Spectral-domain optical coherence tomography images of inner/outer segment junctions and macular hole surgery outcomes

Inoue, Maiko; Watanabe, Yoichiro; Arakawa, Akira; Sato, Shimpei; Kobayashi, Satoshi; Kadonosono, Kazuaki

doi:10.1007/s00417-008-0999-9

Cited by 137 publications

(111 citation statements)

References 24 publications

(13 reference statements)

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“…Similarly, other previously published studies [1][2][3] have identified the integrity of the IS-OS as correlating with the visual outcome. Chalam et al 2 reported that all patients who had a postoperative BCVA improvement of Z2 lines had a continuous IS-OS line on SD-OCT at the fovea.…”

Section: Discussionsupporting

confidence: 59%

“…Both quantitative and qualitative correlations between the size of the defect in IS-OS and BCVA have been found. 3,4,23,30 Although the postoperative integrity of the IS-OS junction layer is considered to be one of the most important predicting factors for visual success, the findings in the ELM c /IS-OS d group demonstrated that visual acuity could still improve even in those eyes that showed IS-OS discontinuity at 6 weeks and had a persistent IS-OS discontinuity at 6 months (48.3% of the eyes in ELM c /IS-OS d group), while their ELM layer was restored. There was no difference between the eyes with restored IS-OS and the eyes with disrupted IS-OS at 6 months in the ELM c /IS-OS d group (P ¼ 0.53).…”

Section: Discussionmentioning

confidence: 99%

“…Recent reports have demonstrated that the postoperative status of the IS-OS layer significantly correlates with the visual outcome of MH surgery. [1][2][3][4][5] Specifically, disruptions in this layer were associated with poorer visual outcomes. [1][2][3][4][5] The ELM appears as another hyper-reflective landmark in the outer retina.…”

Section: Introductionmentioning

confidence: 99%

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External limiting membrane and visual outcome in macular hole repair: spectral domain OCT analysis

Landa

Gentile

Garcia

et al. 2011

Eye

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Purpose To investigate the relationship between postoperative visual acuity and integrity of the external limiting membrane (ELM) and inner segment-outer segment (IS-OS) junction layers, using spectral domain optical coherence tomography (SD-OCT), in eyes with macular holes (MHs) following surgical repair. Methods Medical charts of MH-operated cases were retrospectively identified and reviewed. The primary outcome measures were best-corrected visual acuity (BCVA) and the status of the ELM and IS-OS lines, using SD-OCT, at 6 weeks and 6 months postoperatively. Results Sixty-two eyes of 62 patients were included. At 6 weeks following surgery, out of 56 (90.3%) eyes with successful MH closure: 0 eyes showed the combination of disrupted ELM and continuous IS-OS layers; 7 eyes (12.5%) demonstrated continuity of both ELM and IS-OS (ELM c /IS-OS c group); 29 eyes (51.8%) had continuous ELM with discontinuous IS-OS layers (ELM c /IS-OS d group); and 20 eyes (35.7%) had discontinuities in both the layers (ELM d /IS-OS d group). The ELM d /IS-OS d group had the lowest visual gain at 6 months (P ¼ 0.03). At 6 months, a restoration of the integrity of IS-OS layer was observed in 51.7% eyes in the ELM c /IS-OS d group and in 5% in the ELM d /IS-OS d group (P ¼ 0.001). Conclusions When both ELM and IS-OS layers showed disruptions 6 weeks postoperatively, a significantly worse BCVA was measured at 6 months, compared with the eyes with only IS-OS disruptions, detected 6 weeks following surgery. The integrity of the ELM layer appears to be a critical factor for the restoration of the photoreceptor layer and for predicting a successful visual outcome following MH repair.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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External limiting membrane and visual outcome in macular hole repair: spectral domain OCT analysis

Landa

Gentile

Garcia

et al. 2011

Eye

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“…Furthermore, OCT allows the physician to follow-up changes in retinal microstructure, particularly integrity of photoreceptor inner segment/outer segment (IS/OS) junction, which was found associated with postoperative visual improvement. 7,8 Most of the studies concluded that an interrupted or absent IS/OS junction on OCT was significantly correlated with poor preoperative and postoperative visual acuity in patients with EMM. 9,10 In clinical practice, physicians are generally unable to detect functional loss in photoreceptors on OCT until IS/OS junction is obviously damaged.…”

Section: Introductionmentioning

confidence: 99%

Decreased photoreceptor inner segment/outer segment junction reflectivity in patients with idiopathic epimacular membrane

Toprak

Yaylalı

Yıldırım

2014

Eye

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Purpose To assess the effects of idiopathic epimacular membrane (IEMM) on retinal pigment epithelium (RPE), photoreceptor inner segment/outer segment (IS/OS) junction, and external limiting membrane (ELM) reflectivities to determine functional alterations in these layers using optical coherence tomography (OCT) image analysis. Methods Fifty eyes of 50 patients with untreated IEMM and 41 eyes of 41 age-and sex-matched healthy controls with normal OCT scans were retrospectively reviewed. A single masked physician analyzed OCT images randomly. Reflectivity values of RPE, IS/OS junction, and ELM were obtained using 'plot profile' mode of a medical image processing computer software. Results The study comprised 50 patients with untreated IEMM and age-and sexmatched 41 control subjects (P40.05). Image analysis demonstrated that IS/OS junction and ELM had significantly lower reflectivity in patients with IEMM compared with those of the control eyes (P ¼ 0.008, P ¼ 0.009, respectively). However, RPE reflectivity did not differ between two groups (P ¼ 0.100). Correlation analyses showed no significant associations between reflectivity values and corrected visual acuity (P40.05). Conclusion In patients with IEMM, photoreceptor IS/OS junction and ELM seem to have lower reflectivity, which might indicate impaired functionality even though these layers are not apparently damaged on OCT imaging.

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“…The inner segment/outer segment (IS/OS) is the junction of inner segment and outer segment, which divides the photoreceptors into two parts. Recently, many studies have shown that the extent of the defect of the IS/OS junction is an important clinical indicator for the injury degree of photoreceptors, which may be closely associated with visual acuity in different eye diseases [2][3][4][5][6][7][8][9], although controversy remains [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

An automated framework of inner segment/outer segment defect detection for retinal SD-OCT images

Zhu¹,

Shi²,

Xiang³

et al. 2014

Proceedings of the Ophthalmic Medical Image Analysis First International Workshop

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Abstract. The integrity of inner segment/outer segment (IS/OS) has high correlation with lower visual acuity in patients suffering from blunt trauma. An automated 3D IS/OS defect detection method based on the SD-OCT images was proposed. First, 11 surfaces were automatically segmented using the multiscale 3D graph-search approach. Second, the sub-volumes between surface 7 and 8 containing IS/OS region around the fovea (diameter of 1mm) were extracted and flattened based on the segmented retinal pigment epithelium layer. Third, 5 kinds of texture based features were extracted for each voxel. A KNN classifier was trained and each voxel was classified as disrupted or nondisrupted and the responding defect volume was calculated. The proposed method was trained and tested on 9 eyes from 9 trauma subjects using the leave-one-out cross validation method. The preliminary results demonstrated the feasibility and efficiency of the proposed method.

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Spectral-domain optical coherence tomography images of inner/outer segment junctions and macular hole surgery outcomes

Abstract: SD-OCT is useful for quantitatively measuring IS/OS junction defects. The postoperative IS/OS junction may play an important role in visual recovery after macular hole surgery.

Cited by 137 publications

References 24 publications

External limiting membrane and visual outcome in macular hole repair: spectral domain OCT analysis

External limiting membrane and visual outcome in macular hole repair: spectral domain OCT analysis

Decreased photoreceptor inner segment/outer segment junction reflectivity in patients with idiopathic epimacular membrane

An automated framework of inner segment/outer segment defect detection for retinal SD-OCT images

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