Photoreceptor inner segment ellipsoid band integrity on spectral domain optical coherence tomography

Saxena, Sandeep; Srivastav, Khushboo; Cheung, Chui Ming Gemmy; Ng, Joanne Yw; Lai, Timothy Y. Y.

doi:10.2147/opth.s72132

Cited by 32 publications

(23 citation statements)

References 143 publications

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“…It now is possible to resolve multiple (typically 4) hyperreflective bands in the human outer retina. 7 – 9 Starting from the inner retina, these bands are termed the outer limiting membrane (OLM), inner segment (IS)/outer segment (OS) junction or IS/ellipsoid (IS/ep), 7 , 10 photoreceptor tips (PRT) in interaction with the RPE (retinal pigment epithelium) processes, and RPE cell and Bruch's membrane (BM) complex. 8 …”

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confidence: 99%

Light-Induced Thickening of Photoreceptor Outer Segment Layer Detected by Ultra-High Resolution OCT Imaging

Fariss

Qian

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PurposeWe examined if light induces changes in the retinal structure that can be observed using optical coherence tomography (OCT).MethodsNormal C57BL/6J mice (age 3–6 months) adapted to either room light (15 minutes to ∼5 hours, 50–500 lux) or darkness (overnight) were imaged using a Bioptigen UHR-OCT system. Confocal histologic images were obtained from mice killed under light- or dark-adapted conditions.ResultsThe OCT image of eyes adapted to room light exhibited significant increases (6.1 ± 0.8 μm, n = 13) in total retina thickness compared to the same eyes after overnight dark adaptation. These light-adapted retinal thickness changes occurred mainly in the outer retina, with the development of a hyporeflective band between the RPE and photoreceptor-tip layers. Histologic analysis revealed a light-evoked elongation between the outer limiting membrane and Bruch's membrane from 45.8 ± 1.7 μm in the dark (n = 5) to 52.1 ± 3.7 μm (n = 5) in the light. Light-adapted retinas showed an increase of actin staining in RPE apical microvilli at the same location as the hyporeflective band observed in OCT images. Elongation of the outer retina could be detected even with brief light exposures, increasing 2.1 ± 0.3 μm after 15 minutes (n = 9), and 4.1 ± 1.0 μm after 2 hours (n = 6). Conversely, dark-adaptation caused outer retinal shortening of 1.4 ± 0.4 μm (n = 7) and 3.0 ± 0.5 μm (n = 8) after 15 minutes and 2 hours, respectively.ConclusionsLight-adaption induces an increase in the thickness of the outer retina and the appearance of a hyporeflective band in the OCT image. This is consistent with previous reports of light-induced fluid accumulation in the subretinal space.

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confidence: 99%

Light-Induced Thickening of Photoreceptor Outer Segment Layer Detected by Ultra-High Resolution OCT Imaging

Fariss

Qian

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…An intact ELM may predict potential photoreceptor recovery. 15, 16 If true, and if SHRM causes loss of overlying photoreceptors, we speculate that treatments to resolve SHRM might allow VA to recover through photoreceptor regeneration. A detailed evaluation of changes over time in the integrity of photoreceptors overlying SHRM is beyond the current study scope.…”

Section: Discussionmentioning

confidence: 98%

Subretinal Hyperreflective Material in the Comparison of Age-Related Macular Degeneration Treatments Trials

Willoughby¹,

Ying²,

Toth³

et al. 2015

Ophthalmology

160

135

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Objective To evaluate the association of subretinal hyper-reflective material (SHRM) with visual acuity (VA), geographic atrophy (GA) and scar in the Comparison of Age related Macular Degeneration Treatments Trials (CATT) Design Prospective cohort study within a randomized clinical trial. Participants The 1185 participants in CATT. Methods Participants were randomly assigned to ranibizumab or bevacizumab treatment monthly or as-needed. Masked readers graded scar and GA on fundus photography and fluorescein angiography images, SHRM on time domain (TD) and spectral domain (SD) optical coherence tomography (OCT) throughout 104 weeks. Measurements of SHRM height and width in the fovea, within the center 1mm2, or outside the center 1mm2 were obtained on SD-OCT images at 56 (n=76) and 104 (n=66) weeks. VA was measured by certified examiners. Main Outcome Measures SHRM presence, location and size, and associations with VA, scar, and GA. Results Among all CATT participants, the percentage with SHRM at enrollment was 77%, decreasing to 68% at 4 weeks after treatment and 54% at 104 weeks. At 104 weeks, scar was present more often in eyes with persistent SHRM than eyes with SHRM that resolved (64% vs. 31%; p<0.0001). Among eyes with detailed evaluation of SHRM at weeks 56 (n=76) and 104 (n=66), mean [SE] VA letter score was 73.5 [2.8], 73.1 [3.4], 65.3 [3.5], and 63.9 [3.7] when SHRM was absent, present outside the central 1mm2, present within the central 1mm2 but not the foveal center, or present at the foveal center (p=0.02). SHRM was present at the foveal center in 43 (30%), within the central 1mm2 in 21 (15%) and outside the central 1mm2 in 19 (13%). When SHRM was present, the median maximum height in microns under the fovea, within the central 1 mm2 including the fovea and anywhere within the scan was 86; 120; and 122, respectively. VA was decreased with greater SHRM height and width (p<0.05). Conclusions SHRM is common in eyes with NVAMD and often persists after anti-VEGF treatment. At 2 years, eyes with scar were more likely to have SHRM than other eyes. Greater SHRM height and width were associated with worse VA. SHRM is an important morphological biomarker in eyes with NVAMD.

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“…In patients with STDG1, SD-OCT has allowed clinicians to accurately visualize the extent and the degree of the degeneration of both inner and outer retinal layers [ 13 – 15 ]. More specifically, ellipsoid zone extension can be considered an important imaging parameter that allows clinicians to evaluate to the extent of damage of macular photoreceptors [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation of Macular Focal Electroretinogram with Ellipsoid Zone Extension in Stargardt Disease

Abed

Placidi

Calandriello

et al. 2017

Journal of Ophthalmology

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Stargardt disease (STGD1) is the most common cause of inherited juvenile macular degeneration. This disease is characterized by a progressive accumulation of lipofuscin in the outer retina and subsequent loss of photoreceptors and retinal pigment epithelium. The aim of this study was to evaluate the relationship between cone photoreceptor function and structure in STGD1. Macular function was assessed by visual acuity measurement and focal electroretinogram (FERG) recording while spectral domain optical coherence tomography (SD-OCT) imaging was performed to evaluate the integrity of photoreceptors. FERG amplitude was significantly reduced in patients with Stargardt disease (p < 0.0001). The amplitude of FERG showed a negative relationship with interruption of ellipsoid zone (EZ) (R2 = 0.54, p < 0.0001) and a positive correlation with average macular thickness (AMT). Conversely, visual acuity was only weakly correlated with central macular thickness (CMT) (R2 = 0.12, p = 0.04). In conclusion, this study demonstrates that FERG amplitude is a reliable indicator of macular cone function while visual acuity reflects the activity of the foveal region. A precise assessment of macular cone function by FERG recording may be useful to monitor the progression of STGD1 and to select the optimal candidates to include in future clinical trials to treat this disease.

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Photoreceptor inner segment ellipsoid band integrity on spectral domain optical coherence tomography

Cited by 32 publications

References 143 publications

Light-Induced Thickening of Photoreceptor Outer Segment Layer Detected by Ultra-High Resolution OCT Imaging

Light-Induced Thickening of Photoreceptor Outer Segment Layer Detected by Ultra-High Resolution OCT Imaging

Subretinal Hyperreflective Material in the Comparison of Age-Related Macular Degeneration Treatments Trials

Correlation of Macular Focal Electroretinogram with Ellipsoid Zone Extension in Stargardt Disease

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