scholarly journals Solar Retinopathy: A Multimodal Analysis

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Claudia Bruè ◽  
Cesare Mariotti ◽  
Edoardo De Franco ◽  
Yale Fisher ◽  
Jacopo Maria Guidotti ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Outer Segment ◽  
Fundus Autofluorescence ◽  
Fundus Examination ◽  
Outer Retina ◽  
External Limiting Membrane ◽  
Multimodal Analysis ◽  
Morphological Findings ◽  
Sd Oct

Purpose. Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT) findings are not always consistent. We report on two cases of solar retinopathy and discuss its differential diagnosis.Methods. This is an observational case study.Results. A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autofluorescence showed hypoautofluorescence surrounded by a relatively hyperautofluorescent ring, bilaterally. Similar clinical and morphological findings were detected in a 27-year-old male.Conclusions. Solar retinopathy has a subtle presentation and patients often deny sun-gazing. SD-OCT and fundus autofluorescence are noninvasive and useful tools for its diagnosis.

scholarly journals Photoreceptor Impairment and Restoration on Optical Coherence Tomographic Image

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Yoshinori Mitamura ◽  
Sayaka Mitamura-Aizawa ◽  
Takashi Katome ◽  
Takeshi Naito ◽  
Akira Hagiwara ◽  
...  
Keyword(s):  
Outer Segment ◽  
Histopathological Change ◽  
Line Length ◽  
Retinal Layer ◽  
Tomographic Image ◽  
Optical Coherence ◽  
External Limiting Membrane ◽  
Photoreceptor Outer Segments ◽  
The Cost ◽  
Sd Oct

With recent development of spectral-domain optical coherence tomography (SD-OCT), the pathological changes of retina can be observed in much greater detail. SD-OCT clearly delineates three highly reflective lines in the outer retina, which are external limiting membrane (ELM), photoreceptor inner and outer segment (IS/OS) junction, and cone outer segment tips (COST) in order from inside. These lines can serve as hallmarks for the evaluation of photoreceptor condition. In retinitis pigmentosa (RP) leading to photoreceptor degeneration, the ELM, IS/OS, and COST lines are shortened with the progression of the disease. In addition, shortening of the ELM, IS/OS and COST lines is significantly associated with each other. The line length is longest in the ELM, followed by the IS/OS, and COST, suggesting that retinal layer becomes disorganized first at the COST, followed by the IS/OS and finally the ELM. This finding is consistent with the previous report that the earliest histopathological change in RP is a shortening of the photoreceptor outer segments. On the other hand, retinal layer becomes restored first at the ELM, followed by the IS/OS and finally the COST after macular hole surgery. There may be a directionality of photoreceptor impairment or restoration on optical coherence tomographic image.

Changes of outer retinal thickness with increasing age in normal eyes

2020 ◽  
Vol 1 (2) ◽  
pp. 108-112
Author(s):  
Zi-Jing Li ◽  
◽  
Jian-Hui Xiao ◽  
Peng Zeng ◽  
Xiang Gao ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Outer Segment ◽  
Retinal Thickness ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Retinal Layer ◽  
External Limiting Membrane ◽  
The Cost ◽  
The Relationship ◽  
Sd Oct

AIM: To comprehensively investigate the relationship between outer retinal layer thickness and age in normal eyes. METHODS: One hundred normal eyes of 100 subjects who underwent spectral-domain optical coherence tomography (SD-OCT) were included in this retrospective study. The distances between the external limiting membrane (ELM) line and the photoreceptor inner segment/outer segment (IS/OS) line (ELM-IS/OS), the IS/OS line and the cone outer segment tips (COST) line (IS/OS-COST), the COST line and the retinal pigment epithelium (RPE) complex (COST-RPE) and the full retinal thickness (RT) were measured at the fovea and on four quarters. The relationship between thickness and age or sex was then analysed. CONCLUSION: In normal eyes, the RT thickness on the nasal quarter and the ELM-IS/OS thickness were significantly and negatively correlated with age. The IS/OS-COST and COST-RPE thicknesses were not significantly correlated with age or sex.

scholarly journals Acute Retinal Pigment Epitheliitis: Spectral Domain Optical Coherence Tomography, Fluorescein Angiography, and Autofluorescence Findings

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Tuğba Aydoğan ◽  
Esra Güney ◽  
Betül İlkay Sezgin Akçay ◽  
Tahir Kansu Bozkurt ◽  
Cihan Ünlü ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Fluorescein Angiography ◽  
Pigment Epithelium ◽  
Outer Nuclear Layer ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Spectral Domain ◽  
Fundus Examination ◽  
Optical Coherence ◽  
Sd Oct

A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes’ best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA) showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF) was slightly increased. Spectral domain optical coherence tomography (SD-OCT) showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL). One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.

scholarly journals Two Novel Disease-Causing Variants in the PDE6C Gene Underlying Achromatopsia

2021 ◽  
pp. 749-760
Author(s):  
Carolina Madeira ◽  
Gonçalo Godinho ◽  
Ana Grangeia ◽  
Manuel Falcão ◽  
Renato Silva ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Colour Vision ◽  
Clinical Phenotype ◽  
Compound Heterozygous ◽  
Outer Retina ◽  
Heterozygous Genotype ◽  
Flicker Stimulation ◽  
Empty Cavity ◽  
Rod Response ◽  
Sd Oct

We report the clinical phenotype and genetic findings of two variants in PDE6C underlying achromatopsia (ACHM). Four patients with the variant c.1670G&#x3e;A in exon 13 of the PDE6C gene were identified. Additionally, one had compound heterozygous genotype, with two variants in the <i>PDE6C</i> gene, a variant of c.2192G&#x3e;A in exon 18 and c.1670G&#x3e;A in exon 13. All patients presented the symptomatic triad of decreased visual acuity, severe photophobia, and colour vision disturbances. SD-OCT showed an absence of the ellipsoid zone, creating an optically empty cavity at the fovea in three patients. The patient with the compound heterozygous genotype presented a more severe subfoveal outer retina atrophy. ERG recordings showed extinguished responses under photopic and 30-Hz flicker stimulation, with a normal rod response. We identified two new variants in the <i>PDE6C</i> gene that leads to ACHM.

scholarly journals Percentage of Foveal vs Total Macular Geographic Atrophy as a Predictor of Visual Acuity in Age-Related Macular Degeneration

2019 ◽  
Vol 3 (5) ◽  
pp. 278-282 ◽  
Author(s):  
Saghar Bagheri ◽  
Ines Lains ◽  
Rebecca F. Silverman ◽  
Ivana Kim ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Fundus Autofluorescence ◽  
Cross Sectional Study ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Age Related ◽  
The Impact ◽  
Sd Oct

Purpose: This article investigates the relationship between visual acuity (VA), total area of geographic atrophy (GA), and percentage of foveal GA. Methods: A multicenter, retrospective, cross-sectional study was conducted of patients with GA due to age-related macular degeneration. Demographics, VA, fundus autofluorescence (FAF), and spectral-domain optical coherence tomography (SD-OCT) images were collected. Using FAF images aided by SD-OCT, fovea-sparing status, GA pattern, total GA size, and percentage of GA covering the foveal area—within a 1.5-mm-diameter circle centered on the fovea centralis—were assessed. Univariable and multiple linear regression analyses were performed. Results: Fifty-four eyes (mean age, 78.7 ±7.7 years [SD], 60.0% female) were studied. Mean VA was 0.8 ± 0.6 logarithm of the minimum angle of resolution (Snellen equivalent 20/126 ± 20/80), mean total GA 8.8 ± 6.7 mm2, and mean percentage of foveal GA was 71.5 ± 30.9%. Of all assessed eyes, 48.2% (n = 26) presented with multifocal GA, and 18.5% (n = 10) had foveal sparing. Multiple regression analysis revealed that, controlling for age and GA pattern, the percentage of foveal GA presented a statistically significant association with VA (ß = 0.41, P = .004). No significant associations were observed with mean total GA size, while controlling for the same variables (ß = 0.010, P = .440). Conclusions: Percentage of foveal GA was significantly associated with VA impairment, although the same was not verified for total GA area. These findings suggest that percentage of foveal GA may represent a more useful tool for assessing the impact of GA on VA. Further validation is needed in larger cohorts.

scholarly journals Fundus Autofluorescence in Lamellar Macular Holes and Pseudoholes: A Review

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Ferdinando Bottoni
Keyword(s):  
Optical Coherence Tomography ◽  
Thin Layer ◽  
Fundus Autofluorescence ◽  
Internal Limiting Membrane ◽  
Optical Coherence ◽  
Outer Retina ◽  
Small Loss ◽  
Macular Holes ◽  
Definition Of ◽  
Sd Oct

Macular pseudoholes (MPHs) and lamellar macular holes (LMHs) have been recently defined according to spectral domain optical coherence tomography (SD-OCT) criteria. A major feature for differentiating an MPH from an LMH remains the loss of foveal tissue. The anatomy of the foveola is peculiar with the macular pigment (MP) embedded in a very thin layer of tissue underlying the internal limiting membrane and mainly constituted of a specialized group of Müller cells and Henle’s fibers. Despite the near microscopic resolution (≈5–7 μm) and the capability to visualize the outer retina in detail, SD-OCT may fail to ascertain whether a very small loss of this foveolar tissue has occurred. Blue-fundus autofluorescence (B-FAF) imaging is useful in this respect because even very small loss of MP can be identified, suggesting a corresponding localized loss of the innermost layers of the foveola. A definition of MP loss would help differentiating an LMH from an MPH where B-FAF imaging will be negative.

scholarly journals Inner Segment Ellipsoid Band and Cone Outer Segment Tips Changes Preceding Macular Hole Development in a Young Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Mariana Harasawa ◽  
Hugo Quiroz-Mercado ◽  
Guillermo Salcedo-Villanueva ◽  
Gerardo Garcia-Aguirre ◽  
Shulamit Schwartz
Keyword(s):  
Visual Acuity ◽  
Young Patient ◽  
Macular Hole ◽  
Outer Segment ◽  
Young Patients ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Pars Plana ◽  
Sd Oct

Purpose. Pathophysiology of macular hole (MH) is not yet well defined but the advances of spectral domain optical coherence tomography (SD-OCT) give us access to further detailed imaging. We report a case with macular inner segment ellipsoid (ISe) band loss and cone outer segment tips (COST) line changes seen in SD-OCT preceding MH appearance in a young patient.Methods. 21-year-old woman presented with a partial central scotoma, metamorphopsia, and a 20/25 vision in her right eye. Past medical history was positive for laser assisted in situ keratomileusis (LASIK) surgery 7 months ago with no complications. Macular SD-OCT showed ISe band loss and COST line elevation. She was followed a month later with visual acuity deteriorating to 20/200 and a full thickness MH.Results. The patient underwent a pars plana vitrectomy with internal limiting membrane peeling. Her visual acuity 2 months later was 20/20.Conclusion. SD-OCT can identify preliminary changes, yet to be described, preceding MH formation. Our patient demonstrated ISe band loss and COST abnormalities on SD-OCT a month prior to MH development. SD-OCT should be considered in young patients with subtle visual symptoms and mild changes in visual acuity that are not readily explained by ophthalmological exam.

scholarly journals External limiting membrane and ellipsoid zone structural integrity in diabetic macular edema

2021 ◽  
pp. 112067212110261
Author(s):  
Sandeep Saxena ◽  
Carsten H Meyer ◽  
Levent Akduman
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Structural Integrity ◽  
External Limiting Membrane ◽  
Ellipsoid Zone ◽  
Anti Vegf ◽  
Central Subfield Thickness ◽  
Structural Barrier ◽  
Sd Oct

The external limiting membrane (ELM) and ellipsoid zone (EZ) can be observed exquisitely by SD-OCT. In diabetic macular edema (DME), dysfunction of mitochondria, represented by the EZ in the foveal photoreceptors results in reduced visual acuity (VA). An increase in VEGF was found to correlate with increased severity of DR, increased central subfield thickness (CST), and sequential disruption of ELM and EZ. The mechanism of ELM and EZ restoration after anti-VEGF therapy in DME has been discovered. The ELM restores first followed by EZ restoration. Thus, authors have discovered and established ELM as a novel retinal structural barrier.

scholarly journals Correlation between Visual Acuity, Inner Segment/Outer Segment Junction, and Cone Outer Segment Tips Line Integrity in Uveitic Macular Edema

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Paolo Tortorella ◽  
Enzo D’Ambrosio ◽  
Ludovico Iannetti ◽  
Federica De Marco ◽  
Maurizio La Cava
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Outer Segment ◽  
Poor Vision ◽  
Ellipsoid Zone ◽  
Logistic Analysis ◽  
Uveitic Macular Edema ◽  
Interdigitation Zone ◽  
Spectralis Oct ◽  
Sd Oct

Purpose. To investigate the correlation between best-corrected visual acuity (BCVA), the foveal inner segment/outer segment (IS/OS) junction or ellipsoid portion of inner segment (EPIS/ellipsoid zone), and the cone outer segment tips (COST) line or interdigitation zone integrity in eyes with uveitic macular edema (ME).Method. A retrospective observational study involving all patients from January 2012 to December 2013 with uveitic ME was performed. All patients underwent BCVA using Snellen charts spectral-domain optical coherence tomography (SD-OCT) examination using Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany).Results. Fifty-two eyes from 45 patients were included in this study. Multivariate analysis showed a negative correlation between BCVA and the central retinal subfield thickness (CST), the cystoid pattern of edema, and the interdigitation zone interruption. Univariate logistic analysis showed a strong correlation between the ellipsoid zone and the interdigitation zone integrity.Conclusions. The ellipsoid zone defect, the interdigitation zone interruption, and the CST are correlated with poor vision. Visual acuity is also strongly affected by the cystoid pattern. The interdigitation zone integrity appears to be the most important factor in the visual prognosis of uveitic ME.

scholarly journals Subretinal leakage of a retinal capillary macroaneurysm - a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmad S. Rehmani ◽  
Touka Banaee ◽  
Fuad Makkouk
Keyword(s):  
Rare Case ◽  
Subretinal Fluid ◽  
Fundus Examination ◽  
Initial Visit ◽  
Outer Retina ◽  
External Limiting Membrane ◽  
Cystic Fluid ◽  
Case Presentation ◽  
Intraretinal Fluid ◽  
Retinal Capillary

Abstract Background Report a rare case of retinal capillary macroaneurysm with associated subretinal fluid. Case presentation A 71-year-old male underwent full ophthalmic examination including Optical Coherence Tomography (OCT), Fluorescein Angiography (FA). Fundus examination showed moderate non-proliferative diabetic retinopathy of both eyes with scattered microaneurysms. On initial visit, FA displayed a hyperfluorescent lesion with leakage on late frames in the left eye. OCT revealed the lesion to be spheroid with a hyperreflective wall and hyporeflective lumen in the inner retina, corresponding to a capillary macroaneurysm. Intraretinal cystic fluid surrounded the lesion. On subsequent visit 7 months later, subretinal fluid in the location of the capillary macroaneurysm was noted on OCT. Vision was maintained at 20/30–2 OD, 20/40 OS throughout. No treatment was necessary. Conclusion Subretinal fluid from the capillary macroaneurysm likely developed from its juxtafoveal location and discontinuity of the external limiting membrane (ELM); a barrier preventing flow of intraretinal fluid to the outer retina.

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