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 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 External limiting membrane: retinal structural barrier in diabetic macular edema

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sandeep Saxena ◽  
Levent Akduman ◽  
Carsten H. Meyer
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Barrier Effect ◽  
External Limiting Membrane ◽  
Ellipsoid Zone ◽  
Structural Barrier ◽  
Sd Oct

AbstractAdvances in spectral-domain optical coherence tomography (SD-OCT) technology have enhanced the understanding of external limiting membrane (ELM) and ellipsoid zone (EZ) in diabetic macular edema. An increase in VEGF has been demonstrated to be associated with sequential ELM and EZ disruption on SD-OCT. An intact ELM is a prerequisite for an intact EZ in DME. Anti-VEGF therapy leads to restoration of barrier effect of ELM. The ELM restores first followed by EZ restoration.

Rapid response to dexamethasone intravitreal implant in diabetic macular edema

2017 ◽  
Vol 28 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Giuseppe Lo Giudice ◽  
Antonio Avarello ◽  
Gianluca Campana ◽  
Alessandro Galan
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Secondary Outcome ◽  
Dexamethasone Intravitreal Implant ◽  
Clinical Series ◽  
Intravitreal Implant ◽  
Early Effects ◽  
Sd Oct

Purpose: To evaluate the early effects of dexamethasone (DEX) intravitreal implants in patients with diabetic macular edema (DME). Methods: This was a prospective, single-arm, interventional clinical series. Eighteen patients (18 eyes) with chronic/recalcitrant or naive DME were included. Patients underwent single DEX intravitreal implant. Clinical assessments, including ophthalmologic examination, central retinal thickness (CRT) measurement by spectral-domain optical coherence tomography (SD-OCT) scan, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were carried out at baseline, 1-3 hours, and then 3, 7, and 30 days after treatment. The main outcome was change in CRT on SD-OCT, while secondary outcome measures included visual acuity (VA) and changes in IOP following implant. Results: Mean CRT significantly decreased from 565 ± 171 µm at baseline to 310 ± 89 µm at end of follow-up (p<0.001), with reduction becoming evident 1-3 hours after injection. Mean BCVA also significantly improved 7 days and 30 days after treatment up to 0.14 logMAR (p<0.05). All patients had a controlled IOP after the injection with only 1/18 eyes having a transient increase in IOP during follow-up. Conclusions: This is the first study showing very early effects of DEX implants on CRT reduction and VA improvement in DME.

Optical Coherence Tomographic Features and Visual Prognosis after Treatment for Idiopathic Choroidal Neovascularization

2015 ◽  
Vol 234 (2) ◽  
pp. 67-72
Author(s):  
Xu-Sheng Cao ◽  
Xiao-Yan Peng ◽  
Qi-Sheng You ◽  
Yong-Peng Zhang ◽  
Jost B. Jonas
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Univariate Analysis ◽  
Final Visual Acuity ◽  
Lower Amount ◽  
Optical Coherence ◽  
Intravitreal Ranibizumab ◽  
Visual Prognosis ◽  
Ellipsoid Zone ◽  
Sd Oct

Background: The aim of this study was to determine whether pretreatment spectral-domain optical coherence tomographic (SD-OCT) features are associated with visual prognosis after treatment for idiopathic subfoveal choroidal neovascularization (ISCNV) with intravitreal ranibizumab. Methods: We retrospectively evaluated SD-OCT images of eyes with ISCNV undergoing treatment with intravitreal ranibizumab with a mean follow-up of 7 months. Results: This study included 22 patients (22 eyes) with a mean age of 32.7 ± 8.1 years. In univariate analysis, better final visual acuity expressed in logMAR units was significantly associated with a lower amount of pretreatment ellipsoid zone defects (p = 0.03; standardized correlation coefficient β = 0.46) and a lower amount of pretreatment external limiting membrane (ELM) damage (p = 0.007; β = 0.56). All other SD-OCT parameters were not significantly associated with final visual acuity. A higher improvement in visual acuity was marginally significantly associated with larger pretreatment ellipsoid zone defects (p = 0.049; β = -0.43). Conclusions: The integrity of the outer retinal layers at baseline, in particular of the ELM, is of importance in predicting the final visual outcome in patients undergoing intravitreal medical therapy for ISCNV.

scholarly journals RELATIONSHIP BETWEEN PHOTORECEPTOR OUTER SEGMENT LENGTH AND VISUAL ACUITY IN DIABETIC MACULAR EDEMA

Retina ◽  
2010 ◽  
Vol 30 (1) ◽  
pp. 63-70 ◽  
Author(s):  
FARZIN FOROOGHIAN ◽  
PAUL F. STETSON ◽  
SCOTT A. MEYER ◽  
EMILY Y. CHEW ◽  
WAI T. WONG ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Outer Segment ◽  
Segment Length ◽  
Photoreceptor Outer Segment

scholarly journals Correlation of retinal layer changes with vision gain in diabetic macular edema during conbercept treatment

2019 ◽  
Author(s):  
Yupeng Xu ◽  
Yuan Qu ◽  
Yan Suo ◽  
Jian Gao ◽  
Xia Chen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Outer Nuclear Layer ◽  
Plexiform Layer ◽  
Retinal Layer ◽  
Central Field ◽  
Inner Plexiform Layer ◽  
Clinically Significant ◽  
Sd Oct

Abstract Purpose To assess the changes in individual retinal layer thickness and visual function associated with gains in visual acuity after an intravitreal conbercept injection in the diabetic macular edema (DME) on spectral domain optical coherence tomography (SD-OCT) and microperimetry during 1-year follow-up. Methods Retrospective observational study. Twenty patients with clinically significant DME in the study eye were imaged by SD-OCT every three months and MP1 microperimeter in the third month while receiving anti-VEGF (conbercept) treatment. In each patient, seven retinal layers were segmented in 98 scans covering a 6mm×6mm area of the macula at baseline and during 1 year of treatment. An automatic, full-threshold microperimetry of the central field (10°×10°, 40 stimulated points) with the MP1 microperimeter. Thickness and microperimetry changes were quantitatively measured and evaluated for their correlation with increases in visual acuity. Results Although thicknesses of the inner nuclear layer (INL) and the outer nuclear layer (ONL) were reduced the most after treatment (p< 0.05), decreases of the ganglion cell layer (GCL) (r = 0.591, p= 0.006) and inner plexiform layer (IPL) (r= 0.663, p= 0.001) in central subfield area was associated with BCVA gain, and had the best estimation of BCVA gain (adjust R2=0.544). Mean macular sensitivity in the central subfield was also well correlated with BCVA gain (r=0.531, p=0.016). Conclusions Neural recovery occurred after the resolution of edema during conbercept treatment, due to the decreases in GCL and IPL associating with gains in vision and improved microperimetry.

scholarly journals Ellipsoid Zone Integrity and Visual Acuity Changes during Diabetic Macular Edema Therapy: A Longitudinal Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Lucy J. Kessler ◽  
Gerd U. Auffarth ◽  
Dmitrii Bagautdinov ◽  
Ramin Khoramnia
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Visual Outcome ◽  
Long Term Results ◽  
First Year ◽  
Ellipsoid Zone ◽  
Anti Vegf ◽  
Potential Biomarker

Purpose. Ellipsoid zone (EZ) integrity is identified as a potential biomarker for therapy surveillance and outcome prediction of visual acuity (VA). However, only a few studies report long-term results of over 1 year of clinical and anatomical changes in patients with diabetic macular edema (DME). This study is aimed at describing the long-term VA and anatomical outcomes in spectral domain optical coherence tomography (OCT) (relative ellipsoid zone reflectivity ratio, central macular thickness, and volume) in patients with DME treated with antivascular endothelial growth factor (anti-VEGF) therapy. Furthermore, we studied the correlation between EZ integrity and changes in visual acuity. Methods. 71 eyes of 71 patients were included in this retrospective study. Clinical characteristics were reviewed yearly. OCT data were assessed at baseline and after 1, 3, and 5 years. EZ parameters were quantified automatically. OCT parameters and visual outcome were correlated and analyzed in multivariable regression models. Results. EZ reflectivity ratio correlated with functional outcome in DME patients from baseline to fifth year at all time points (for all p < 0.05 ). EZ reflectivity improved the most in the first year of treatment (0.68 to 0.75; p < 0.05 ) and declined gradually until year 5 of therapy (0.71; compared to baseline p > 0.05 ). Similarly, best VA was achieved after 1 year (0.40 logarithm of the minimum angle of resolution (logMAR) to 0.28 logMAR; p < 0.001 ) and declined gradually until year 5. Final VA in year 5 was comparable to baseline (0.45 logMAR, compared to baseline p > 0.05 ). Together with baseline VA, baseline EZ parameters did predict VA outcome after 1 year ( p < 0.05 ). Concordantly, VA and EZ parameters from year 1 were associated with VA outcome in year 2. Conclusion. This study described the long-term course of EZ changes during anti-VEGF treatment in DME patients. In addition, our results underlined the potential of EZ parameters as novel OCT biomarkers for prediction of VA outcomes during therapy.

scholarly journals Quantitative Assessment of Outer Retinal Layer and Photoreceptor Outer Segment Layer and Their Relation to Visual Acuity in Diabetic Macular Edema

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Ahmed Hosni Abd Elhamid
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Quantitative Assessment ◽  
Outer Segment ◽  
Retinal Layer ◽  
Moderate Correlation ◽  
Weak Correlation ◽  
Photoreceptor Outer Segment ◽  
Corrected Visual Acuity

Purpose. To compare outer retinal layer (ORL) thickness and photoreceptor outer segment (PROS) length between normal eyes and eyes with diabetic macular edema (DME), and also, to study the correlation between central macular thicknesses (CMT), ORL, and PROS length with best corrected visual acuity (BCVA) in DME. Methods. 80 eyes were included in the study; they were divided into two groups, group Ι (40 normal eyes) and group ΙΙ (40 eyes) with DME. Complete ophthalmic examination and OCT were done for all eyes. Comparison between ORL and PROS was done between both groups; also, correlation between ORL thickness, PROS length, and CMT with BCVA in group ΙΙ was studied. Results. CMT was greater in group ΙΙ than group Ι (392.70 ± 62.91 and 265.73 ± 17.17, respectively) (SS, p<0.001). ORL thickness was statistically significantly greater in group Ι than group ΙΙ (104.80 ± 4.94, 93.68 ± 6.34, p<0.001). Regarding PROS length, it was statistically significantly greater in group Ι than group ΙΙ (31.38 ± 3.4 and 26.65 ± 3.39, respectively, p<0.001). There was moderate correlation between BCVA and ORL thickness (r = −0.440, p=0.004) and strong correlation between BCVA and PROS length in group ΙΙ (r = − 0.690, p<0.001), while there was weak correlation between BCVA and CMT (r = 0.198, p=0.220). Conclusion. Both ORL thickness and PROS length were greater in healthy normal eyes than eyes with DME. BCVA was correlated better with PROS length and ORL thickness than CMT.

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