Evaluation of focal damage in the retinal pigment epithelium layer in serous retinal pigment epithelium detachment

Abstract

The purpose of this study was to evaluate focal damage in the retinal pigment epithelium (RPE) layer in serous retinal pigment epithelium detachment (PED) with multi-contrast optical coherence tomography (OCT), which is capable of simultaneous measurement of OCT angiography, polarization-sensitive OCT and standard OCT images. We evaluated 37 eyes with age-related macular degeneration that had serous PED. Focal RPE damage was indicated by hyper-transmission beneath the RPE-Bruch’s membrane band in standard OCT images. Distribution of RPE melanin was calculated using the dataset from multi-contrast OCT. Twenty-four points with hyper-transmission were detected in 21 of the 37 eyes. Standard OCT images failed to show disruption of the RPE-Bruch’s membrane band at 5 of the 24 hyper-transmission points. Conversely, multi-contrast OCT images clearly showed melanin defects in the RPE-Bruch’s membrane band at all points. Areas of melanin defects with disruption of the RPE-Bruch’s membrane band were significantly larger than those without disruption. The volume of intraretinal hyper-reflective foci was significantly larger in eyes with hyper-transmission than that in eyes without hyper-transmission. Multi-contrast OCT is more sensitive than standard OCT for displaying changes at the RPE-Bruch’s membrane band when there are small areas of RPE damage.

Evaluation of Retinal Pigment Epithelium Layer Change in Vogt-Koyanagi-Harada Disease With Multicontrast Optical Coherence Tomography

“…Multimodal imaging techniques, including MC-OCT, could be applicable in various macular diseases, such as age-related macular degeneration. 19,21 Furthermore, MC-OCT can simultaneously provide standard OCT and OCT angiography images 20,23 ; hence, MC-OCT has potential to be an all-in-one tool for 3D retinal imaging, and a promising tool for the clinical evaluation of macular diseases.…”

“…16 A chorioretinal melanin thickness map was created by counting the number of pixels with low DOPU (<0.8) at each A-line in the 3D dataset. 17,19 A chorioretinal melanin thickness map represents the overall thickness of melanin in the choroid and RPE. For automatic segmentation of RPE-melanin, we computed a new index (F RPE ) 21 using an attenuation coefficient, 27 the DOPU, 25 and the blood flow signal in OCT angiography, 26 as…”

“…18 However, the evaluation of melanin in RPE (RPE-melanin) with PS-OCT has some limitations, due to the inability to discriminate between melanin in the RPE and that in the choroid. 19 Discrimination of RPE-melanin in PS-OCT imaging is important for the proper evaluation of RPE changes in chronic VKH disease.…”

Clinical multi-functional OCT for retinal imaging

“…Several clinical studies using clinical multi-functional OCT prototypes have been reported [27,42,43]. The images of multiple properties obtained by JM-OCT can be used to generate "synthetic images."…”

“…For instance, an RPE-melanin image can be generated by synthesizing attenuation, OCTA, and DOPU images obtained by JM-OCT [44]. This approach enables easier and more comprehensive interpretation of JM-OCT data [43]. Hence, JM-OCT is a promising modality for clinical applications.…”