Abstract
PurposeEllipsoid zone (EZ) and outer retinal integrity are strongly linked to visual prognosis, but quantitative normative data is lacking. This study evaluates the EZ, outer retina, and inner retina in eyes without macular disease across a wide age spectrum.MethodsAn IRB-approved study was performed for eyes without macular pathology undergoing Spectral Domain Optical Coherence Tomography (SD-OCT) scans on the Cirrus HD-OCT system (Carl Zeiss Meditec, Oberkochen, Germany). Scans were analyzed using a previously described automated EZ mapping tool with line-by-line manual verification. Segmentation included internal limiting membrane (ILM), outer nuclear layer/Henle fiber layer complex (ONL/HFL), EZ, and the retinal pigment epithelium (RPE). The output included metrics for the inner retina (ILM-OPL/HFL), outer retina (ONL/HFL-RPE), EZ-RPE area and volume, and en face EZ mapping. EZ-RPE attenuation on en face mapping was defined as EZ-RPE thickness < 20 um, and total attenuation was 0 um. Imaging parameters were assessed for the group and compared to age, sex, visual acuity and spherical equivalent.Results167 eyes from 167 subjects were included. Mean age was 49.7 years (range 10–84 years). The mean foveal retinal thickness was 200.58 ± 19.22 um. Mean inner retinal thickness was 21.47 ± 13.60 um. Mean outer retinal thickness was 179.11 ± 18.52 um. Mean EZ-RPE thickness was 50.58 ± 6.01um. The mean EZ-RPE volume was 1.20 ± 0.10 mm3. Mean EZ attenuation percentage per macular map area was 0.87% ± 1.13% and mean percentage total attenuation was 0.12% ± 0.14%. Total and inner retinal thickness metrics decreased with age. Mean outer retinal thickness increased with age. EZ-RPE parameters were unchanged with age. However, EZ attenuation was negatively correlated with age.ConclusionThis study provides important information for inner and outer retinal parameters. Future research on quantitative EZ integrity can utilize this data for comparison.
Highlights
Total and inner retinal thickness metrics decreased with age
This study provides important information for inner and outer retinal parameters
This study aims to establish an outer retinal metrics dataset in eyes without macular pathology utilizing a recently developed, automated segmentation algorithm based on the internal limiting membrane, (ILM), outer nuclear layer/henle fiber layer complex (ONL/HFL), and various ellipsoid zone (EZ) parameters
Summary
The availability of an age-stratified normative dataset for inner and outer retinal parameters and metrics is important to provide comparative data for evaluation of pathologic alterations. This study aims to establish an outer retinal metrics dataset in eyes without macular pathology utilizing a recently developed, automated segmentation algorithm based on the internal limiting membrane, (ILM), outer nuclear layer/henle fiber layer complex (ONL/HFL), and various EZ parameters. This algorithm calculates various meters, including thickness, area, and volumetric measurements in eyes. Subject demographics and clinical data were gathered through the electronic medical record
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