Photoreceptor Impairment and Restoration on Optical Coherence Tomographic Image

With recent development of spectral-domain optical coherence tomography (SD-OCT), the pathological changes of retina can be observed in much greater detail. SD-OCT clearly delineates three highly reflective lines in the outer retina, which are external limiting membrane (ELM), photoreceptor inner and outer segment (IS/OS) junction, and cone outer segment tips (COST) in order from inside. These lines can serve as hallmarks for the evaluation of photoreceptor condition. In retinitis pigmentosa (RP) leading to photoreceptor degeneration, the ELM, IS/OS, and COST lines are shortened with the progression of the disease. In addition, shortening of the ELM, IS/OS and COST lines is significantly associated with each other. The line length is longest in the ELM, followed by the IS/OS, and COST, suggesting that retinal layer becomes disorganized first at the COST, followed by the IS/OS and finally the ELM. This finding is consistent with the previous report that the earliest histopathological change in RP is a shortening of the photoreceptor outer segments. On the other hand, retinal layer becomes restored first at the ELM, followed by the IS/OS and finally the COST after macular hole surgery. There may be a directionality of photoreceptor impairment or restoration on optical coherence tomographic image.

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Changes of outer retinal thickness with increasing age in normal eyes

International Eye Research ◽

10.18240/ier.2020.02.08 ◽

2020 ◽

Vol 1 (2) ◽

pp. 108-112

Author(s):

Zi-Jing Li ◽

◽

Jian-Hui Xiao ◽

Peng Zeng ◽

Xiang Gao ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Outer Segment ◽

Retinal Thickness ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Retinal Layer ◽

External Limiting Membrane ◽

The Cost ◽

The Relationship ◽

Sd Oct

AIM: To comprehensively investigate the relationship between outer retinal layer thickness and age in normal eyes. METHODS: One hundred normal eyes of 100 subjects who underwent spectral-domain optical coherence tomography (SD-OCT) were included in this retrospective study. The distances between the external limiting membrane (ELM) line and the photoreceptor inner segment/outer segment (IS/OS) line (ELM-IS/OS), the IS/OS line and the cone outer segment tips (COST) line (IS/OS-COST), the COST line and the retinal pigment epithelium (RPE) complex (COST-RPE) and the full retinal thickness (RT) were measured at the fovea and on four quarters. The relationship between thickness and age or sex was then analysed. CONCLUSION: In normal eyes, the RT thickness on the nasal quarter and the ELM-IS/OS thickness were significantly and negatively correlated with age. The IS/OS-COST and COST-RPE thicknesses were not significantly correlated with age or sex.

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External limiting membrane: retinal structural barrier in diabetic macular edema

International Journal of Retina and Vitreous ◽

10.1186/s40942-021-00284-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Sandeep Saxena ◽

Levent Akduman ◽

Carsten H. Meyer

Keyword(s):

Optical Coherence Tomography ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Spectral Domain ◽

Optical Coherence ◽

Barrier Effect ◽

External Limiting Membrane ◽

Ellipsoid Zone ◽

Structural Barrier ◽

Sd Oct

AbstractAdvances in spectral-domain optical coherence tomography (SD-OCT) technology have enhanced the understanding of external limiting membrane (ELM) and ellipsoid zone (EZ) in diabetic macular edema. An increase in VEGF has been demonstrated to be associated with sequential ELM and EZ disruption on SD-OCT. An intact ELM is a prerequisite for an intact EZ in DME. Anti-VEGF therapy leads to restoration of barrier effect of ELM. The ELM restores first followed by EZ restoration.

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Optical coherence tomography identifies outer retina thinning in frontotemporal degeneration

Neurology ◽

10.1212/wnl.0000000000004500 ◽

2017 ◽

Vol 89 (15) ◽

pp. 1604-1611 ◽

Cited By ~ 12

Author(s):

Benjamin J. Kim ◽

David J. Irwin ◽

Delu Song ◽

Ebenezer Daniel ◽

Jennifer D. Leveque ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Outer Nuclear Layer ◽

Retinal Layer ◽

Optical Coherence ◽

Outer Retina ◽

Frontotemporal Degeneration ◽

Cross Sectional ◽

Clinical Criteria ◽

Retinal Layers ◽

Sd Oct

Objective:Whereas Alzheimer disease (AD) is associated with inner retina thinning visualized by spectral-domain optical coherence tomography (SD-OCT), we sought to determine if the retina has a distinguishing biomarker for frontotemporal degeneration (FTD).Methods:Using a cross-sectional design, we examined retinal structure in 38 consecutively enrolled patients with FTD and 44 controls using a standard SD-OCT protocol. Retinal layers were segmented with the Iowa Reference Algorithm. Subgroups of highly predictive molecular pathology (tauopathy, TAR DNA–binding protein 43, unknown) were determined by clinical criteria, genetic markers, and a CSF biomarker (total tau: β-amyloid) to exclude presumed AD. We excluded eyes with poor image quality or confounding diseases. SD-OCT measures of patients (n = 46 eyes) and controls (n = 69 eyes) were compared using a generalized linear model accounting for intereye correlation, and correlations between retinal layer thicknesses and Mini-Mental State Examination (MMSE) were evaluated.Results:Adjusting for age, sex, and race, patients with FTD had a thinner outer retina than controls (132 vs 142 μm, p = 0.004). Patients with FTD also had a thinner outer nuclear layer (ONL) (88.5 vs 97.9 μm, p = 0.003) and ellipsoid zone (EZ) (14.5 vs 15.1 μm, p = 0.009) than controls, but had similar thicknesses for inner retinal layers. The outer retina thickness of patients correlated with MMSE (Spearman r = 0.44, p = 0.03). The highly predictive tauopathy subgroup (n = 31 eyes) also had a thinner ONL (88.7 vs 97.4 μm, p = 0.01) and EZ (14.4 vs 15.1 μm, p = 0.01) than controls.Conclusions:FTD is associated with outer retina thinning, and this thinning correlates with disease severity.

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Inner macular layer thickness by spectral domain optical coherence tomography in children and adults: a hospital-based study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312349 ◽

2019 ◽

Vol 103 (11) ◽

pp. 1576-1583 ◽

Cited By ~ 5

Author(s):

Yung Ju Yoo ◽

Jeong-Min Hwang ◽

Hee Kyung Yang

Keyword(s):

Optical Coherence Tomography ◽

Layer Thickness ◽

Male Gender ◽

Spectral Domain ◽

Retinal Layer ◽

Inner Plexiform Layer ◽

Optical Coherence ◽

Korean Children ◽

Factors Associated ◽

Sd Oct

PurposeTo establish the normative ranges of macular ganglion cell layer (mGCL) and macular inner plexiform layer (mIPL) thickness using Spectralis spectral domain optical coherence tomography (SD-OCT) (Heidelberg Engineering, Inc., Heidelberg, Germany) in both Korean children and adults, and to determine factors associated with mGCL and mIPL thickness.MethodsWe conducted a retrospective, observational study of 573 healthy subjects (5–70 years old) who underwent comprehensive ophthalmic examinations in a single institution. Each inner retinal layer thickness was measured using SD-OCT and automatic segmentation software. Cross-sectional analysis was used to evaluate the effect of gender, age and ocular parameters on mGCL and mIPL thickness. Normative ranges of mGCL and mIPL thickness according to age, gender and factors associated with mGCL and mIPL thickness were measured.ResultsThe mean mGCL and mIPL thickness were 40.6±2.8 and 33.8±2.0 µm, respectively. Determinants of inner sector mGCL thickness were circumpapillary retinal nerve fibre layer (cpRNFL) thickness (β=1.172, p<0.001), age (β=−0.019, p=0.021) and male gender (β=1.452, p<0.001). Determinants of inner sector mIPL thickness were cpRNFL (β=0.952, p<0.001) and male gender (β=1.163, p<0.001). The inner sector mGCL and mIPL thickness increased significantly with age in children (β=0.174, p=0.009 and β=0.115, p=0.013), and then decreased in adults (β=−0.070, p<0.001 and β=−0.024, p=0.032). In the case of outer sectors, mGCL and mIPL thickness were not significantly related to age and gender.ConclusionsThis study ensured a normative range of the mGCL and mIPL thickness using Spectralis OCT. Gender, age and cpRNFL thickness significantly correlated with mGCL and mIPL thickness. This information should be considered in the interpretation of SD-OCT data.

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Optical Coherence Tomography Angiography (OCT-A) in a Patient with Occult Retinal Dysfunction

Case Reports in Ophthalmological Medicine ◽

10.1155/2019/4349692 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Juliana Wons ◽

Jana Dinges ◽

Matthias D. Becker ◽

Stephan Michels

Keyword(s):

Optical Coherence Tomography ◽

Visual Field ◽

Near Infrared ◽

Infrared Imaging ◽

Imaging Techniques ◽

Visual Field Defects ◽

Retinal Layer ◽

Optical Coherence ◽

Large Area ◽

Sd Oct

Multimodal imaging techniques were performed in a patient with a newly emerged visual field defect; a missing retinal lesion on fundus examination made the diagnosis challenging but infrared imaging showed a larger area of retinal abnormality temporal to the fovea. Indocyanine green angiography (IA) showed late hypofluorescence and there was mild hyperautofluorescence which is known from acute zonal occult outer retinopathy (AZOOR). Despite normal fluorescein angiography (FA) results, a perfusion loss in the outer retinal layer was detected by OCT-A. Similar OCT-A findings were recently described in patients with acute macular neuroretinopathy (AMN). Methods. The methods included FA and IA, spectral domain optical coherence tomography (SD-OCT), near infrared imaging, and autofluorescence imaging (AF), as well as OCT-A. Patient. A 36-year-old patient who suffered from acute symptoms of photopsia and scotoma on her left eye. She had an influenza-like illness two weeks earlier. The scotoma could be verified by visual field testing. Results. The affected retinal zone showed mild fading of external limiting membrane (ELM) and a disorganisation of the ellipsoid zone (EZ) on SD-OCT. OCT-A revealed a large area of reduced perfusion in the outer retinal vascular layer. Conclusion. OCT-A can help to detect reduced capillary network in patients with visual field defects and no visible fundus changes. This case seems to have features of different occult retinal disorders such as AZOOR and AMN.

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Automatic Anisotropic Diffusion Filtering and Graph-search Segmentation of Macular Spectral-domain Optical Coherence Tomographic (SD-OCT) Images

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405613666171201155119 ◽

2019 ◽

Vol 15 (3) ◽

pp. 308-318 ◽

Cited By ~ 1

Author(s):

A. Usha ◽

Nijisha Shajil ◽

M. Sasikala

Keyword(s):

Anisotropic Diffusion ◽

Ground Truth ◽

Speckle Noise ◽

Graph Search ◽

Retinal Layer ◽

Optical Coherence ◽

Dijkstra Algorithm ◽

Image Processing Algorithm ◽

Cross Sectional ◽

Sd Oct

Background: Optical Coherence Tomography (OCT) is a non-invasive medical imaging technique that provides high-resolution cross-sectional images of the retina. There is a need to develop algorithms for obtaining quantitative and qualitative information about the retina which are essential for assessing and managing eye conditions. Methods: This work emphasizes on an automated image processing algorithm for segmenting retinal layers. It involves preprocessing of the acquired retinal SD-OCT image (B-scan) using the proposed automatic Anisotropic diffusion filter, followed with contrast stretching to suppress intrinsic speckle noise without blurring structural edges. Graph search segmentation using Dijkstra algorithm with a combination of threshold and axial gradient as the cost function is used to segment the retinal layer boundaries. Results: The algorithm was performed and the average thickness of the segmented retina was computed for the 3D retinal scan (128 B-scans) of 8 subjects (4 normal and 4 abnormal) using Early Treatment Diabetic Retinopathy Screening (ETDRS) chart. Conclusion: Segmentation was evaluated using manually segmented B-scan by an Ophthalmologist as ground truth and accuracy was found to be 99.14 ± 0.27%.

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Solar Retinopathy: A Multimodal Analysis

Case Reports in Ophthalmological Medicine ◽

10.1155/2013/906920 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Claudia Bruè ◽

Cesare Mariotti ◽

Edoardo De Franco ◽

Yale Fisher ◽

Jacopo Maria Guidotti ◽

...

Keyword(s):

Visual Acuity ◽

Outer Segment ◽

Fundus Autofluorescence ◽

Fundus Examination ◽

Outer Retina ◽

External Limiting Membrane ◽

Multimodal Analysis ◽

Morphological Findings ◽

Sd Oct

Purpose. Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT) findings are not always consistent. We report on two cases of solar retinopathy and discuss its differential diagnosis.Methods. This is an observational case study.Results. A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autofluorescence showed hypoautofluorescence surrounded by a relatively hyperautofluorescent ring, bilaterally. Similar clinical and morphological findings were detected in a 27-year-old male.Conclusions. Solar retinopathy has a subtle presentation and patients often deny sun-gazing. SD-OCT and fundus autofluorescence are noninvasive and useful tools for its diagnosis.

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The Application of OCTA in Assessment of Anti-VEGF Therapy for Idiopathic Choroidal Neovascularization

Journal of Ophthalmology ◽

10.1155/2016/5608250 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Qin Chen ◽

Xiaobing Yu ◽

Zihan Sun ◽

Hong Dai

Keyword(s):

Optical Coherence Tomography ◽

Choroidal Neovascularization ◽

Retinal Layer ◽

Therapeutic Effects ◽

Optical Coherence ◽

Flow Area ◽

Anti Vegf ◽

Endothelial Growth Factor ◽

Sd Oct

Purpose. To assess the morphology of idiopathic choroidal neovascularization (ICNV) by optical coherence tomography angiography (OCTA) and determine the therapeutic effects of intravitreal antivascular endothelial growth factor (anti-VEGF).Method. Patients with naive ICNV were assessed by spectral domain optical coherence tomography (SD-OCT) and OCTA in this observational study. The timing of observation was before treatment, 1 day after treatment with intravitreal anti-VEGF injection, and 1 month after the treatment. The central retina thickness (CRT) on SD-OCT, selected CNV area, and flow area on OCTA were measured.Results. A total of 17 eyes from 17 patients with ICNV were included in this study. OCTA showed visible irregular choroidal neovascularization with “tree-in-bud” form on outer retinal layer. After treatment, as well as in the 1-day follow-up, CNV decreased in size from the periphery, and the vessel density was reduced. As shown on OCTA, the selected CNV area and flow area were significantly reduced compared to pretreatment. The rate of CNV vessel area changes was higher on OCTA than the changes in CRT on SD-OCT at 1-day and 1-month follow-up.Conclusion. Intravitreal injection of anti-VEGF is effective for idiopathic choroidal neovascularization, and the treatment outcomes are observable after 1 day. OCTA provides a useful approach for monitoring and evaluating the treatment of intravitreal anti-VEGF for CNV.

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Macular capillary plexuses after epiretinal membrane surgery: an optical coherence tomography angiography study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311188 ◽

2017 ◽

Vol 102 (8) ◽

pp. 1086-1091 ◽

Cited By ~ 20

Author(s):

Yoon Jeon Kim ◽

Seungmo Kim ◽

Joo Yong Lee ◽

June-Gone Kim ◽

Young Hee Yoon

Keyword(s):

Optical Coherence Tomography ◽

Epiretinal Membrane ◽

Optical Coherence Tomography Angiography ◽

Vascular Density ◽

Retinal Layer ◽

Optical Coherence ◽

Vascular Integrity ◽

Capillary Plexus ◽

Fellow Eyes ◽

Sd Oct

AimsTo investigate macular vascular integrity using optical coherence tomography angiography (OCTA) in patients undergoing vitrectomy for idiopathic epiretinal membrane (ERM) removal and to determine its association with structural and visual outcomes.MethodsForty-three patients with unilateral ERM who were followed for ≥6 months after surgery were included. Ophthalmological evaluations included best-corrected visual acuity (BCVA) and spectral-domain OCT (SD-OCT) before surgery and 6 months after surgery. We obtained en face OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) for both eyes 6 months after ERM removal. We compared eyes with ERM to unaffected fellow eyes as controls and used interocular differences in the analyses.ResultsCompared with the fellow eyes, eyes with ERM after surgery had a lower parafoveal vascular density (VD) and a smaller foveal avascular zone (FAZ) area in both SCP and DCP (all p<0.001). Interocular differences in the FAZ area and parafoveal VD were correlated with preoperative and postoperative central foveal thicknesses (all p<0.05). In addition, interocular differences in macular vascular integrity had a tendency to be correlated with SD-OCT parameters of the inner retinal layers. Finally, greater interocular differences in the FAZ area and parafoveal VD of both plexuses were significantly associated with worse postoperative BCVAs (all p<0.05).ConclusionsAssessing macular capillary plexuses via OCTA may be useful to quantify structural changes of the inner retinal layer and predict visual function in patients undergoing ERM removal surgery.

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Correlation between Retinal Changes and Visual Function in Late-Stage Vogt-Koyanagi-Harada Disease: An Optical Coherence Tomography Study

Journal of Ophthalmology ◽

10.1155/2015/916485 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Min Zhou ◽

Chunhui Jiang ◽

Ruiping Gu ◽

Zhongcui Sun ◽

Nancy Huynh ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Late Stage ◽

Visual Function ◽

Outer Segment ◽

High Dose ◽

Retinal Sensitivity ◽

Optical Coherence ◽

Macular Function ◽

The Cost ◽

Vkh Disease

Purpose.To characterize the optical coherence tomography (OCT) findings in late-stage Vogt-Koyanagi-Harada (VKH) disease and its correlation with visual function.Methods.The records of patients with late-stage VKH disease (defined as ≥12 months from disease onset) were retrospectively reviewed. The analysis focused on the OCT findings and microperimetry, in addition to the possible correlation between morphology and functional findings.Results.Twenty-nine patients (58 eyes) were included. Mean age at onset was 34.24 ± 10.67 years. The OCT revealed that the outer retina and retinal pigment epithelium (RPE) were mainly affected. These effects included RPE thickening and breakage or disappearance of the cone outer segment tip (COST) line and/or inner segment/outer segment (IS/OS) junction. The COST line and IS/OS results were related to macular function and the interval between symptom onset and initiation of high-dose corticosteroid treatment (allP<0.01). Eyes with intact COST lines demonstrated intact IS/OS and normal RPE layers as well as better visual function and normal retinal sensitivity.Conclusions.The OCT findings are strongly correlated with macular function, as well as other clinical findings in late-stage VKH. With respect to the COST line and retinal sensitivity especially, the OCT and microperimetry findings may be useful for evaluating later-stage VKH.

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