June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Objective analysis of outer retinal layers imaged by optical coherence tomography in patients with Stargardt disease.
Author Affiliations & Notes
  • Jason C Park
    Ophthalmology, University of Illinois at Chicago, Chicago, IL
  • Frederick T Collison
    The Pangere Center for Hereditary Retinal Diseases, The Chicago Lighthouse for People Who Are Blind or Visually Impaired, Chicago, IL
  • Gerald A Fishman
    Ophthalmology, University of Illinois at Chicago, Chicago, IL
    The Pangere Center for Hereditary Retinal Diseases, The Chicago Lighthouse for People Who Are Blind or Visually Impaired, Chicago, IL
  • Rando Allikmets
    Department of Ophthalmology, Columbia University, New York, NY
    Department of Pathology and Cell Biology, Columbia University, New York, NY
  • Jana Zernant
    Department of Ophthalmology, Columbia University, New York, NY
  • J Jason McAnany
    Ophthalmology, University of Illinois at Chicago, Chicago, IL
  • Footnotes
    Commercial Relationships Jason Park, None; Frederick Collison, None; Gerald Fishman, None; Rando Allikmets, None; Jana Zernant, None; J Jason McAnany, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 587. doi:https://doi.org/
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      Jason C Park, Frederick T Collison, Gerald A Fishman, Rando Allikmets, Jana Zernant, J Jason McAnany; Objective analysis of outer retinal layers imaged by optical coherence tomography in patients with Stargardt disease.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):587. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To develop and apply an objective, semi-automated algorithm for analyzing outer retinal layers imaged by spectral domain optical coherence tomography (SD-OCT) in patients with Stargardt disease.

Methods: Horizontal macular B-scans were acquired (Optos SD-OCT/SLO) from 22 normal controls and 20 genetically confirmed patients with stage 1 Stargardt disease. The number of hyper-reflective, outer-retina bands was quantified for each subject using a novel, semi-automated algorithm. The algorithm detected the number of hyper-reflective bands based on longitudinal reflectance profiles (LRPs) as follows: 1) LRPs were generated by averaging 43 adjacent A-scans (305 µm in width); 2) The number of bands was quantified based on the second derivative of the LRP. The present analysis focused on the 3 outermost retinal bands, currently associated with the retinal pigment epithelium complex (RPE), the cone outer segment/RPE interdigitation zone (IZ), and the ellipsoid zone (EZ). To validate the algorithm, band detection was also determined manually by four graders.

Results: The semi-automated algorithm and manual analysis showed excellent agreement. The RPE and EZ bands were detected throughout the entire B-scan in all controls. The RPE band was detected throughout the entire B-scan in all Stargardt patients, whereas the EZ band was detected only outside the central lesion. The extent of IZ band detection differed throughout the B-scan for the controls and patients. That is, IZ detection for controls was greatest in the para- and peri-foveal regions (0.5 to 2.6 mm from the fovea), with a mean detection over these areas of 82%. IZ band detection for the controls decreased towards the fovea and near-periphery (mean detection over these areas of 50% and 55%, respectively). In patients, the IZ band was generally not present in the fovea, para-, or peri-fovea due to the central lesion. Outside of the lesion, the IZ band was detected in 26% of the patients (mean detection across the near-periphery), which is less than half of the detection in controls.

Conclusions: An objective, semi-automated approach can be used successfully to quantify the number of hyper-reflective, outer-retina OCT bands. The IZ band is less frequently detected in Stargardt patients compared to controls, even outside the central lesion, suggesting abnormalities in outer segment structure and/or RPE interdigitation.

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