Assessment of the Deformation of the Outer Nuclear Layer in the Epiretinal Membrane Using Spectral-Domain Optical Coherence Tomography

Abstract Background We aimed to investigate the deformation of the outer nuclear layer using optical coherence tomography in patients with epiretinal membrane (ERM) and its relationship with metamorphopsia. Methods Thirty-nine eyes from 39 patients with ERM were included in the study. Patients with the subtypes of pseudo macula hole and lamellar hole were excluded. Twenty-one fellow eyes without macular disease were included as normal controls. Forty-nine B-scan images were obtained in the range of 20 degrees around the macula using SD-OCT. The outer nuclear layer (ONL) was evaluated as a three-dimensional image (3D-ONL) reconstructed using the distance between the ONL and retinal pigment epithelium (RPE) line. The deformation of the ONL was figured at the reference plane and evaluation plane (ONL-B). The characteristic parameters of the ONL-B were defined as circularity, area ratio, and axis ratio. The correlations between these parameters and visual acuity and MCHART score ratio (MH/MV) were then evaluated. Results ONL height was significantly higher in ERM patients than in normal controls (54.1 ± 5.3 μm and 84.1 ± 12.9 μm, respectively; P<0.001). In ERM patients, the MV score was 0.53 ± 0.50, the MH score was 0.71 ± 0.61, and the distance from the RPE line to the ONL-B was 153.5 ±13.5µm. The axis of the ONL-B in normal controls and ERM patients was -6.25±21.8 and -1.28±29.1, respectively, which indicates that the ONL is horizontally long in both normal individuals and ERM patients. The circularity and area ratio were significantly smaller in ERM patients than in normal controls. In all ERM patients, MH/MV had a significant correlation with axis (r=-0.29, p=0.034), circularity (r=-0.28, p=0.044), area ratio (r=-0.47, p=0.001). Moreover, we found that the correlation was more significant if the subjects had an axis of the ONL within ± 10 degrees (n=16); the correlations of MH/MV with axis (r=-0.29, p=0.034), circularity (r=-0.53, p=0.021), and area ratio were more significant (r=-0.78, P<0.0001). Conclusion The ONL is horizontally long in normal individuals and ERM patients. The direction of metamorphopsia is correlated with the direction of ONL deformation.

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Assessment of the Deformation of the Outer Nuclear Layer in the Epiretinal Membrane Using Spectral-Domain Optical Coherence Tomography

10.21203/rs.2.281/v4 ◽

2019 ◽

Author(s):

Seiji Takagi ◽

Shigeki Kudo ◽

Hideo Yokota ◽

Masahiro Akiba ◽

Michiko Mandai ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Epiretinal Membrane ◽

Outer Nuclear Layer ◽

Retinal Pigment ◽

Area Ratio ◽

Reference Plane ◽

Optical Coherence ◽

Axis Ratio ◽

Normal Individuals ◽

Normal Controls

Abstract Background We aimed to investigate the deformation of the outer nuclear layer using optical coherence tomography in patients with epiretinal membrane (ERM) and its relationship with metamorphopsia. Methods Thirty-nine eyes from 39 patients with ERM were included in the study. Patients with the subtypes of pseudo macula hole and lamellar hole were excluded. Twenty-one fellow eyes without macular disease were included as normal controls. Forty-nine B-scan images were obtained in the range of 20 degrees around the macula using SD-OCT. The outer nuclear layer (ONL) was evaluated as a three-dimensional image (3D-ONL) reconstructed using the distance between the ONL and retinal pigment epithelium (RPE) line. The deformation of the ONL was figured at the reference plane and evaluation plane (ONL-B). The characteristic parameters of the ONL-B were defined as circularity, area ratio, and axis ratio. The correlations between these parameters and visual acuity and MCHART score ratio (MH/MV) were then evaluated. Results ONL height was significantly higher in ERM patients than in normal controls (54.1 ± 5.3 μm and 84.1 ± 12.9 μm, respectively; P<0.001). In ERM patients, the MV score was 0.53 ± 0.50, the MH score was 0.71 ± 0.61, and the distance from the RPE line to the ONL-B was 153.5 ±13.5µm. The axis of the ONL-B in normal controls and ERM patients was -6.25±21.8 and -1.28±29.1, respectively, which indicates that the ONL is horizontally long in both normal individuals and ERM patients. The circularity and area ratio were significantly smaller in ERM patients than in normal controls. In all ERM patients, MH/MV had a significant correlation with axis (r=-0.29, p=0.034), circularity (r=-0.28, p=0.044), area ratio (r=-0.47, p=0.001). Moreover, we found that the correlation was more significant if the subjects had an axis of the ONL within ± 10 degrees (n=16); the correlations of MH/MV with axis (r=-0.29, p=0.034), circularity (r=-0.53, p=0.021), and area ratio were more significant (r=-0.78, P<0.0001). Conclusion The ONL is horizontally long in normal individuals and ERM patients. The direction of metamorphopsia is correlated with the direction of ONL deformation.

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Assessment of the Deformation of the Outer Nuclear Layer in the Epiretinal Membrane Using Spectral-Domain Optical Coherence Tomography

10.21203/rs.2.281/v3 ◽

2019 ◽

Author(s):

Seiji Takagi ◽

Shigeki Kudo ◽

Hideo Yokota ◽

Masahiro Akiba ◽

Michiko Mandai ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Epiretinal Membrane ◽

Outer Nuclear Layer ◽

Retinal Pigment ◽

Area Ratio ◽

Reference Plane ◽

Optical Coherence ◽

Axis Ratio ◽

Normal Individuals ◽

Normal Controls

Abstract Background We aimed to investigate the deformation of the outer nuclear layer using optical coherence tomography in patients with epiretinal membrane (ERM) and its relationship with metamorphopsia. Methods Thirty-nine eyes from 39 patients with ERM were included in the study. Patients with the subtypes of pseudo macula hole and lamellar hole were excluded. Twenty-one fellow eyes without macular disease were included as normal controls. Forty-nine B-scan images were obtained in the range of 20 degrees around the macula using SD-OCT. The outer nuclear layer (ONL) was evaluated as a three-dimensional image (3D-ONL) reconstructed using the distance between the ONL and retinal pigment epithelium (RPE) line. The deformation of the ONL was figured at the reference plane and evaluation plane (ONL-B). The characteristic parameters of the ONL-B were defined as circularity, area ratio, and axis ratio. The correlations between these parameters and visual acuity and MCHART score ratio (MH/MV) were then evaluated. Results ONL height was significantly higher in ERM patients than in normal controls (54.1 ± 5.3 μm and 84.1 ± 12.9 μm, respectively; P<0.001). In ERM patients, the MV score was 0.53 ± 0.50, the MH score was 0.71 ± 0.61, and the distance from the RPE line to the ONL-B was 153.5 ±13.5µm. The axis of the ONL-B in normal controls and ERM patients was -6.25±21.8 and -1.28±29.1, respectively, which indicates that the ONL is horizontally long in both normal individuals and ERM patients. The circularity and area ratio were significantly smaller in ERM patients than in normal controls. In all ERM patients, MH/MV had a significant correlation with axis (r=-0.29, p=0.034), circularity (r=-0.28, p=0.044), area ratio (r=-0.47, p=0.001). Moreover, we found that the correlation was more significant if the subjects had an axis of the ONL within ± 10 degrees (n=16); the correlations of MH/MV with axis (r=-0.29, p=0.034), circularity (r=-0.53, p=0.021), and area ratio were more significant (r=-0.78, P<0.0001). Conclusion The ONL is horizontally long in normal individuals and ERM patients. The direction of metamorphopsia is correlated with the direction of ONL deformation.

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Assessment of the deformation of the outer nuclear layer in the Epiretinal membrane using spectral-domain optical coherence tomography

BMC Ophthalmology ◽

10.1186/s12886-019-1124-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Seiji Takagi ◽

Shigeki Kudo ◽

Hideo Yokota ◽

Masahiro Akiba ◽

Michiko Mandai ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Epiretinal Membrane ◽

Outer Nuclear Layer ◽

Spectral Domain ◽

Optical Coherence

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B-Scan and “En-Face” Spectral-Domain Optical Coherence Tomography Imaging for the Diagnosis and Followup of Acute Retinal Pigment Epitheliitis

Case Reports in Medicine ◽

10.1155/2013/260237 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Flore De Bats ◽

Benjamin Wolff ◽

Martine Mauget-Faÿsse ◽

Claire Scemama ◽

Laurent Kodjikian

Keyword(s):

Optical Coherence Tomography ◽

Indocyanine Green ◽

Structural Damage ◽

Outer Nuclear Layer ◽

Retinal Pigment ◽

Spectral Domain ◽

Optical Coherence ◽

En Face Oct ◽

En Face ◽

Sd Oct

Purpose. To report B-scan and “En-face” spectral-domain optical coherence tomography (SD-OCT) findings in acute retinal pigment epitheliitis (ARPE).Methods. Two patients (3 eyes) with ARPE were examined. Fluorescein and indocyanine green (ICGA) angiography, B-scan, and “En-face” SD-OCT were performed in each patient at initial and follow-up visits.Results. Both patients presented with acute onset of blurred vision, and one with bilateral involvement. B-can OCT revealed disruption of the macular retinal pigment epithelial (RPE) inner band layer and photoreceptors’ inner and outer segment (IS-OS) junction. Hyperreflective dots were observed in the outer nuclear layer (ONL) above the RPE/IS-OS disruption. Just around these hyperreflective dots, slight thickening of the hyperreflective IS/OS junction was observed. During the late phase, indocyanine green angiography (ICGA) showed a macular cockade-like hyperfluorescent halo. “En-face” OCT showed the same cockade-like appearance with a hyporeflective center and a hyperreflective border matching the pattern observed on ICGA. At followup, as vision improved without treatment, B-scan OCT demonstrated progressive resolution of the hyperreflective and disrupted lesions; “en-face” OCT also showed disappearance of the macular cockade-like halo with a transient discrete hyperreflective macular star at the RPE level in one eye.Conclusion. “En-face” OCT associated with B-scan SD-OCT analysis appears to be very helpful in the diagnosis and followup of ARPE. The pathophysiology of ARPE remains complex and still poorly understood. These techniques help define the location and extent of structural damage occurring in this disease.

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Acute Retinal Pigment Epitheliitis: Spectral Domain Optical Coherence Tomography, Fluorescein Angiography, and Autofluorescence Findings

Case Reports in Medicine ◽

10.1155/2015/149497 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Tuğba Aydoğan ◽

Esra Güney ◽

Betül İlkay Sezgin Akçay ◽

Tahir Kansu Bozkurt ◽

Cihan Ünlü ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Fluorescein Angiography ◽

Pigment Epithelium ◽

Outer Nuclear Layer ◽

Fundus Autofluorescence ◽

Retinal Pigment ◽

Spectral Domain ◽

Fundus Examination ◽

Optical Coherence ◽

Sd Oct

A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes’ best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA) showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF) was slightly increased. Spectral domain optical coherence tomography (SD-OCT) showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL). One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.

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Macular Electroretinography and Methods of Retina Visualization in Diagnostics of Standard Stargardt Disease, Verified by Molecular Genetic Methods

Journal of New Medical Technologies eJournal ◽

10.12737/2827 ◽

2014 ◽

Vol 8 (1) ◽

pp. 1-8

Author(s):

Стрельников ◽

V. Strelnikov ◽

Рогова ◽

S. Rogova ◽

Егорова ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Wave Amplitude ◽

Structural Changes ◽

Pigment Epithelium ◽

Outer Nuclear Layer ◽

Retinal Pigment ◽

Molecular Genetic ◽

Posterior Pole ◽

Optical Coherence ◽

Transverse Defect

The aim of the study was to assess the data concerning the modern methods of retina visualization (optical coherence tomography and autofluorescence) and its interrelation with the data concerning the modern elec-troretinographic methods for research of Stargardt desease, verified with the help of molecular genetic methods. It was found that the shift of macular electroretinogramm to the red stimulus correlates with the parameters of optic coherent tomography: inverse high correlation between the "transverse defect" and a-wave amplitude of macular electroretinogramm (r=-0,83, p<0,01), thus indicating interconnection between lowering of photoreceptor function and structural changes of junction between outer and inner photoreceptor segments. Correlation between the "transverse defect" and b-wave amplitude of macular electroretinogramm (r=-0,37, p<0,01) proves the existence of interrelation between electrogenesis of middle retina layers (bipolar cells) in fovea and biometrical markers of structural changes in photoreceptors caused by Stargardt desease. The hallmarks of Stargardt desease, revealed by the optical coherence tomography, are the hyperreflective spots, localized in retinal pigment epithelium and reaching the outer nuclear layer, together with the damaged interface line of the outer and inner photoreceptors segments. Autofluoresence caused by Stargardt desease demonstrates combination of hypofluorescence in fovea with hypofluorescence in the posterior pole. For the first time the following etiologic mutations of ABCA4 gene, associated with Stargardt desease were revealed in Russian population: rsl800553 (Glyl961Glu), rs61752418 (Aspl093Gly), rs61751374 (Alal038Val), rs201471607 (Asn965Ser), rsl801581 (Arg943Gln), rs75197161 (Gly863Ala delG863), rs76157638 (Arg653Cys) и rs61751392 (Leu541Pro) ABCA4.

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Clinical and Optical Coherence Tomography Analysis of Intraretinal Microcysts in Patients with Epiretinal Membrane

Seminars in Ophthalmology ◽

10.1080/08820538.2021.1906915 ◽

2021 ◽

pp. 1-7

Author(s):

Mete Güler ◽

Selma Urfalıoğlu ◽

Elif Damar Güngör ◽

Emine Atalay ◽

Gökhan Köküsarı

Keyword(s):

Optical Coherence Tomography ◽

Epiretinal Membrane ◽

Optical Coherence ◽

Tomography Analysis

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Inner Retinal Morphology and Visual Outcomes in Idiopathic Epiretinal Membrane Surgery: A Retrospective Optical Coherence Tomography Study

Journal of VitreoRetinal Diseases ◽

10.1177/2474126421989614 ◽

2021 ◽

pp. 247412642198961

Author(s):

Ioannis S. Dimopoulos ◽

Michael Dollin

Keyword(s):

Optical Coherence Tomography ◽

Epiretinal Membrane ◽

Strong Predictor ◽

Plexiform Layer ◽

Inner Plexiform Layer ◽

Optical Coherence ◽

Visual Outcomes ◽

Retinal Pathology

Purpose: Epiretinal membrane (ERM) is a common retinal finding for patients older than 50 years. Disorganization of the retinal inner layers (DRIL) has emerged as a novel predictor of poor visual acuity (VA) in eyes with inner retinal pathology. The aim of our study is to correlate preoperative DRIL with visual outcomes after ERM surgery. Methods: Medical records and optical coherence tomography (OCT) images of 81 pseudophakic patients who underwent treatment of idiopathic ERM were reviewed. Preoperative DRIL on OCT was correlated with VA at baseline and at 3 and 6 months after ERM surgery. DRIL was defined as the loss of distinction between the ganglion cell–inner plexiform layer complex, inner nuclear layer, and outer plexiform layer. DRIL severity was based on its extent within the central 2-mm region of a transfoveal B-scan (absent/mild: <one-third, severe: >one-third horizontal width). Results: Review of preoperative OCT showed severe DRIL in 41% and absent/mild DRIL in 59%. Severe DRIL was associated with worse baseline VA ( P < .001). Preoperative VA and DRIL status at baseline were both predictors of postoperative VA at follow-up time points ( P < .001). Severe DRIL was associated with significantly less improvement in VA at 6 months (–0.23 logMAR for absent/mild vs –0.14 for severe DRIL). Conclusions: Presence of severe preoperative DRIL correlates with worse baseline VA in patients with ERM and reduced VA improvement at 6 months. DRIL can be a strong predictor of long-term poor visual outcomes in ERM surgery.

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En face image-based classification of diabetic macular edema using swept source optical coherence tomography

Scientific Reports ◽

10.1038/s41598-021-87440-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Atsushi Fujiwara ◽

Yuki Kanzaki ◽

Shuhei Kimura ◽

Mio Hosokawa ◽

Yusuke Shiode ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Outer Nuclear Layer ◽

Subretinal Fluid ◽

Plexiform Layer ◽

Optical Coherence ◽

Fiber Layer ◽

Swept Source ◽

En Face

AbstractThis retrospective study was performed to classify diabetic macular edema (DME) based on the localization and area of the fluid and to investigate the relationship of the classification with visual acuity (VA). The fluid was visualized using en face optical coherence tomography (OCT) images constructed using swept-source OCT. A total of 128 eyes with DME were included. The retina was segmented into: Segment 1, mainly comprising the inner nuclear layer and outer plexiform layer, including Henle’s fiber layer; and Segment 2, mainly comprising the outer nuclear layer. DME was classified as: foveal cystoid space at Segment 1 and no fluid at Segment 2 (n = 24), parafoveal cystoid space at Segment 1 and no fluid at Segment 2 (n = 25), parafoveal cystoid space at Segment 1 and diffuse fluid at Segment 2 (n = 16), diffuse fluid at both segments (n = 37), and diffuse fluid at both segments with subretinal fluid (n = 26). Eyes with diffuse fluid at Segment 2 showed significantly poorer VA, higher ellipsoid zone disruption rates, and greater central subfield thickness than did those without fluid at Segment 2 (P < 0.001 for all). These results indicate the importance of the localization and area of the fluid for VA in DME.

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