
Vol 11 (4) ◽  
pp. 753-761 ◽  
Author(s):  
Ron P. Gallemore ◽  
Jian-Dong Li ◽  
Victor I. Govardovskii ◽  
Roy H. Steinberg
Keyword(s):  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Rapid Onset ◽  
Subretinal Space ◽  
Inner Plexiform Layer ◽  
Rod Outer Segments ◽  
Volume Increase ◽  
Cat Retina ◽  
Dependent Sources

AbstractWe have studied light-evoked changes in extracellular Ca2+ concentration in the intact cat eye using ion-sensitive double-barreled microelectrodes. Two prominent changes in Ca2+ concentration were observed that differed in retinal location. There was a light-evoked increase in accompanied by brief ON and OFF transients, which was maximal in the inner plexiform layer and was not further studied. There was an unexpected sustained light-evoked decrease in of relatively rapid onset and offset, which was maximal in the distalmost region of the subretinal space (SRS). in the SRS was 1.0 mM higher than in the vitreous humor during dark adaptation and this transretinal gradient disappeared during rod-saturating illumination. After correcting for the light-evoked increase in the volume of the SRS, an increase in the total Ca2+ content of the SRS during illumination was revealed, which presumably represents the Ca2+ released by rods. To explain the light-evoked changes, we used the diffusion model described in the accompanying paper (Li et al., 1994b), with the addition of light-dependent sources of Ca2+ at the retina/retinal pigment epithelium (RPE) border and rod outer segments. We conclude that a drop in around photoreceptors, which persists during illumination and reduces a transretinal Ca2+ gradient, is the combined effect of the light-evoked SRS volume increase, Ca2+ release from photoreceptors, and an unidentified mechanism(s), which is presumably Ca2+ transport by the RPE. The relatively rapid onset and offset of the decrease remains unexplained. These steady-state shifts in should have significant effects on photoreceptor function, especially adaptation.

scholarly journals Association between Visual Acuity and Retinal Layer Metrics in Diabetics with and without Macular Edema

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
LakshmiPriya Rangaraju ◽  
Xuejuan Jiang ◽  
J. Jason McAnany ◽  
Michael R. Tan ◽  
Justin Wanek ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Layer Thickness ◽  
Pigment Epithelium ◽  
Outer Nuclear Layer ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Retinal Layer ◽  
Inner Plexiform Layer ◽  
Retinal Microvasculature

Purpose. Diabetes is known to cause alterations in retinal microvasculature and tissue that progressively lead to visual impairment. Optical coherence tomography (OCT) is useful for assessment of total retinal thickening due to diabetic macular edema (DME). In the current study, we determined associations between visual acuity (VA) and retinal layer thickness, reflectance, and interface disruption derived from enface OCT images in subjects with and without DME. Materials and Methods. Best corrected VA was measured and high-density OCT volume scans were acquired in 149 diabetic subjects. A previously established image segmentation method identified retinal layer interfaces and locations of visually indiscernible (disrupted) interfaces. Enface thickness maps and reflectance images of the nerve fiber layer (NFL), combined ganglion cell and inner plexiform layer (GCLIPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor outer segment layer (OSL), and retinal pigment epithelium (RPE) were generated in the central macular subfield. The associations among VA and retinal layer metrics were determined by multivariate linear regressions after adjusting for covariates (age, sex, race, HbA1c, diabetes type, and duration) and correcting for multiple comparisons. Results. In DME subjects, increased GCLIPL and OPL thickness and decreased OSL thickness were associated with reduced VA. Furthermore, increased NFL reflectance and decreased OSL reflectance were associated with reduced VA. Additionally, increased areas of INL and ONL interface disruptions were associated with reduced VA. In subjects without DME, increased INL thickness was associated with reduced VA, whereas in subjects without DME but with previous antivascular endothelium growth factor treatment, thickening of OPL was associated with reduced VA. Conclusions. Alterations in retinal layer thickness and reflectance metrics derived from enface OCT images were associated with reduced VA with and without presence of DME, suggestive of their potential for monitoring development, progression, and treatment of DME.

scholarly journals Optical Coherence Tomography Findings (SD-OCT and OCTA) in Early-Stage Type 3 Neovascularization

2020 ◽  
Vol 11 (2) ◽  
pp. 493-499
Author(s):  
Nisa Silva ◽  
Ana Marta ◽  
Pedro Baptista ◽  
Maria João Furtado ◽  
Miguel Lume
Keyword(s):  
Optical Coherence Tomography ◽  
Early Stage ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Optical Coherence ◽  
Outer Retina ◽  
Type 3 Neovascularization ◽  
Intraretinal Fluid ◽  
Type 3 ◽  
Sd Oct

A 76-year-old male presented with a small hyperreflective density in the outer nuclear layer with subtle retinal pigment epithelium (RPE) elevation and few intraretinal cysts on spectral-domain optical coherence tomography (SD-OCT). Optical coherence tomography angiography (OCTA) confirmed the presence of a tuft-shaped intraretinal neovascular lesion. SD-OCT performed 2 months before showed a smaller RPE elevation at the same location without intraretinal fluid. A 79-year-old male presented with a small hyperreflective density in the outer retina surrounded by scant intraretinal fluid on SD-OCT and a bright vessel on OCTA, suggesting early-stage type 3 neovascularization. SD-OCT performed 2 months before showed a smaller hyperreflectivity at the same location, without intraretinal fluid. An 84-year-old female presented with hyperreflective foci in the outer retina overlying a serous pigment epithelium detachment (PED) with focal RPE disruption on SD-OCT. SD-OCT performed 2 months before showed the same hyperreflective lesion associated with a shallower PED. No neovascular lesions were found on OCTA after six injections of bevacizumab. To conclude, careful evaluation of SD-OCT allows for early detection of type 3 neovascularization at a pre-exudative stage. OCTA may be useful in confirming the presence of intraretinal neovascular lesion and monitoring response to anti-vascular endothelial growth factor agents.

scholarly journals Reduced vessel density in deep capillary plexus correlates with retinal layer thickness in choroideremia

2020 ◽  
pp. bjophthalmol-2020-316528
Author(s):  
Alessandro Arrigo ◽  
Francesco Romano ◽  
Maurizio Battaglia Parodi ◽  
Peter Charbel Issa ◽  
Johannes Birtel ◽  
...  
Keyword(s):  
Layer Thickness ◽  
Pigment Epithelium ◽  
Outer Nuclear Layer ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Vessel Density ◽  
Retinal Layer ◽  
Inner Plexiform Layer ◽  
Retinal Layers ◽  
Clinical Series

BackgroundTo assess retinal layer thickness in choroideremia (CHM) and to reveal its correlation with optical coherence tomography (OCT) angiography (OCTA) findings.MethodsThe study was designed as an observational, cross-sectional clinical series of patients with CHM, which included 14 CHM eyes and 14 age-matched controls. Multimodal imaging included OCT and OCTA. The vessel density (VD) of superficial capillary (SCP), deep capillary (DCP) and choriocapillaris (CC) plexuses was analysed by OCTA. The apparently preserved retinal islet and atrophic regions were investigated separately. Main outcome measures were as follows: best-corrected visual acuity (BCVA), total retinal layers, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), ellipsoid zone–retinal pigment epithelium (EZ-RPE) layer, choroidal thickness and VDs of SCP, DCP and of CC.ResultsMean BCVA was 0.0±0.0 LogMAR in both groups. GCL, ONL, EZ-RPE and choroid were significantly thinned in CHM, particularly in the atrophic region. OPL was unaffected in the apparently preserved islet, whereas INL and IPL were similarly thinned in the atrophic and apparently preserved retina. DCP appeared severely affected in both regions, while CC was only altered in the atrophic retina. Significant correlations were found between OCT and OCTA parameters.ConclusionsOur study showed severe alterations in both outer and inner retinal layers of patients with CHM. The extended retinal involvement might be the consequence of neuronal and vascular trophic factor reduction produced by the primarily altered RPE and/or secondary Müller glial cell reaction.

Neuroretinal atrophy following resolution of macular oedema in retinal vein occlusion

2018 ◽  
Vol 103 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Dominika Podkowinski ◽  
Ana-Maria Philip ◽  
Wolf-Dieter Vogl ◽  
Jutta Gamper ◽  
Hrvoje Bogunovic ◽  
...  
Keyword(s):  
Retinal Vein Occlusion ◽  
Macular Oedema ◽  
Pigment Epithelium ◽  
Outer Nuclear Layer ◽  
Retinal Pigment ◽  
Retinal Layer ◽  
Inner Plexiform Layer ◽  
Vein Occlusion ◽  
Retinal Atrophy ◽  
Retinal Thinning

Background/aimsTo characterise neuroretinal atrophy in retinal vein occlusion (RVO).MethodsWe included patients with central/branch RVO (CRVO=196, BRVO=107) who received ranibizumab according to a standardised protocol for 6 months. Retinal atrophy was defined as the presence of an area of retinal thickness (RT) <260 µm outside the foveal centre. Moreover, the thickness of three distinct retinal layer compartments was computed as follows: (1) retinal nerve fibre layer to ganglion cell layer, (2) inner plexiform layer (IPL) to outer nuclear layer (ONL) and (3) inner segment/outer segment junction to retinal pigment epithelium. To characterise atrophy further, we assessed perfusion status on fluorescein angiography and best-corrected visual acuity (BCVA), and compared these between eyes with/without atrophy.Results23 patients with CRVO and 11 patients with BRVO demonstrated retinal atrophy, presenting as sharply demarcated retinal thinning confined to a macular quadrant. The mean RT in the atrophic quadrant at month 6 was 249±26 µm (CRVO) and 244±29 µm (BRVO). Individual layer analysis revealed pronounced thinning in the IPL to ONL compartment. Change in BCVA at 6 months was similar between the groups (BRVO, +15 vs +18 letters; CRVO, +14 vs +18 letters).ConclusionsIn this exploratory analysis, we describe the characteristics of neuroretinal atrophy in RVO eyes with resolved macular oedema after ranibizumab therapy. Our analysis shows significant, predominantly retinal thinning in the IPL to ONL compartment in focal macular areas in 11% of patients with RVO. Eyes with retinal atrophy did not show poorer BCVA outcomes.

scholarly journals Intraretinal cysts in Macular Hole: A structure-function correlation based on en face imaging

2021 ◽  
Author(s):  
Unnikrishnan Nair ◽  
Jay Sheth ◽  
Asmita Indurkar ◽  
Manoj Soman
Keyword(s):  
Macular Hole ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Inner Plexiform Layer ◽  
Basal Diameter ◽  
En Face ◽  
Group 2 ◽  
Intraretinal Cysts ◽  
Group 1

Abstract This study determines and characterizes the role of retinal micromorphic changes on en-face optical-coherence tomography(OCT) in macular-hole(MH) surgery. Pre-and post-operative parameters including MH basal-diameter(BD) and minimal inlet-area(MIA), inner-plexiform layer(IPL) and outer-plexiform layer(OPL) cyst-area, IPL and OPL cyst-percentage, and amount of defect in ellipsoid-zone(EZ) and external-limiting membrane(ELM) were compared amongst 28 eyes undergoing successful MH surgery. Their relationship with visual-acuity(VA) outcomes(Group-1: ≥ 20/60;14 eyes; Group-2: < 20/60;14 eyes) was also evaluated. We noted a significant positive correlation between the OPL and IPL cyst-area(r = 0.768;p < 0.001), which in turn were positively correlated with the MH-BD in all eyes. The cyst area was significantly more in IPL as compared to OPL in all eyes (p = 0.049) and in group-2(p = 0.03), but not in group-1(p = 0.62). As compared to group-2, eyes in group-1 had significantly better pre-and post-operative-VA, and significantly smaller BD, MIA, IPL and OPL cyst-area, and ELM(post-operative) and EZ(Pre-and post-operative) defect, respectively. To conclude, an increase in the MH-BD is associated with a simultaneous congruous enlargement of the IPL and OPL cyst-area. The origin of intraretinal cysts could be secondary to breakdown in the physiological retinal-pigment epithelium(RPE) pump due to the anatomical separation of the neurosensory retina from the underlying RPE, i.e., "RPE contact-loss" theory.

Incidence and phenotypical variation of outer retina-associated hyperreflectivity in macular telangiectasia type 2

2021 ◽  
pp. bjophthalmol-2020-317997
Author(s):  
Stefanie Mueller ◽  
Frederic Gunnemann ◽  
Kai Rothaus ◽  
Marius Book ◽  
Henrik Faatz ◽  
...  
Keyword(s):  
Disease Severity ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Outer Retina ◽  
Macular Telangiectasia ◽  
Macular Telangiectasia Type 2 ◽  
Disease Severity Scale ◽  
Variable Presentation ◽  
Sd Oct

BackgroundMacular telangiectasia type 2 (MacTel) is a neurodegenerative disease resulting in photoreceptor loss. Optical coherence tomography (OCT) reveals outer retina-associated hyperreflectivity (ORaH) as part of this process. The purpose of this study was to describe the incidence and phenotypical variation of ORaH.MethodsDifferent parameters of ORaH were analysed: OCT characteristics (Spectralis SD-OCT), correlation with vascular changes (OCT angiography; OCTA 3×3 mm Optovue) and correlation with hyperpigmentation (autofluorescence/fundus images). ORaH was also evaluated regarding the grade of severity of photoreceptor loss (Disease Severity Scale).ResultsOf 220 eyes with MacTel type 2, 106 demonstrated ORaH. On OCT, the size, the extension into the inner retina and the contact with retinal pigment epithelium (RPE) of the ORaH were variable. On OCTA neovascularisation (NV) in the outer retina (OR) was present at the location of the ORaH in 97.6%. Increasing size of NV correlated with progressive photoreceptor loss. In 86.6% with NV, the flow signals were visible between the OR and the choriocapillaris. In 85.7%, the ORaH was associated with hyperpigmentation on autofluorescence and fundus colour images.ConclusionsThe presence of ORaH is associated with increasing photoreceptor loss and disease severity. In these more advanced cases of the present study, a variable presentation of ORaH in respect to size and form was seen, but in most cases, ORaH was in contact to the RPE. Additionally, ORaH was associated with hyperpigmentation and OR NV on OCTA. These results are consistent with the concept of ORaH representing fibrovascular OR-NV with RPE proliferation after contact with the RPE.

scholarly journals Normative Database for All Retinal Layer Thicknesses Using SD-OCT Posterior Pole Algorithm and the Effects of Age, Gender and Axial Lenght

2020 ◽  
Vol 9 (10) ◽  
pp. 3317
Author(s):  
Ana Palazon-Cabanes ◽  
Begoña Palazon-Cabanes ◽  
Elena Rubio-Velazquez ◽  
Maria Dolores Lopez-Bernal ◽  
Jose Javier Garcia-Medina ◽  
...  
Keyword(s):  
Axial Length ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Posterior Pole ◽  
Optic Disk ◽  
Retinal Layer ◽  
Inner Plexiform Layer ◽  
Normative Database ◽  
The Mean ◽  
Sd Oct

Our aim was to provide, for the first time, reference thickness values for the SD-OCT posterior pole algorithm (PPA) available for Spectralis OCT device (Heidelberg Engineering, Heidelberg, Germany) and to analyze the correlations with age, gender and axial length. We recruited 300 eyes of 300 healthy Caucasian subjects between 18 and 84 years. By PPA, composed of 64 (8 × 8) cells, we analyzed the thickness of the following macular layers: retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), inner retina, outer retina and full retina. Mean ± SD, 1st, 5th, 95th percentiles were obtained for each cell at all macular layers. Significant negative correlations were found between age and thickness for most macular layers. The mean thickness of most macular layers was thicker for men than women, except for RNFL, OPL and RPE, with no gender differences. GCL, IPL and INL thicknesses positively correlated with axial length in central cells, and negatively in the cells near the optic disk. The mean RNFL thickness was positively associated with axial length. This is the first normative database for PPA. Age, gender and axial length should be taken into account when interpreting PPA results.

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