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Habibi A, Ashrafkhorasani M, Santina A, Emamverdi M, Corradeti G, Abbasgholizadeh R, Nittala MG, Freund KB, Sarraf D, Sadda SR. Evaluating fingerprint-like patterns in the healthy Henle fiber layer using enface OCT imaging. Exp Eye Res 2024; 245:109979. [PMID: 38909669 DOI: 10.1016/j.exer.2024.109979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/06/2024] [Accepted: 06/20/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE Enface OCT may disclose a distinct "fingerprint-like' pattern within the HFL in various macular disorders. This study aims to investigate the frequency and characteristics of this pattern in healthy eyes and identify potential factors influencing its visibility. METHODS Two, independent masked reading center graders evaluated for the presence and prominence of a fingerprint pattern in the Henle fiber layer (HFL) on enface OCT images from 33 healthy subjects (66 eyes). The prominence of the pattern was rated qualitatively using a 0-3 scale, with 3 indicating the strongest prominence. Tilt angles (relative to the normal/perpendicular at the center) of the retina were measured on horizontal and vertical B-scans, and the retinal curvature was assessed using ImageJ, in order to determine the impact of the incident light angle on the visibility and prominence of the fingerprint pattern. Inter-grader agreement using Cohen's kappa and the frequency and percentage of patterns in the entire enface image and in each quadrant were calculated and compared using the Friedman test with Dunn's post-test. A generalized estimating equation (GEE) was used to analyze the association between these metrics and fingerprint prominence. RESULTS Substantial inter-grader agreement was observed (Cohen's kappa = 0.71) for assessing the prominence of the fingerprint pattern. Over 70% of eyes exhibited some evidence of the pattern (score ≥1). Significant difference in pattern prominence across quadrants was detected (p < 0.05), with lowest prominence in the temporal quadrant (p < 0.001 for pairwise comparisons against all other quadrants). The GEE analysis to account for the extent of the effect of scan tilt angle and RPE curvature was not able to predict the prominence of the fingerprint pattern, highlighting that angle of incidence (of the scanning laser light) alone could not explain the pattern. CONCLUSIONS This study confirms that a fingerprint-like pattern within the HFL can also be observed in healthy eyes, challenging the notion that this finding is only manifest in the setting of disease. In addition, the lack of correlation with angle of incident light suggests that the pattern may be related to other intrinsic characteristics of the HFL.
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Affiliation(s)
- Abbas Habibi
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Maryam Ashrafkhorasani
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Ahmad Santina
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Mehdi Emamverdi
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Giulia Corradeti
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Rouzbeh Abbasgholizadeh
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - Muneeswar G Nittala
- Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA
| | - K Bailey Freund
- NYU Grossman School of Medicine, New York, NY, USA; Vitreous Retina Macula Consultants of New York, New York, NY, USA
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Greater Los Angeles VA Healthcare Center, Los Angeles, CA, USA
| | - SriniVas R Sadda
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Doheny Image Reading and Research Laboratory, Doheny Eye Institute, Pasadena, CA, USA.
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Kim YH, Togloom A, Oh J. Fingerprint sign of the Henle fibre layer in epiretinal membrane: a cross-sectional and longitudinal study. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06543-5. [PMID: 38856954 DOI: 10.1007/s00417-024-06543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/25/2024] [Accepted: 06/01/2024] [Indexed: 06/11/2024] Open
Abstract
PURPOSE To investigate the incidence and distribution of fingerprint-like microwaves in the Henle fibre layer (HFL) of the eyes with epiretinal membrane (ERM). METHODS Patients with idiopathic ERM were included. The fingerprint sign was defined using en-face optical coherence tomography images of the HFL, and its extent was classified into three grades. RESULTS At baseline, fingerprint sign was found in 70 of 83 (84.3%) eyes with ERM and was more frequently observed in eyes with a higher ERM stage (P < 0.001). Its extent increased (P < 0.001) with an increase in ERM stage or the central macular thickness (P < 0.001). Best corrected visual acuity (BCVA) was worse in eyes with a fingerprint sign than in those without (P = 0.024). Metamorphopsia was more common in eyes with a greater extent of fingerprint-like microwaves (P = 0.048). The fingerprint sign persisted over a mean follow-up period of 18.0 ± 23.3 without surgery. In 45 eyes that underwent surgery, the extent of fingerprint-like microwaves decreased at 1.2 months (P = 0.001), and further decreased at 13.7 months postoperatively (P = 0.019). However, the proportion of eyes with a fingerprint sign after surgery was similar to that observed preoperatively (P = 0.912). CONCLUSIONS Fingerprint-like microwaves were commonly found in eyes with ERM and were associated with ERM severity and BCVA. The microwaves remained long after surgery, although their extent may have decreased after the ERM was resolved. These results suggest that ERM traction may cause long-lasting changes in the HFL.
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Affiliation(s)
- Young Ho Kim
- Department of Ophthalmology, Korea University College of Medicine, 73 Goryeodae-ro Sungbuk-ku, Seoul, 02841, Korea
| | - Ariunaa Togloom
- Department of Ophthalmology, Korea University College of Medicine, 73 Goryeodae-ro Sungbuk-ku, Seoul, 02841, Korea
| | - Jaeryung Oh
- Department of Ophthalmology, Korea University College of Medicine, 73 Goryeodae-ro Sungbuk-ku, Seoul, 02841, Korea.
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Woertz EN, Ayala GD, Wynne N, Tarima S, Zacharias S, Brilliant MH, Dunn TM, Costakos D, Summers CG, Strul S, Drack AV, Carroll J. Quantitative Foveal Structural Metrics as Predictors of Visual Acuity in Human Albinism. Invest Ophthalmol Vis Sci 2024; 65:3. [PMID: 38441889 PMCID: PMC10916884 DOI: 10.1167/iovs.65.3.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/03/2024] [Indexed: 03/07/2024] Open
Abstract
Purpose To assess the degree to which quantitative foveal structural measurements account for variation in best-corrected visual acuity (BCVA) in human albinism. Methods BCVA was measured and spectral domain optical coherence tomography (SD-OCT) images were acquired for 74 individuals with albinism. Categorical foveal hypoplasia grades were assessed using the Leicester Grading System for Foveal Hypoplasia. Foveal anatomical specialization (foveal versus parafoveal value) was quantified for inner retinal layer (IRL) thickness, outer segment (OS) length, and outer nuclear layer (ONL) thickness. These metrics, participant sex, and age were used to build a multiple linear regression of BCVA. This combined linear model's predictive properties were compared to those of categorical foveal hypoplasia grading. Results The cohort included three participants with type 1a foveal hypoplasia, 23 participants with type 1b, 33 with type 2, ten with type 3, and five with type 4. BCVA ranged from 0.08 to 1.00 logMAR (mean ± SD: 0.53 ± 0.21). IRL ratio, OS ratio, and ONL ratio were measured in all participants and decreased with increasing severity of foveal hypoplasia. The best-fit combined linear model included all three quantitative metrics and participant age expressed as a binary variable (divided into 0-18 years and 19 years or older; adjusted R2 = 0.500). This model predicted BCVA more accurately than a categorical foveal hypoplasia model (adjusted R2 = 0.352). Conclusions A quantitative model of foveal specialization accounts for more variance in BCVA in albinism than categorical foveal hypoplasia grading. Other factors, such as optical aberrations and eye movements, may account for the remaining unexplained variance.
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Affiliation(s)
- Erica N. Woertz
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Gelique D. Ayala
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Niamh Wynne
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Sergey Tarima
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Serena Zacharias
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Murray H. Brilliant
- Center for Precision Medicine Research, Marshfield Clinic, Marshfield, Wisconsin, United States
| | - Taylor M. Dunn
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
| | - Deborah Costakos
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - C. Gail Summers
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, United States
| | - Sasha Strul
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, United States
| | - Arlene V. Drack
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
| | - Joseph Carroll
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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Britten-Jones AC, Thai L, Flanagan JPM, Bedggood PA, Edwards TL, Metha AB, Ayton LN. Adaptive optics imaging in inherited retinal diseases: A scoping review of the clinical literature. Surv Ophthalmol 2024; 69:51-66. [PMID: 37778667 DOI: 10.1016/j.survophthal.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
Adaptive optics (AO) imaging enables direct, objective assessments of retinal cells. Applications of AO show great promise in advancing our understanding of the etiology of inherited retinal disease (IRDs) and discovering new imaging biomarkers. This scoping review systematically identifies and summarizes clinical studies evaluating AO imaging in IRDs. Ovid MEDLINE and EMBASE were searched on February 6, 2023. Studies describing AO imaging in monogenic IRDs were included. Study screening and data extraction were performed by 2 reviewers independently. This review presents (1) a broad overview of the dominant areas of research; (2) a summary of IRD characteristics revealed by AO imaging; and (3) a discussion of methodological considerations relating to AO imaging in IRDs. From 140 studies with AO outcomes, including 2 following subretinal gene therapy treatments, 75% included fewer than 10 participants with AO imaging data. Of 100 studies that included participants' genetic diagnoses, the most common IRD genes with AO outcomes are CNGA3, CNGB3, CHM, USH2A, and ABCA4. Confocal reflectance AO scanning laser ophthalmoscopy was the most reported imaging modality, followed by flood-illuminated AO and split-detector AO. The most common outcome was cone density, reported quantitatively in 56% of studies. Future research areas include guidelines to reduce variability in the reporting of AO methodology and a focus on functional AO techniques to guide the development of therapeutic interventions.
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Affiliation(s)
- Alexis Ceecee Britten-Jones
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
| | - Lawrence Thai
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Jeremy P M Flanagan
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Phillip A Bedggood
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Thomas L Edwards
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Andrew B Metha
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
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Zhang WB, Guo C, Wu Y. Concentric macular rings in a patient with foveal hypoplasia. J Fr Ophtalmol 2023; 46:1267-1268. [PMID: 37620199 DOI: 10.1016/j.jfo.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 08/26/2023]
Affiliation(s)
- W-B Zhang
- Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China
| | - C Guo
- Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China
| | - Y Wu
- Department of Ophthalmology, Peking University First Hospital, Beijing 100034, China.
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Domdei N, Ameln J, Gutnikov A, Witten JL, Holz FG, Wahl S, Harmening WM. Cone Density Is Correlated to Outer Segment Length and Retinal Thickness in the Human Foveola. Invest Ophthalmol Vis Sci 2023; 64:11. [PMID: 38064229 PMCID: PMC10709802 DOI: 10.1167/iovs.64.15.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Purpose Assessment of the relationship between in vivo foveolar cone density, cone outer segment length (OSL), and foveal retinal thickness (RT). Methods Foveolar cone density maps covering the central ±300 µm of the retina were derived from adaptive optics scanning laser ophthalmoscopy images. The corresponding maps of foveal cone OSL and RT were derived from high-resolution optical coherence tomography volume scans. Alignment of the two-dimensional maps containing OSL and RT with the cone density map was achieved by placing the location of maximum OSL on the cone density centroid (CDC). Results Across 10 participants (27 ± 9 years; 6 female), cone density at the CDC was found to be between 147,038 and 215,681 cones/mm². The maximum OSL and minimum RT were found to lie between 31 and 40, and 193 and 226 µm, respectively. A significant correlation was observed between cone density at the CDC and maximum OSL (P = 0.001), as well as the minimal RT (P < 0.05). Across all participants, the best fit for the relationship between normalized cone density and normalized OSL within the central 300 µm was given by a quadratic function. Conclusions Using optical coherence tomography-derived measurements of OSL enables to estimate CDC cone density and two-dimensional foveal cone density maps for example in patient eyes unsuitable for adaptive optics imaging. Furthermore, the observation of a fixed relationship between the normalized OSL and cone density points to a conserved mechanism shaping the foveal pit.
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Affiliation(s)
- Niklas Domdei
- Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Julius Ameln
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | | | - Jenny L Witten
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Siegfried Wahl
- Carl Zeiss Vision International GmbH, Aalen, Germany
- Institute for Ophthalmic Research, Eberhard Karls University Tübingen, Tübingen, Germany
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Knebel D, Rudolph G, Herold T, Priglinger S. [Waardenburg's Syndrome Type IIA with Partial Albinism]. Klin Monbl Augenheilkd 2022; 239:1467-1470. [PMID: 34571549 DOI: 10.1055/a-1610-9690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Dominik Knebel
- Augenklinik und Poliklinik, Klinikum der Universität München, Deutschland
| | - Günter Rudolph
- Augenklinik und Poliklinik, Klinikum der Universität München, Deutschland
| | - Tina Herold
- Augenklinik und Poliklinik, Klinikum der Universität München, Deutschland
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The OCT angular sign of Henle fiber layer (HFL) hyperreflectivity (ASHH) and the pathoanatomy of the HFL in macular disease. Prog Retin Eye Res 2022:101135. [DOI: 10.1016/j.preteyeres.2022.101135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022]
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Neveu MM, Padhy SK, Ramamurthy S, Takkar B, Jalali S, Cp D, Padhi TR, Robson AG. Ophthalmological Manifestations of Oculocutaneous and Ocular Albinism: Current Perspectives. Clin Ophthalmol 2022; 16:1569-1587. [PMID: 35637898 PMCID: PMC9148211 DOI: 10.2147/opth.s329282] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/14/2022] [Indexed: 11/23/2022] Open
Abstract
Albinism describes a heterogeneous group of genetically determined disorders characterized by disrupted synthesis of melanin and a range of developmental ocular abnormalities. The main ocular features common to both oculocutaneous albinism (OCA), and ocular albinism (OA) include reduced visual acuity, refractive errors, foveal hypoplasia, congenital nystagmus, iris and fundus hypopigmentation and visual pathway misrouting, but clinical signs vary and there is phenotypic overlap with other pathologies. This study reviews the prevalence, genetics and ocular manifestations of OCA and OA, including abnormal development of the optic chiasm. The role of visual electrophysiology in the detection of chiasmal dysfunction and visual pathway misrouting is emphasized, highlighting how age-associated changes in visual evoked potential (VEP) test results must be considered to enable accurate diagnosis, and illustrated further by the inclusion of novel VEP data in genetically confirmed cases. Differential diagnosis is considered in the context of suspected retinal and other disorders, including rare syndromes that may masquerade as albinism.
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Affiliation(s)
- Magella M Neveu
- Department Electrophysiology, Moorfields Eye Hospital, London, EC1V 2PD, UK.,Institute of Ophthalmology, University College London, London, UK
| | | | | | - Brijesh Takkar
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Subhadra Jalali
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Deepika Cp
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Tapas Ranjan Padhi
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, India
| | - Anthony G Robson
- Department Electrophysiology, Moorfields Eye Hospital, London, EC1V 2PD, UK.,Institute of Ophthalmology, University College London, London, UK
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Henle Fiber Layer Mapping with Directional Optical Coherence Tomography. Retina 2022; 42:1780-1787. [PMID: 35504010 DOI: 10.1097/iae.0000000000003514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To perform a macular volumetric and topographic analysis of Henle Fiber Layer (HFL) from retinal scans acquired by directional optical coherence tomography (D-OCT). METHODS 30 healthy eyes of 17 subjects were imaged using the Heidelberg SD-OCT (Spectralis®, Heidelberg Engineering, Heidelberg, Germany) with varied horizontal and vertical pupil entry. Manual segmentation of HFL was performed from retinal sections of horizontally and vertically tilted OCT images acquired within macular 20×20° area. Total HFL volume, mean HFL thickness and HFL coverage area within ETDRS grid were calculated from mapped images. RESULTS HFL of 30 eyes were imaged, segmented and mapped. The mean total HFL volume was 0.74±0.08 mm3 with 0.16±0.02, 0.18±0.03, 0.17±0.02 and 0.19±0.03 mm3 for superior, temporal, inferior and nasal quadrants, respectively. The mean HFL thickness was 26.5±2.9 µm. Central 1 mm macular zone had the highest mean HFL thickness with 51.0±7.6 µm. The HFL coverage which have thickness equal or above to the mean value had a mean 10.771 ± 0.574 mm2 of surface area. CONCLUSION HFL mapping is a promising tool for structural analysis of HFL. Identifying a normative data of HFL morphology will allow further studies to investigate HFL involvement in various ocular and systemic disorders.
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Bringmann A, Barth T, Ziemssen F. Morphology of foveal hypoplasia: Hyporeflective zones in the Henle fiber layer of eyes with high-grade foveal hypoplasia. PLoS One 2022; 17:e0266968. [PMID: 35417487 PMCID: PMC9007365 DOI: 10.1371/journal.pone.0266968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/30/2022] [Indexed: 11/19/2022] Open
Abstract
Background Foveal hypoplasia is characterized by the persistance of inner retinal layers at the macular center. We evaluated using spectral-domain optical coherence tomography (SD-OCT) morphological parameters of the macular center of eyes with foveal hypoplasia and describe the presence of hyporeflective zones in the Henle fiber layer (HFL) of eyes with high-grade foveal hypoplasia. Methods Eyes with foveal hypoplasia were classified into two groups: high-grade foveal hypoplasia with thick inner retinal layers at the macular center (thickness above 100 μm; 16 eyes of 9 subjects) and low-grade foveal hypoplasia with thinner inner retinal layers at the macular center (thickness below 100 μm; 25 eyes of 13 subjects). As comparison, SD-OCT images of normal control eyes (n = 75) were investigated. Results Eyes with foveal hypoplasia displayed shorter central photoreceptor outer segments (POS), a thinner central myoid zone, and a thicker central HFL compared to control eyes. Eyes with high-grade foveal hypoplasia also displayed a thinner central outer nuclear layer (ONL) compared to eyes with low-grade foveal hypoplasia and control eyes. There was a negative correlation between the thicknesses of the central ONL and HFL in eyes with foveal hypoplasia; however, the total thickness of both ONL and HFL was similar in all eye populations investigated. Visual acuity of subjects with foveal hypoplasia was negatively correlated to the thickness of the central inner retinal layers and positively correlated to the length of central POS. In contrast to central POS, the length of paracentral POS (0.5 and 1.0 mm nasal from the macular center) was not different between the three eye populations investigated. The paracentral ONL was thickest in eyes with high-grade foveal hypoplasia and thinnest in control eyes. Hyporeflective zones in the HFL were observed on SD-OCT images of eyes with high-grade foveal hypoplasia, but not of eyes with low-grade foveal hypoplasia and control eyes. OCT angiography images recorded at the level of the HFL of eyes with high-grade foveal hypoplasia showed concentric rings of different reflectivity around the macular center; such rings were not observed on images of eyes with low-grade foveal hypoplasia and control eyes. Conclusions It is suggested that the hyporeflective zones in the HFL of eyes with high-grade foveal hypoplasia represent cystoid spaces which are surrounded by Henle fiber bundles. Cystoid spaces are likely formed because there are fewer Henle fibers and a thinner central ONL despite an unchanged thickness of both ONL and HFL. Cystoid spaces may cause the concentric rings of different reflectivity around the macular center in the HFL of eyes with high-grade foveal hypoplasia.
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Affiliation(s)
- Andreas Bringmann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig, Germany
- * E-mail:
| | - Thomas Barth
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig, Germany
| | - Focke Ziemssen
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig, Germany
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Semi-automated quantitative analysis of the middle limiting membrane in tubercular serpiginous-like choroiditis using swept-source optical coherence tomography. Sci Rep 2021; 11:23493. [PMID: 34873214 PMCID: PMC8648791 DOI: 10.1038/s41598-021-02894-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/22/2021] [Indexed: 11/08/2022] Open
Abstract
To analyze the longitudinal changes in the outer plexiform layer (OPL) in patients with tubercular serpiginous-like choroiditis (TB SLC) and compare it to the healthy control population. Clinical and imaging data of subjects with TB SLC (minimum 6-month follow-up) and healthy control subjects were reviewed. Optical coherence tomography (OCT) imaging obtained using swept-source device (DRI Triton, Topcon, Japan) from three visits (baseline, 3 months, and 6 months) were analyzed. Three OCT scans were chosen-one passing through the center of the fovea, one line above, and one line below. After random indexing to anonymize the images, they were pre-processed and fed into an automated pipeline to identify, crop, and measure the area of the OPL in the line scan. Longitudinal comparisons of OPL within the patient group were performed. The study included 32 eyes (16 patients; 11 males; mean age: 32.9 ± 7.8 years) with TB SLC. Twenty-eight eyes (14 subjects; 10 males: mean age: 31.1 ± 6.2 years) of healthy control subjects (age- and gender-matched) were also selected. The area of OPL was significantly different between the baseline and month 6 visit (6288 ± 1803 versus 5487 ± 1461; p = 0.0002) at the central scan passing through the fovea. For the scans above and below the fovea, the reduction in OPL area was significant at each visit (p < 0.0001). In comparison with healthy control subjects, OPL area values in patients with TB SLC were significantly lower at the month-3 (6116 ± 1441 versus 7136 ± 2539; p = 0.04) and the 6-month visit (5487 ± 1461 versus 7136 ± 2539; p < 0.001). The atrophied OPL at month 6 has been referred to as the "middle limiting membrane" (MLM). Subjects with TB SLC may develop progressive atrophy of the OPL resulting in formation of MLM, which is seen as a hyper-reflective line replacing the OPL. The analysis of longitudinal changes in the OPL may be useful in predicting anatomical and functional outcomes in these patients.
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Ansari D, Borkar PP, Davis PL, Collison FT, Wynne N, Zangler N, Fishman GA, Carroll J, Yao X, Grassi MA. Pathognomonic macular ripples are revealed by polarized infrared retinal imaging. Exp Biol Med (Maywood) 2021; 246:2202-2206. [PMID: 34233520 PMCID: PMC8718259 DOI: 10.1177/15353702211021089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/10/2021] [Indexed: 01/21/2023] Open
Abstract
A pathognomonic macular ripple sign has been reported with scanning laser ophthalmoscopy images in patients with foveal hypoplasia, though the optical basis of this sign is presently unknown. Here we present a case series of seven individuals with foveal hypoplasia (based on spectral domain optical coherence tomography). Each patient underwent infrared scanning laser ophthalmoscopy retinal imaging in both eyes, acquired with and without a polarization filter and assessment for a ripple-like effect in the fovea. On imaging, macular ripples were present in all eyes with foveal hypoplasia when using a polarization filter, but not when imaged without the filter. We conclude that the macular ripple sign is an imaging artifact attributable to the unique pattern of phase retardation of the Henle fiber layer in the setting of foveal hypoplasia. By utilizing a polarization filter with retinal photography, this feature can be exploited to promptly identify foveal hypoplasia in settings where OCT is not possible due to nystagmus.
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Affiliation(s)
- Darius Ansari
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
| | - Poulami P Borkar
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
| | | | - Frederick T Collison
- The Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, IL 60608, USA
- Chicago College of Optometry, Midwestern University, Downers Grove, IL 60515, USA
| | - Niamh Wynne
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | | | - Gerald A Fishman
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- The Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, IL 60608, USA
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Xincheng Yao
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- Department of Bioengineering, University of Illinois at Chicago College of Engineering, Chicago, IL 60607, USA
| | - Michael A Grassi
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- Grassi Retina, Naperville, IL 60564, USA
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14
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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 2021; 83:100920. [PMID: 33161127 PMCID: PMC8639282 DOI: 10.1016/j.preteyeres.2020.100920] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [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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15
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Litts KM, Woertz EN, Wynne N, Brooks BP, Chacon A, Connor TB, Costakos D, Dumitrescu A, Drack AV, Fishman GA, Hauswirth WW, Kay CN, Lam BL, Michaelides M, Pennesi ME, Stepien KE, Strul S, Summers CG, Carroll J. Examining Whether AOSLO-Based Foveal Cone Metrics in Achromatopsia and Albinism Are Representative of Foveal Cone Structure. Transl Vis Sci Technol 2021; 10:22. [PMID: 34111268 PMCID: PMC8132001 DOI: 10.1167/tvst.10.6.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Adaptive optics scanning light ophthalmoscopy (AOSLO) imaging in patients with achromatopsia (ACHM) and albinism is not always successful. Here, we tested whether optical coherence tomography (OCT) measures of foveal structure differed between patients for whom AOSLO images were either quantifiable or unquantifiable. Methods The study included 166 subjects (84 with ACHM; 82 with albinism) with previously acquired OCT scans, AOSLO images, and best-corrected visual acuity (BCVA, if available). Foveal OCT scans were assessed for outer retinal structure, outer nuclear layer thickness, and hypoplasia. AOSLO images were graded as quantifiable if a peak cone density could be measured and/or usable if the location of peak density could be identified and the parafoveal mosaic was quantifiable. Results Forty-nine percent of subjects with ACHM and 57% of subjects with albinism had quantifiable AOSLO images. Older age and better BCVA were found in subjects with quantifiable AOSLO images for both ACHM (P = 0.0214 and P = 0.0276, respectively) and albinism (P = 0.0073 and P < 0.0004, respectively). There was a significant trend between ellipsoid zone appearance and ability to quantify AOSLO (P = 0.0028). In albinism, OCT metrics of cone structure did not differ between groups. Conclusions Previously reported AOSLO-based cone density measures in ACHM may not necessarily reflect the degree of remnant cone structure in these patients. Translational Relevance Until AOSLO is successful in all patients with ACHM and albinism, the possibility of the reported data from a particular cohort not being representative of the entire population remains an important issue to consider when interpreting results from AOSLO studies.
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Affiliation(s)
- Katie M Litts
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Erica N Woertz
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.,School of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Niamh Wynne
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Alicia Chacon
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Thomas B Connor
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Deborah Costakos
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alina Dumitrescu
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Arlene V Drack
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Gerald A Fishman
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Byron L Lam
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mark E Pennesi
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Kimberly E Stepien
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Sasha Strul
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA
| | - C Gail Summers
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.,Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
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16
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Duwell EJ, Woertz EN, Mathis J, Carroll J, DeYoe EA. Aberrant visual population receptive fields in human albinism. J Vis 2021; 21:19. [PMID: 34007988 PMCID: PMC8142699 DOI: 10.1167/jov.21.5.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Retinotopic organization is a fundamental feature of visual cortex thought to play a vital role in encoding spatial information. One important aspect of normal retinotopy is the representation of the right and left hemifields in contralateral visual cortex. However, in human albinism, many temporal retinal afferents decussate aberrantly at the optic chiasm resulting in partially superimposed representations of opposite hemifields in each hemisphere of visual cortex. Previous functional magnetic resonance imaging (fMRI) studies in human albinism suggest that the right and left hemifield representations are superimposed in a mirror-symmetric manner. This should produce imaging voxels which respond to two separate locations mirrored across the vertical meridian. However, it is not yet clear how retino-cortical miswiring in albinism manifests at the level of single voxel population receptive fields (pRFs). Here, we used pRF modeling to fit both single and dual pRF models to the visual responses of voxels in visual areas V1 to V3 of five subjects with albinism. We found that subjects with albinism (but not controls) have sizable clusters of voxels with unequivocal dual pRFs consistently corresponding to, but not fully coextensive with, regions of hemifield overlap. These dual pRFs were typically positioned at locations roughly mirrored across the vertical meridian and were uniquely clustered within a portion of the visual field for each subject.
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Affiliation(s)
- Ethan J Duwell
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.,
| | - Erica N Woertz
- Department of Cell Biology, Neurobiology, and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.,
| | - Jedidiah Mathis
- Department of Neurology, Medical College of Wisconsin, USA.,
| | - Joseph Carroll
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.,Department of Cell Biology, Neurobiology, and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.,Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.,
| | - Edgar A DeYoe
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.,
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17
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Griffin SM, McDonald HR, Johnson RN, Jumper JM, Fu AD, Cunningham ET, Lee K, Ng CC, Lujan BJ. FINGERPRINT SIGN OF THE HENLE FIBER LAYER. Retina 2021; 41:381-386. [PMID: 32604343 PMCID: PMC7959252 DOI: 10.1097/iae.0000000000002875] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To describe the appearance of concentric, fingerprint-like waves within the Henle fiber layer (HFL) using en face optical coherence tomography in patients with tractional pathologies of the retina. METHODS Retrospective analysis of six eyes of six patients imaged by optical coherence tomography with volumetric slabs positioned at the level of the HFL. RESULTS Optical coherence tomography data from six patients with tractional vitreoretinal pathology were reviewed. Concentric, fingerprint-like microwaves were visualized through en face optical coherence tomography in all six study eyes at the level of the HFL. This finding resembled the finding of HFL waves previously noted histopathologically from force exerted on this layer. CONCLUSION In retinal pathologies in which specific physical forces act on the retina, volumetric optical coherence tomography may permit visualization of en face concentric, fingerprint-like hyperreflective rings within the HFL. This "fingerprint sign" may represent a biomechanical consequence of traction on the retina and allow clinical decision making based on improved recognition of the existence of such traction.
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Affiliation(s)
- Shane M. Griffin
- Casey Eye Institute, Oregon Health & Science University, Portland, OR
| | - H. Richard McDonald
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Robert N. Johnson
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - J. Michael Jumper
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Arthur D. Fu
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Emmett T. Cunningham
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
- The Francis I Proctor Foundation, UCSF School of Medicine, San Francisco, CA
| | - Kiang Lee
- Casey Eye Institute, Oregon Health & Science University, Portland, OR
| | - Caleb C. Ng
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Brandon J. Lujan
- Casey Eye Institute, Oregon Health & Science University, Portland, OR
- West Coast Retina Medical Group, San Francisco, CA
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18
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Woertz EN, Omoba BS, Dunn TM, Chiu SJ, Farsiu S, Strul S, Summers CG, Drack AV, Carroll J. Assessing Ganglion Cell Layer Topography in Human Albinism Using Optical Coherence Tomography. Invest Ophthalmol Vis Sci 2020; 61:36. [PMID: 32196097 PMCID: PMC7405956 DOI: 10.1167/iovs.61.3.36] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose To test whether ganglion cell layer (GCL) and inner plexiform layer (IPL) topography is altered in albinism. Methods Optical coherence tomography scans were analyzed in 30 participants with albinism and 25 control participants. Horizontal and vertical line scans were acquired at the fovea, then strip registered and averaged. The Duke Optical Coherence Tomography Retinal Analysis Program was used to automatically segment the combined GCL and IPL and total retinal thickness, followed by program-assisted manual segmentation of the boundary between the GCL and IPL. Layer thickness and area under the curve (AUC) were calculated within 2.5 mm of the fovea. Nasal-temporal and superior-inferior asymmetry were calculated as an AUC ratio in each quadrant. Results GCL and IPL topography varied between participants. The summed AUC in all quadrants was similar between groups for both the GCL (P = 0.84) and IPL (P = 0.08). Both groups showed nasal-temporal asymmetry in the GCL, but only participants with albinism had nasal-temporal asymmetry in the IPL. Nasal-temporal asymmetry was greater in albinism for both the GCL (P < 0.0001) and the IPL (P = 0.0006). The GCL usually comprised a greater percentage of the combined GCL and IPL in controls than in albinism. Conclusions The GCL and IPL have greater structural variability than previously reported. GCL and IPL topography are significantly altered in albinism, which suggests differences in the spatial distribution of retinal ganglion cells. This finding provides insight into foveal development and structure-function relationships in foveal hypoplasia.
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19
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Inter- and Intra-individual Variations in Foveal Outer Nuclear Layer Thickness and Their Associations with Clinical Characteristics in a Healthy Chinese Population. J Ophthalmol 2020; 2020:7967393. [PMID: 32566269 PMCID: PMC7267860 DOI: 10.1155/2020/7967393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/23/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate foveal outer nuclear layer (ONL) thickness and the difference thereof between bilateral eyes and their possible associations with clinical characteristics in a healthy Chinese population. Materials and Methods Normal subjects were enrolled. Generalized linear models were used to assess the associations of foveal ONL thickness with sex, age, and spherical equivalents (SEs) and the associations of the difference in foveal ONL thickness between bilateral eyes with sex, age, and difference in SEs between bilateral eyes. Results Totally, 304 subjects were included. The average foveal ONL thickness was 103.19 ± 14.25 (range 70-151) μm in the right eye and 103.90 ± 14.63 (range 69-155) μm in the left eye. The mean difference in foveal ONL thickness between right and left eyes was -0.71 ± 4.36 (range -13 to +12) μm. Men had slightly greater foveal ONL thickness values in both right and left eyes compared with women (both P < 0.05); however, some women had a thicker foveal ONL than that of men (85/198 vs. 46/106 in the right eye; 79/198 vs. 52/106in the left eye). Age and SEs were not associated with foveal ONL thickness in either eye (all P > 0.05). Sex, age, and difference in SEs between bilateral eyes were not associated with the difference in foveal ONL thickness between bilateral eyes (all P > 0.05). Conclusions Foveal ONL thickness showed wide variation in a normal Chinese population but little difference between bilateral eyes. Both these parameters could not be adjusted by sex, age, SEs, or the SEs difference between bilateral eyes. Thus, in those diseases involving only one eye, the difference or ratio of foveal ONL thickness between the affected eye and normal fellow eye may reflect the actual degree of the disease, rather than the foveal ONL thickness in the affected eye alone.
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20
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Ramtohul P, Comet A, Denis D. Multimodal Imaging Correlation of the Concentric Macular Rings Sign in Foveal Hypoplasia: A Distinctive Henle Fiber Layer Geometry. Ophthalmol Retina 2020; 4:946-953. [PMID: 32418844 DOI: 10.1016/j.oret.2020.03.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To expand the multimodal imaging correlation of the concentric macular rings (CMR) sign seen on ultra-widefield fundus photography in patients with foveal hypoplasia. DESIGN Retrospective case series. PARTICIPANTS Thirty-two patients with foveal hypoplasia who demonstrated the CMR sign on ultra-widefield fundus photography. METHODS Inclusion criterion was the presence of a CMR sign detected on ultra-widefield fundus photography. MAIN OUTCOME MEASURES Noninvasive multimodal retinal imaging, including ultra-widefield fundus photography, structural OCT, near-infrared reflectance, and blue fundus autofluorescence, were investigated. Horizontal dense B-scans and en face OCT images were acquired. RESULTS Evaluation of all patients (n = 32 patients) demonstrated a CMR sign on ultra-widefield fundus photography. Structural OCT scans were consistent with foveal hypoplasia in all patients. En face OCT images acquired at the level of the Henle fiber layer highlighted similar concentric rings around the location of the incipient fovea. The series of concentric rings was not visible at any other level of the macula. A significant correlation was found between the horizontal diameter of the largest outer ring and foveal hypoplasia grades (P < 0.0001). CONCLUSIONS The CMR sign seen on ultra-widefield fundus imaging may be a distinctive feature of foveal hypoplasia and can support this diagnosis, especially in patients in whom OCT cannot be performed (patients with poor fixation or nystagmus or young children). Multimodal imaging correlation suggests that these concentric rings occur exclusively at the level of the Henle fiber layer. This distinctive Henle fiber layer geometry may reflect an arrested development stage in the timeline of foveal maturation.
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Affiliation(s)
- Prithvi Ramtohul
- Centre Hospitalier Universitaire de l'Hôpital Nord, Marseille, France.
| | - Alban Comet
- Centre Hospitalier Universitaire de l'Hôpital Nord, Marseille, France
| | - Danièle Denis
- Centre Hospitalier Universitaire de l'Hôpital Nord, Marseille, France
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21
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Baraas RC, Pedersen HR, Hagen LA. Single-cone imaging in inherited and acquired colour vision deficiencies. Curr Opin Behav Sci 2019. [DOI: 10.1016/j.cobeha.2019.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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Linderman RE, Cava JA, Salmon AE, Chui TY, Marmorstein AD, Lujan BJ, Rosen RB, Carroll J. Visual Acuity and Foveal Structure in Eyes with Fragmented Foveal Avascular Zones. Ophthalmol Retina 2019; 4:535-544. [PMID: 31956075 DOI: 10.1016/j.oret.2019.11.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/08/2019] [Accepted: 11/15/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE To assess the frequency and impact of abnormal foveal avascular zone (FAZ) topography (i.e., a fragmented FAZ) on visual acuity and foveal anatomic features. DESIGN Prospective, cross-sectional study from March 2018 through July 2019. PARTICIPANTS Two-hundred fifty participants were screened from a normative OCT angiography database. Of those, 12 participants were found to have at least 1 eye with a fragmented FAZ. Eight returned for follow-up imaging, along with an additional 3 participants with ocular disease (amblyopia, autosomal recessive bestrophinopathy, premature birth) having a similar FAZ phenotype. METHODS Follow-up OCT imaging and monocular best-corrected visual acuity (BCVA) were performed for these 11 participants. Twenty-four participants with a clearly defined FAZ were recruited for comparison. A normative database was created measuring parafoveal intercapillary area (PICA) to determine if an FAZ was fragmented. MAIN OUTCOME MEASURES Monocular BCVA, foveal pit depth, foveal pit area, PICA, outer nuclear layer thickness, foveal inner retinal area, and peak cone density. RESULTS The frequency of a fragmented FAZ was 4.8% of individuals (12 of 250) or 3.6% of eyes (18 of 500 eyes). A significant difference was found between the control eyes and eyes with fragmented FAZs for foveal pit depth, pit area, and total PICA (P < 0.001, P = 0.002, and P < 0.001, respectively). The presence of a fragmented FAZ did not affect visual acuity. CONCLUSIONS The presence of a fragmented FAZ seems not to be a rare phenotype in individuals with normal vision. The presence of altered FAZ topography in patients with retinal or systemic disease could negatively impact the accuracy and sensitivity of biomarkers dependent on FAZ identification.
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Affiliation(s)
- Rachel E Linderman
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jenna A Cava
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Alexander E Salmon
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Toco Y Chui
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York; Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Brandon J Lujan
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Richard B Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York; Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joseph Carroll
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin.
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23
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Zhang Y, Zhang Y, Liu T, Bai D, Yang X, Li W, Wei A. Identification of two Chinese oculocutaneous albinism type 6 patients and mutation updates of the
SLC
24A5
gene. J Dermatol 2019; 46:1027-1030. [DOI: 10.1111/1346-8138.15065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 08/01/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yunlan Zhang
- Department of Dermatology Beijing Tongren Hospital Capital Medical University BeijingChina
| | - Yingzi Zhang
- Department of Dermatology Shunyi Women and Children's Hospital of Beijing Children's Hospital BeijingChina
| | - Teng Liu
- Department of Dermatology Beijing Tongren Hospital Capital Medical University BeijingChina
| | - Dayong Bai
- Department of Ophthalmology Beijing Children's Hospital Capital Medical University BeijingChina
| | - Xiumin Yang
- Department of Dermatology Beijing Tongren Hospital Capital Medical University BeijingChina
| | - Wei Li
- Laboratory for Genetics of Birth Defects Beijing Pediatric Research Institute Beijing Children's Hospital Capital Medical University National Center for Children's Health BeijingChina
- Shunyi Women and Children's Hospital of Beijing Children's Hospital Beijing China
| | - Aihua Wei
- Department of Dermatology Beijing Tongren Hospital Capital Medical University BeijingChina
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24
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Brandl C, Brücklmayer C, Günther F, Zimmermann ME, Küchenhoff H, Helbig H, Weber BHF, Heid IM, Stark KJ. Retinal Layer Thicknesses in Early Age-Related Macular Degeneration: Results From the German AugUR Study. Invest Ophthalmol Vis Sci 2019; 60:1581-1594. [PMID: 30995315 PMCID: PMC6892378 DOI: 10.1167/iovs.18-25332] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose To systematically analyze thicknesses of retinal layers in an older population and their link to early age-related macular degeneration (AMD). Methods In the AugUR baseline survey from a population aged ≥70 years, we conducted multimodal retinal imaging, including spectral-domain optical coherence tomography. Autosegmentation of eight distinct retinal layers was followed by manual correction of segmentation errors. AMD status was graded on color fundus images according to the Three Continent AMD Consortium Severity Scale. We tested the association of early AMD on retinal layer thicknesses by using linear mixed models and replicated significant results in independent data also from the AugUR platform. Results When comparing layer thicknesses between early AMD and no AMD (822 eyes, 449 participants), the retinal pigment epithelium/Bruch's membrane complex demonstrated a statistically significant thickening (e.g., P = 6.41 × 10−92 for severe early versus no AMD) and photoreceptor layers showed a significant thinning. Autosegmented retinal layer thicknesses revealed similar associations as manually corrected values but underestimated some effects. Independent replication analysis in 1026 eyes (546 participants) confirmed associations (e.g., P = 9.38 × 10−36 for retinal pigment epithelium/Bruch's membrane complex, severe early versus no AMD). Conclusions This first population-based study on spectral-domain optical coherence tomography-derived retinal layer thicknesses in a total of ∼1000 individuals provides insights into the reliability of autosegmentation and layer-specific reference values for an older population. Our findings show a difference in thicknesses between early AMD and no AMD for some retinal layers, suggesting these as potential imaging biomarkers. The thinning of photoreceptor layers substantiates a photoreceptor cell loss/damage already occurring in early AMD.
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Affiliation(s)
- Caroline Brandl
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany.,Department of Ophthalmology, University Hospital Regensburg, Regensburg, Germany.,Institute of Human Genetics, University of Regensburg, Regensburg, Germany
| | | | - Felix Günther
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany.,Statistical Consulting Unit StaBLab, Department of Statistics, Ludwig-Maximilians-University Munich, Germany
| | - Martina E Zimmermann
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Helmut Küchenhoff
- Statistical Consulting Unit StaBLab, Department of Statistics, Ludwig-Maximilians-University Munich, Germany
| | - Horst Helbig
- Department of Ophthalmology, University Hospital Regensburg, Regensburg, Germany
| | - Bernhard H F Weber
- Institute of Human Genetics, University of Regensburg, Regensburg, Germany
| | - Iris M Heid
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Klaus J Stark
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
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Georgiou M, Litts KM, Kalitzeos A, Langlo CS, Kane T, Singh N, Kassilian M, Hirji N, Kumaran N, Dubra A, Carroll J, Michaelides M. Adaptive Optics Retinal Imaging in CNGA3-Associated Achromatopsia: Retinal Characterization, Interocular Symmetry, and Intrafamilial Variability. Invest Ophthalmol Vis Sci 2019; 60:383-396. [PMID: 30682209 PMCID: PMC6354941 DOI: 10.1167/iovs.18-25880] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/21/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate retinal structure in subjects with CNGA3-associated achromatopsia and evaluate disease symmetry and intrafamilial variability. Methods Thirty-eight molecularly confirmed subjects underwent ocular examination, optical coherence tomography (OCT), and nonconfocal split-detection adaptive optics scanning light ophthalmoscopy (AOSLO). OCT scans were used for evaluating foveal hypoplasia, grading foveal ellipsoid zone (EZ) disruption, and measuring outer nuclear layer (ONL) thickness. AOSLO images were used to quantify peak foveal cone density, intercell distance (ICD), and the coefficient of variation (CV) of ICD. Results Mean (±SD) age was 25.9 (±13.1) years. Mean (± SD) best corrected visual acuity (BCVA) was 0.87 (±0.14) logarithm of the minimum angle of resolution. Examination with OCT showed variable disruption or loss of the EZ. Seven subjects were evaluated for disease symmetry, with peak foveal cone density, ICD, CV, ONL thickness, and BCVA not differing significantly between eyes. A cross-sectional evaluation of AOSLO imaging showed a mean (±SD) peak foveal cone density of 19,844 (±13,046) cones/mm2. There was a weak negative association between age and peak foveal cone density (r = -0.397, P = 0.102), as well as between EZ grade and age (P = 0.086). Conclusions The remnant cone mosaics were irregular and variably disrupted, with significantly lower peak foveal cone density than unaffected individuals. Variability was also seen among subjects with identical mutations. Therefore, subjects should be considered on an individual basis for stratification in clinical trials. Interocular symmetry suggests that both eyes have comparable therapeutic potential and the fellow eye can serve as a valid control. Longitudinal studies are needed, to further examine the weak negative association between age and foveal cone structure observed here.
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Affiliation(s)
- Michalis Georgiou
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Katie M. Litts
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Angelos Kalitzeos
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Christopher S. Langlo
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Thomas Kane
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Navjit Singh
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Melissa Kassilian
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Nashila Hirji
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Neruban Kumaran
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
| | - Alfredo Dubra
- Department of Ophthalmology, Stanford University, Palo Alto, California, United States
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, United Kingdom
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