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"En face" OCT imaging of the IS/OS junction line in type 2 idiopathic macular telangiectasia.

2012 Sep 14

Journal Article

Authors:
Sallo, F.B.; Peto, T.; Egan, C.; Wolf-Schnurrbusch, U.E.K.; Clemons, T.E.; Gillies, M.C.; Pauleikhoff, D.; Rubin, G.S.; Chew, E.Y.; Bird, A.C.

Secondary:
Invest Ophthalmol Vis Sci

Volume:
53

Pagination:
6145-52

Issue:
10

PMID:
22899757

DOI:
10.1167/iovs.12-10580

Keywords:
Adult; Aged; Cohort Studies; Female; Humans; Male; Middle Aged; Retinal Telangiectasis; Sensory Thresholds; Tomography, Optical Coherence; visual acuity

Abstract:
PURPOSE: We investigated abnormalities of the photoreceptor inner/outer segment (IS/OS) junction layer viewed "en face" and their functional correlates in type 2 idiopathic macular telangiectasia (type 2 MacTel).METHODS: Segmentation and "en face" imaging of the IS/OS lines in spectral domain optical coherence tomographic (SD-OCT) volumes were performed manually. Mesopic retinal sensitivity thresholds were determined using a Nidek MP1 microperimeter. "En face" SD-OCT images and microperimetric data were superimposed over images of the fundus. Retinal structure and characteristics of type 2 MacTel were analyzed, and associations of structural changes with function were investigated.RESULTS: We examined 49 eyes of 28 patients (mean age 62.6 ± 9.4 years). Total IS/OS break area ranged from 0.04 to 2.23 mm² (mean 0.63 mm², SD 0.53 mm²) and 0.03 to 1.49 mm² (mean 0.49 mm², SD 0.42 mm²) in right and left eyes, respectively. A correlation between fellow eyes was present (Spearman correlation ρ = 0.770, P < 0.01). An assessment of the repeatability of IS/OS lesion area measurements (n = 19 eyes) revealed an intra-class correlation coefficient of 0.99 (95% confidence interval [CI] of 0.975-0.996). Retinal areas corresponding to an IS/OS break showed a mean retinal sensitivity of 8.3 ± 5.8 and 8.7 ± 5.7 decibels (dB) in right and left eyes, respectively. Mean sensitivity over retinal areas outside the lesion was significantly higher, 17.0 ± 3.3 and 16.7 ± 3.6 dB in right and left eyes, respectively (paired t-test, P < 0.01). Mean aggregate retinal sensitivity loss was 33.5 ± 30.4 dB (n = 40), correlating well with IS/OS lesion area (Pearson correlation coefficient = 0.848, P < 0.01).CONCLUSIONS: "En face" OCT imaging of the IS/OS junction layer provides a functionally relevant method for assessing disease severity in type 2 MacTel.

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