Involvement Of Retinal Layers Research Articles

Optical Coherence Tomography Characteristics for Differentiating Scars in Type 1 (Polypoidal Choroidal Vasculopathy (PCV)) and Type 2 (Classical) Macular Neovascularization (MNV) in Age-Related Macular Degeneration (AMD).

This study aimed to assess the optical coherence tomography (OCT) characteristics for differentiating scars in the scarred stages of macular neovascularization (MNV) in age-related macular degeneration (AMD). Medical records of 20 patients, 10 in each group with type 1 and type 2 MNV, were selected for the study. Participants chosen were above 50 years of age and underwent comprehensive eye examination alongside indocyanine green angiography (ICGA), fundus fluorescence angiography (FFA), and Spectralis optical coherence tomography (SOCT) (Heidelberg Engineering, Germany), respectively. The qualitative and quantitative OCT measurements, such as the frequency of outer retinal tubulations, presence of cystoid spaces, scar area, choroid thickness, retinal thickness, presence of disorganization in retinal layers (DRIL), foveal contour, and involvement of retinal layers in the scar, were meticulously evaluated and compared between the two groups. Significant disparities between type 1 MNV and type 2 MNV in choroidal thickness were identified in the nasal and superior quadrants within 1 mm, in the superior quadrant within 3 mm, and in all quadrants except the inferior quadrant within 6 mm. Overall, type 2 MNV showed thinner choroid than type 1 MNV. Although there are several overlapping features noticed between the groups, the OCT was able to pick up characteristic features that aid in differentiating type 1 (polypoidal choroidal vasculopathy (PCV)) and type 2 (classic) MNV in AMD. This precise differentiation has the potential to assist ophthalmologists in making well-informed decisions, thereby enhancing patient care.

Regional Analysis of Inner Retinal Layer Changes in Multiple Sclerosis with and without Optic Neuritis.

The study aimed to investigate inner retinal changes in multiple sclerosis (MS) patients by comparing them with healthy controls. The study also aimed to assess regional differences of inner retinal layer involvement in eyes with and without optic neuritis (ON). This retrospective, cross-sectional study consisted of 141 eyes of 74 relapsing-remitting MS patients and 80 eyes of 40 healthy controls. The study group was separated into two subgroups according to the presence of ON history. Peripapillary retinal nerve fiber layer (pRNFL) thickness, total macular thickness, and thicknesses of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer were compared between the MS and healthy control groups and between eyes with and without ON history. Mean pRNFL, total macular, mRNFL, GCL, and IPL thicknesses were significantly thinner in the MS group than in the control group (p<0.001) and in eyes with ON compared to those without ON (p<0.05). Comparison of inner retinal layer thicknesses in the inner 3-mm ring subfields of the ETDRS grid revealed significant thinning in all subfields of the GCL and IPL of eyes with ON (p<0.05). The inferior subfield demonstrated the highest difference. The study demonstrated that GCL and IPL thinning is a robust and reliable biomarker in all MS patients. The thinning was significantly greater in eyes with ON than in eyes without ON. The study also documented that the inferior region showed significantly greater GCL and IPL thinning in eyes with previous ON attacks.

Adaptive Optics Imaging to Analyze the Photoreceptor Layer Reconstitution in Acute Syphilitic Posterior Placoid Chorioretinopathy.

Acute posterior syphilitic placoid chorioretinopathy (ASPPC) is a rare ocular manifestation of syphilis characterized by outer retinal layers involvement and drop in visual acuity. The current work documents outer retinal layer involvement in this pathology and their reconstitution with treatment by means of adaptive optics (AO). Three eyes of two patients together with four controls eyes were included in the study. Patients underwent optical coherence tomography (OCT) and OCT angiography (OCTA) scan centered on fovea, where vessel density (VD) and vessel perfusion (VP) were calculated. AO images centered on fovea were acquired and cone density (CD) and cone spacing (CS) were measured and compared to control group. Multimodal imaging was performed at presentation, at 10 days, and at 2-month follow-up. All eyes improved in visual acuity, with reconstitution in outer retinal layers at 2-month follow-up. Overall choriocapillary layer VD and VP improved. AO imaging was able to identify outer retinal alterations at presentation and at follow-ups, with improvement in tissue architecture. CD and CS was respectively lower and greater than controls at all follow-ups and improved within patients at the 2-month follow-up. In conclusion, AO was able to document outer retinal alterations in ASPPC at presentation and improvement over the follow-up, representing a tool to study photoreceptor layer involvement in this pathology.

Presumed Natural History of Combined Hamartoma of the Retina and Retinal Pigment Epithelium

To correlate structural changes of combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) with patient age. Retrospective study. Fifty eyes of 49 patients (age range, 1-74 years) with CHRRPE studied at 9 tertiary vitreoretinal institutions. We analyzed the clinical findings with respect to lesion topography and pigmentation as well as investigated the OCT findings regarding the thickness, vitreoretinal interface, outer plexiform layer distortion, ellipsoid zone disruption, and retinal pigment epithelium-Bruch's membrane complex involvement of CHRRPE. Clinical and imaging findings of CHRRPE at different ages. Analysis of 50 CHRRPE patients revealed that younger patients were more likely to demonstrate partial thickness involvement of the retina (P= 0.009) with predominantly inner retinal layer involvement (P=0.04). The inverse was true for older patients with CHRRPE. In addition, older patients more commonly showed pigmentary changes. Eyes with CHRRPE were more likely to show an increase in central macular thickness independently of tumor location. Based on these findings, we believe that CHRRPE typically begins in the inner retina and continues toward the outer retina over time, with increase in central macular thickness, despite the location of the tumor.

Retinal and choroidal vascular structures are affected in axial spondyloarthritis: an optical coherence tomography study.

The aim of this study is to evaluate the retinal and choroidal structures in r- and nr-axSpA patients using spectral domain optical coherence tomography (SD-OCT) and to compare changes with healthy controls. In this cross-sectional study, 70 axSpA patients (50 radiographic- and 20 nr-axSpA) and 50 healthy control subjects were included. Choroidal thickness (ChT), macular thickness, retinal nerve fiber layer (RNFL), and the ganglion cell complex (GCC) were measured by SD-OCT. For ChT values, seven lines at nasal and temporal were drawn at 500-μm intervals, centering the subfoveal sclerochoroidal junction. Analysis of the data was performed with the SPSS program. Mann-Whitney U test was performed for comparison of non-normally distributed continuous data; Student's t test was used for normal distributed data. No significant difference was observed between 70 (66% male; mean age 39.7 ± 10.4years) axSpA patients (50 radiographic and 20 nr-axSpA) and 50 (mean age 41.2 ± 6.2years) healthy control subjects (p 0.417). R-axSpA and nr-axSpA groups and control group were similar in terms of spherical equivalent, intraocular pressure, axial length, and body mass index (p 0.574, p 0.874, p 0.918, p 0.344, respectively). While mean macular and GCC thicknesses were significantly lower in the patient group than in the healthy group, there was no significant difference between the two groups in terms of RNFL thickness. The present study showed that there was no significant relationship between markers and scores indicating disease activity and ChT, MT, RNFL, and GCC thicknesses. However, an increase in choroidal thickness and involvement of the retinal layers has also been demonstrated in patients with spondyloarthritis. In addition, the relationship between disease activity and retinal layer involvement is remarkable in the r-axSpA group.

Optical coherence tomography segmentation analysis in relapsing remitting versus progressive multiple sclerosis.

IntroductionOptical coherence tomography (OCT) with retinal segmentation analysis is a valuable tool in assessing axonal loss and neuro-degeneration in multiple sclerosis (MS) by in-vivo imaging, delineation and quantification of retinal layers. There is evidence of deep retinal involvement in MS beyond the inner retinal layers. The ultra-structural retinal changes in MS in different MS phenotypes can reflect differences in the pathophysiologic mechanisms. There is limited data on the pattern of deeper retinal layer involvement in progressive MS (PMS) versus relapsing remitting MS (RRMS). We have compared the OCT segmentation analysis in patients with relapsing-remitting MS and progressive MS.MethodsCross-sectional study of 113 MS patients (226 eyes) (29 PMS, 84 RRMS) and 38 healthy controls (72 eyes). Spectral domain OCT (SDOCT) using the macular cube acquisition protocol (Cirrus HDOCT 5000; Carl Zeiss Meditec) and segmentation of the retinal layers for quantifying the thicknesses of the retinal layers. Segmentation of the retinal layers was carried out utilizing Orion software (Voxeleron, USA) for quantifying the thicknesses of individual retinal layers.ResultsThe retinal nerve finer layer (RNFL) (p = 0.023), the ganglion-cell/inner plexiform layer (GCIPL) (p = 0.006) and the outer plexiform layer (OPL) (p = 0.033) were significantly thinner in PMS compared to RRMS. There was significant negative correlation between the outer nuclear layer (ONL) and EDSS (r = -0.554, p = 0.02) in PMS patients. In RRMS patients with prior optic neuritis, the GCIPL correlated negatively (r = -0.317; p = 0.046), while the photoreceptor layer (PR) correlated positively with EDSS (r = 0.478; p = 0.003).ConclusionsPatients with PMS exhibit more atrophy of both the inner and outer retinal layers than RRMS. The ONL in PMS and the GCIPL and PR in RRMS can serve as potential surrogate of disease burden and progression (EDSS). The specific retinal layer predilection and its correlation with disability may reflect different pathophysiologic mechanisms and various stages of progression in MS.

Functional assessment of macular edema

AbstractAim Macular edema is evaluated using pure morphologic imaging tests and visual acuity as sole visual function test. Unfortutanetly, visual acuity just partly reflects visual function. A new integrated morpho‐functional approach seems useful. Methods Patients affected by macular edema were investigated using a multimodal/integrated imaging approach including currently available pure morphological retinal imaging techniques and microperimetry. Results The correlation between morphologic and functional imaging modalities strictly depends on the different involvement of retinal layers by the pathologic process. Data shows that visual function impairment is better quantified when microperimetry is added to the currently available diagnostic armamentarium. Conclusions Both in clinical trials and in daily clinical practice visual function needs to be better investigated to cope with patient’s requests. Adding reliable, topographically related visual functional data, currently obtained by microperimetry, to other pure retinal imaging investigations allows not only to better identify different “clinical phenotypes “ of macular disorders, but also to provide invaluable information about treatment and retreatment criteria.

Ocular larva migrans and histopathological lesions in mice experimentally infected with Baylisascaris transfuga embryonated eggs

The ability of Baylisascaris transfuga larvae to cause ocular larva migrans (OLM) in mice was examined. Mice were given approximately 3500 infective eggs of B. transfuga per os. Their eyes were removed and examined either microscopically or histologically at various intervals post-infection. Larvae were recovered beginning 7 days after infection. Histologically, free larvae were observed in the posterior chamber and within the ocular membranes. Larval granulomas were present in the choroid involvement of retinal layers. It was concluded that B. transfuga larvae have the ability to produce OLM in mice following oral infection and should be considered as possible agents of OLM in other animals and in human beings.