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Kitahata S, Gocho K, Motozawa N, Yokota S, Yamamoto M, Maeda A, Hirami Y, Kurimoto Y, Kadonosono K, Takahashi M. Evaluation of photoreceptor features in retinitis pigmentosa with cystoid macular edema by using an adaptive optics fundus camera. PLoS One 2024; 19:e0296493. [PMID: 38166083 PMCID: PMC10760661 DOI: 10.1371/journal.pone.0296493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/14/2023] [Indexed: 01/04/2024] Open
Abstract
OBJECTIVE Cystoid macular edema (CME) in retinitis pigmentosa (RP) is an important complication causing visual dysfunction. We investigated the effect of CME on photoreceptors in RP patients with previous or current CME, using an adaptive optics (AO) fundus camera. METHODS We retrospectively observed the CME and ellipsoid zone (EZ) length (average of horizontal and vertical sections) by optical coherence tomography. The density and regularity of the arrangement of photoreceptor cells (Voronoi analysis) were examined at four points around 1.5° from superior to inferior and temporal to nasal. We also performed a multivariate analysis using CME duration, central macular thickness and transversal length of CME. RESULTS We evaluated 18 patients with previous or current CME (18 eyes; age, 48.7 ± 15.6 years) and 24 patients without previous or current CME (24 eyes; age, 46.0 ± 14.5 years). There were no significant differences in age, logMAR visual acuity, or EZ length. In groups with and without CME, cell density was 11967 ± 3148 and 16239 ± 2935 cells/mm2, and sequence regularity was 85.5 ± 3.4% and 88.5 ± 2.8%, respectively; both parameters were significantly different. The correlation between photoreceptor density and age was more negative in group with CME. The CME group tended toward greater reductions in duration of CME. CONCLUSION Complications of CME in RP patients may lead to a decrease in photoreceptor density and regularity. Additionally, a longer duration of CME may result in a greater reduction in photoreceptor density.
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Affiliation(s)
- Shohei Kitahata
- Kobe City Eye Hospital, Chuo-ku, Kobe, Japan
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Minami-ku, Yokohama, Japan
- Department of Ophthalmology, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Japan
| | - Kiyoko Gocho
- Kobe City Eye Hospital, Chuo-ku, Kobe, Japan
- Inserm and Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Naohiro Motozawa
- RIKEN Center for Biosystems Dynamics Research, Chuo-ku, Kobe, Japan
| | - Satoshi Yokota
- Kobe City Eye Hospital, Chuo-ku, Kobe, Japan
- Department of Ophthalmology, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Japan
| | | | - Akiko Maeda
- Kobe City Eye Hospital, Chuo-ku, Kobe, Japan
| | - Yasuhiko Hirami
- Kobe City Eye Hospital, Chuo-ku, Kobe, Japan
- Department of Ophthalmology, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Japan
| | - Yasuo Kurimoto
- Kobe City Eye Hospital, Chuo-ku, Kobe, Japan
- Department of Ophthalmology, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Japan
| | - Kazuaki Kadonosono
- Department of Ophthalmology and Micro-Technology, Yokohama City University, Minami-ku, Yokohama, Japan
| | - Masayo Takahashi
- Kobe City Eye Hospital, Chuo-ku, Kobe, Japan
- RIKEN Center for Biosystems Dynamics Research, Chuo-ku, Kobe, Japan
- Vision Care Inc., Chuo-ku, Kobe, Japan
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Li W, Chen W, Zhou X, Jiang T, Zhang J, Wang M, Wu J, Gu J, Chang Q. Volume-accumulated reflectivity of the outer retina (integral) on spectral domain optical coherence tomography as a predictor of cone cell density: a pilot study. BMC Ophthalmol 2023; 23:100. [PMID: 36918830 PMCID: PMC10012552 DOI: 10.1186/s12886-023-02827-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 02/22/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The study aims to investigate the relationship between the volume-accumulated reflectivity (termed "integral") on spectral domain optical coherence tomography (SD-OCT) and cone density on adaptive optics (AO) imaging. METHODS In this cross-sectional study, both eyes of 32 healthy subjects and 5 patients with inherited retinal diseases (IRD) were studied. The parameter, integral, was defined as the volume-accumulated reflectivity values in a selected region on OCT images; integrals of the ellipsoid zone (EZ) and interdigitation zone (IZ) were measured at 2°, 3°, 4°, 5°and 6° eccentricity along the four meridians on fovea-centered OCT B-scans. Cone density in the same region was measured using a flood illumination adaptive optics camera RTX1. RESULTS Integrals of EZ, IZ and cone density shared similar distribution patterns. Integral of the IZ was better correlated with cone density in both healthy people (r = 0.968, p < 0.001) and those with IRD (r = 0.823, p < 0.001) than direct measurements of reflectivity on OCT images. A strong correlation was found between best corrected visual acuity (BCVA) and cone density at 2° eccentricity (r = -0.857, p = 0.002). BCVA was also correlated with the integral of the IZ at the foveola (r = -0.746, p = 0.013) and fovea (r = -0.822, p = 0.004). CONCLUSIONS The new parameter "integral" of the photoreceptor outer segment measured from SD-OCT was noted to correlate with cone density and visual function in this pilot study.
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Affiliation(s)
- Wenting Li
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Wenwen Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiyue Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Tingting Jiang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Juan Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Min Wang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Jihong Wu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China
| | - Junxiang Gu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China.
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China.
| | - Qing Chang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Xuhui District, 83 Fenyang Rd, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Eye, ENT Hospital of Fudan University, Fudan University, Shanghai, China.
- Key NHC Laboratory of Myopia, Key Laboratory of Myopia, Fudan University), Chinese Academy of Medical Sciences, Shanghai, China.
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Gill JS, Theofylaktopoulos V, Mitsios A, Houston S, Hagag AM, Dubis AM, Moosajee M. Investigating Biomarkers for USH2A Retinopathy Using Multimodal Retinal Imaging. Int J Mol Sci 2022; 23:ijms23084198. [PMID: 35457016 PMCID: PMC9024786 DOI: 10.3390/ijms23084198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 12/13/2022] Open
Abstract
Pathogenic mutations in USH2A are a leading cause of visual loss secondary to non-syndromic or Usher syndrome-associated retinitis pigmentosa (RP). With an increasing number of RP-targeted clinical trials in progress, we sought to evaluate the photoreceptor topography underlying patterns of loss observed on clinical retinal imaging to guide surrogate endpoint selection in USH2A retinopathy. In this prospective cross-sectional study, twenty-five patients with molecularly confirmed USH2A-RP underwent fundus autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT) and adaptive optics scanning laser ophthalmoscopy (AOSLO) retinal imaging. Analysis comprised measurement of FAF horizontal inner (IR) and outer (OR) hyperautofluorescent ring diameter; SD-OCT ellipsoid zone (EZ) and external limiting membrane (ELM) width, normalised EZ reflectance; AOSLO foveal cone density and intact macular photoreceptor mosaic (IMPM) diameter. Thirty-two eyes from 16 patients (mean age ± SD, 36.0 ± 14.2 years) with USH2A-associated Usher syndrome type 2 (n = 14) or non-syndromic RP (n = 2) met the inclusion criteria. Spatial alignment was observed between IR-EZ and OR-ELM diameters/widths (p < 0.001). The IMPM border occurred just lateral to EZ loss (p < 0.001), although sparser intact photoreceptor inner segments were detected until ELM disruption. EZ width and IR diameter displayed a biphasic relationship with cone density whereby slow cone loss occurred until retinal degeneration reached ~1350 μm from the fovea, beyond which greater reduction in cone density followed. Normalised EZ reflectance and cone density were significantly associated (p < 0.001). As the strongest correlate of cone density (p < 0.001) and best-corrected visual acuity (p < 0.001), EZ width is the most sensitive biomarker of structural and functional decline in USH2A retinopathy, rendering it a promising trial endpoint.
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Affiliation(s)
- Jasdeep S. Gill
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (J.S.G.); (V.T.); (A.M.); (S.H.); (A.M.H.); (A.M.D.)
| | - Vasileios Theofylaktopoulos
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (J.S.G.); (V.T.); (A.M.); (S.H.); (A.M.H.); (A.M.D.)
| | - Andreas Mitsios
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (J.S.G.); (V.T.); (A.M.); (S.H.); (A.M.H.); (A.M.D.)
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Sarah Houston
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (J.S.G.); (V.T.); (A.M.); (S.H.); (A.M.H.); (A.M.D.)
| | - Ahmed M. Hagag
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (J.S.G.); (V.T.); (A.M.); (S.H.); (A.M.H.); (A.M.D.)
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Adam M. Dubis
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (J.S.G.); (V.T.); (A.M.); (S.H.); (A.M.H.); (A.M.D.)
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- Global Business School for Health, University College London, London WC1E 6BT, UK
| | - Mariya Moosajee
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK; (J.S.G.); (V.T.); (A.M.); (S.H.); (A.M.H.); (A.M.D.)
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
- Correspondence: ; Tel.: +44-207-608-6971
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Kawashima R, Matsushita K, Hashida N, Kuniyoshi K, Fujikado T, Nishida K. Complete Visual Recovery From Severe Outer Retinitis After Tonsillitis. J Neuroophthalmol 2021; 41:e578-e583. [PMID: 32956228 PMCID: PMC8584224 DOI: 10.1097/wno.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To report a case of severe acute bilateral outer retinitis after tonsillitis and rapid morphologic and functional recovery after steroid treatment. METHODS Observational case report. RESULTS A 26-year-old woman with acute bilateral blurred vision that developed after tonsillitis underwent spectral-domain optical coherence tomography (SD-OCT) that showed photoreceptor outer segment damage. Full-field electroretinography (ERG) and multifocal ERG were nonrecordable. The patient had a remarkable anatomic and functional recovery in response to steroid treatment; however, partial damage remained around the macula on SD-OCT, and an adaptive optics imaging system showed damaged cone photoreceptors. CONCLUSIONS Prednisolone is an effective treatment for a disease that is believed to be due to suspicious involvement of the autoimmune system. Even severe outer retinitis can recover completely with rapid diagnosis and treatment.
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Affiliation(s)
- Rumi Kawashima
- Department of Ophthalmology (RK, KM, NH, KN), Osaka University Graduate School of Medicine, Osaka, Japan; Department of Ophthalmology (KK), Kindai University Faculty of Medicine, Osaka-Sayama City, Japan; Osaka University Graduate School of Frontier Biosciences (TF), Osaka, Japan; and Integrated Frontier Research for Medical Science Division (KN), Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan
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Lee KE, Heitkotter H, Carroll J. Challenges Associated With Ellipsoid Zone Intensity Measurements Using Optical Coherence Tomography. Transl Vis Sci Technol 2021; 10:27. [PMID: 34665233 PMCID: PMC8543396 DOI: 10.1167/tvst.10.12.27] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/16/2021] [Indexed: 12/11/2022] Open
Abstract
Translational Relevance Qualitative evaluation of the ellipsoid zone band on optical coherence tomography is a valuable clinical tool for assessing photoreceptor structure, though more quantitative metrics are emerging. Awareness of the challenges involved in interpreting quantitative metrics is important for their clinical translation.
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Affiliation(s)
- Karen E. Lee
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Heather Heitkotter
- Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
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Tonade D, Kern TS. Photoreceptor cells and RPE contribute to the development of diabetic retinopathy. Prog Retin Eye Res 2021; 83:100919. [PMID: 33188897 PMCID: PMC8113320 DOI: 10.1016/j.preteyeres.2020.100919] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/27/2020] [Accepted: 10/31/2020] [Indexed: 12/26/2022]
Abstract
Diabetic retinopathy (DR) is a leading cause of blindness. It has long been regarded as vascular disease, but work in the past years has shown abnormalities also in the neural retina. Unfortunately, research on the vascular and neural abnormalities have remained largely separate, instead of being integrated into a comprehensive view of DR that includes both the neural and vascular components. Recent evidence suggests that the most predominant neural cell in the retina (photoreceptors) and the adjacent retinal pigment epithelium (RPE) play an important role in the development of vascular lesions characteristic of DR. This review summarizes evidence that the outer retina is altered in diabetes, and that photoreceptors and RPE contribute to retinal vascular alterations in the early stages of the retinopathy. The possible molecular mechanisms by which cells of the outer retina might contribute to retinal vascular damage in diabetes also are discussed. Diabetes-induced alterations in the outer retina represent a novel therapeutic target to inhibit DR.
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Affiliation(s)
- Deoye Tonade
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH, USA
| | - Timothy S Kern
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH, USA; Veterans Administration Medical Center Research Service, Cleveland, OH, USA; Gavin Herbert Eye Institute, University of California Irvine, Irvine, CA, USA; Veterans Administration Medical Center Research Service, Long Beach, CA, USA.
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Gong Y, Chen LJ, Pang CP, Chen H. Ellipsoid zone optical intensity reduction as an early biomarker for retinitis pigmentosa. Acta Ophthalmol 2021; 99:e215-e221. [PMID: 32701217 DOI: 10.1111/aos.14542] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/15/2020] [Accepted: 06/15/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate photoreceptor degeneration in retinitis pigmentosa (RP) by quantitatively analysing optical intensity of ellipsoid zone (EZ) on optical coherence tomography (OCT). METHODS We conducted OCT line scans of the horizontal meridian in 24 eyes of 24 RP patients and 30 eyes of 30 healthy controls and obtained longitudinal reflectance profiles using ImageJ at every 5 pixels. Relative optical intensity was calculated from dividing the peak of EZ by the mean of the whole retina. RESULTS The optical intensity of EZ variation followed a similar pattern in all patients. It decreased with eccentricity and then vanished, regardless whether it was normal or reduced at the fovea. The mean relative optical intensity of EZ in RP patients was 0.69 ± 0.13 to that of control subjects at the location just before it disappeared. The relative optical intensity of EZ at fovea was significantly correlated with the best-corrected visual acuity in patients (r = -0.617, p = 0.001). CONCLUSION The optical intensity of EZ detected by OCT can serve as a biomarker for early detection of photoreceptor degeneration in RP.
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Affiliation(s)
- Yuting Gong
- Joint Shantou International Eye Center Shantou University & the Chinese University of Hong Kong Shantou China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong China
| | - Chi Pui Pang
- Joint Shantou International Eye Center Shantou University & the Chinese University of Hong Kong Shantou China
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong China
| | - Haoyu Chen
- Joint Shantou International Eye Center Shantou University & the Chinese University of Hong Kong Shantou China
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Ishibashi F, Kosaka A, Tavakoli M. The Impact of Glycemic Control on Retinal Photoreceptor Layers and Retinal Pigment Epithelium in Patients With Type 2 Diabetes Without Diabetic Retinopathy: A Follow-Up Study. Front Endocrinol (Lausanne) 2021; 12:614161. [PMID: 33967950 PMCID: PMC8102981 DOI: 10.3389/fendo.2021.614161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/19/2021] [Indexed: 11/29/2022] Open
Abstract
AIMS To establish the sequential changes by glycemic control in the mean thickness, volume and reflectance of the macular photoreceptor layers (MPRLs) and retinal pigment epithelium in patients with type 2 diabetes without diabetic retinopathy. METHODS Thirty-one poorly controlled (HbA1c > 8.0%) patients with type 2 diabetes without diabetic retinopathy undergoing glycemic control and 39 control subjects with normal HbA1c levels (< 5.9%) underwent periodical full medical, neurological and ophthalmological examinations over 2 years. Glycemic variability was evaluated by standard deviation and coefficient of variation of monthly measured HbA1c levels and casual plasma glucose. 3D swept source-optical coherence tomography (OCT) and OCT-Explorer-generated enface thickness, volume and reflectance images for 9 subfields defined by Early Treatment Diabetic Retinopathy Study of 4 MPRLs {outer nuclear layer, ellipsoid zone, photoreceptor outer segment (PROS) and interdigitation zone} and retinal pigment epithelium were acquired every 3 months. RESULTS Glycemic control sequentially restored the thickness and volume at 6, 4 and 5 subfields of outer nuclear layer, ellipsoid zone and PROS, respectively. The thickness and volume of outer nuclear layer were restored related to the decrease in HbA1c and casual plasma glucose levels, but not related to glycemic variability and neurological tests. The reflectance of MPRLs and retinal pigment epithelium in patients was marginally weaker than controls, and further decreased at 6 or 15 months during glycemic control. The reduction at 6 months coincided with high HbA1c levels. CONCLUSION Glycemic control sequentially restored the some MPRL thickness, especially of outer nuclear layer. In contrast, high glucose during glycemic control decreased reflectance and may lead to the development of diabetic retinopathy induced by glycemic control. The repeated OCT examinations can clarify the benefit and hazard of glycemic control to the diabetic retinopathy.
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Affiliation(s)
| | - Aiko Kosaka
- Internal Medicine, Ishibashi Clinic, Hiroshima, Japan
| | - Mitra Tavakoli
- Diabetes and Vascular Research Centre (DVRC), NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom
- *Correspondence: Mitra Tavakoli,
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Gu J, Jiang T, Yu M, Yu J, Li W, Liu S, Zhang P, Chen W, Chang Q. A Novel Approach to Quantitative Evaluation of Outer Retinal Lesions Via a New Parameter "Integral" in Spectral Domain Optical Coherence Tomography. Transl Vis Sci Technol 2020; 9:8. [PMID: 33200049 PMCID: PMC7645250 DOI: 10.1167/tvst.9.12.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 10/03/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to design a new parameter "integral" to quantitatively evaluate the spatial cumulative reflectivity of the outer retinal layers in optical coherence tomography (OCT), and to investigate its role in the detection of outer retinal diseases. Methods This was a cross-sectional study. Fovea-centered line OCT scans were performed on 60 eyes of 60 healthy volunteers and 44 eyes of 44 patients diagnosed with outer retinal diseases. The integrals of the ellipsoid zone (EZ) and interdigitation zone (IZ) were measured by respectively accumulating the grayscale values of all the pixels within the EZ and IZ at specified locations on the scanning lines, and were then adjusted by calculating their percentages on the outer retina. The integrals of the EZ and IZ were compared between the two groups. Results The integrals of the EZ and IZ were stably and normally distributed in the healthy eyes, and were significantly lower in eyes with outer retinal lesions than in healthy ones (P < 0.05). Moreover, the integrals of the EZ and IZ were correlated with best corrected visual acuity (BCVA; adjusted R2 = 0.620) and the presence of outer retinal lesions (Nagelkerke R2 = 0.767). The area under the receiver operating characteristic (ROC) curve was 0.954 (95% confidence interval [CI] = 0.918-0.990) when the integral was selected as a diagnostic variable. Conclusions Obtained from this novel quantification method, the new parameter integral was comparable between different individuals and had the potential to detect outer retinal abnormalities in reflectivity through OCT. Translational Relevance Our work verified the feasibility of the new image analysis technique in the detection of the diseases affecting the outer retina.
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Affiliation(s)
- Junxiang Gu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Key NHC Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Tingting Jiang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Key NHC Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Mingrong Yu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Key NHC Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jian Yu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Key NHC Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Wenting Li
- Shanghai Medical College, Fudan University, Shanghai, China
| | - Shixue Liu
- Shanghai Medical College, Fudan University, Shanghai, China
| | - Peijun Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Key NHC Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Wenwen Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Key NHC Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Qing Chang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and ENT Hospital of Fudan University, Fudan University, Shanghai, China.,Key NHC Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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10
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Wynne N, Carroll J, Duncan JL. Promises and pitfalls of evaluating photoreceptor-based retinal disease with adaptive optics scanning light ophthalmoscopy (AOSLO). Prog Retin Eye Res 2020; 83:100920. [PMID: 33161127 DOI: 10.1016/j.preteyeres.2020.100920] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 12/15/2022]
Abstract
Adaptive optics scanning light ophthalmoscopy (AOSLO) allows visualization of the living human retina with exquisite single-cell resolution. This technology has improved our understanding of normal retinal structure and revealed pathophysiological details of a number of retinal diseases. Despite the remarkable capabilities of AOSLO, it has not seen the widespread commercial adoption and mainstream clinical success of other modalities developed in a similar time frame. Nevertheless, continued advancements in AOSLO hardware and software have expanded use to a broader range of patients. Current devices enable imaging of a number of different retinal cell types, with recent improvements in stimulus and detection schemes enabling monitoring of retinal function, microscopic structural changes, and even subcellular activity. This has positioned AOSLO for use in clinical trials, primarily as exploratory outcome measures or biomarkers that can be used to monitor disease progression or therapeutic response. AOSLO metrics could facilitate patient selection for such trials, to refine inclusion criteria or to guide the choice of therapy, depending on the presence, absence, or functional viability of specific cell types. Here we explore the potential of AOSLO retinal imaging by reviewing clinical applications as well as some of the pitfalls and barriers to more widespread clinical adoption.
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Affiliation(s)
- Niamh Wynne
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jacque L Duncan
- Department of Ophthalmology, University of California, San Francisco, CA, USA.
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