April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Expanded Understanding of Retinal Abnormalities Overlying Choroidal Neovascularization Noted in Minimum Intensity Projection Images (MinIP) from CirrusTM SD-OCT in Patients with Age-related Macular Degeneration
Author Affiliations & Notes
  • Shiri Zayit- Soudry
    Retina Division, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland
  • Paul F. Stetson
    Carl Zeiss Meditec, Dublin, California
  • Mary K. Durbin
    R & D, Carl Zeiss Meditec, Inc, Dublin, California
  • Benedicte M. Dupas
    Ophthalmology, Hospital Lariboisiere, Paris, France
  • Neil M. Bressler
    Ophthalmology, Wilmer Eye Institute, Baltimore, Maryland
  • Footnotes
    Commercial Relationships  Shiri Zayit- Soudry, None; Paul F. Stetson, Carl Zeiss Meditec Inc., CA (I, E, P); Mary K. Durbin, Carl Zeiss Meditec Inc. CA (E); Benedicte M. Dupas, None; Neil M. Bressler, Johns Hopkins University School of Medicine (F)
  • Footnotes
    Support  Johns Hopkins University School of Medicine. Bénédicte Dupas is supported by the Lavoisier grant from the French Ministry of Foreign Affairs. Shiri Soudry is supported by the Tel Aviv Medical center
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4799. doi:
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      Shiri Zayit- Soudry, Paul F. Stetson, Mary K. Durbin, Benedicte M. Dupas, Neil M. Bressler; Expanded Understanding of Retinal Abnormalities Overlying Choroidal Neovascularization Noted in Minimum Intensity Projection Images (MinIP) from CirrusTM SD-OCT in Patients with Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4799.

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

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To describe our expanded understanding of retinal abnormalities overlying choroidal neovascularization (CNV) noted in minimum intensity projection (MinIP) images from CirrusTM (Carl Zeiss Meditec, Dublin, CA) spectral domain optical coherence tomography (SD-OCT) of patients with age-related macular degeneration (AMD), including evaluation of the inter-observer agreement on the shape and extent of the bright signal noted in MinIP images, and its origin from B-scans.


Following IRB approval, 25 eyes from 23 patients were imaged with Macular Cube 512x218 scans on two separate visits. Included were 4 eyes with new-onset CNV secondary to AMD, 16 eyes with CNV during anti-VEGF therapy, and 5 eyes with geographic atrophy of the retinal pigment epithelium due to AMD but no CNV. Lesions noted on the MinIP images at each visit were manually segmented independently by two graders. The shape and extent of the segmented area were qualitatively compared. Origin of the minimum intensity signal was determined for all scans, and reviewed qualitatively.


The inter-grader variability showed good agreement in 15 of 20 study eyes. Qualitative review of the origin of the MinIP signal showed that the gray background intensity corresponding with normal retinal areas typically consisted of reflectivity values from the outer nuclear layer (ONL). This finding was consistent in all study eyes as well as in all control eyes. In the presence of CNV, the ONL often became hyper-reflective, causing a bright lesion with indistinct borders to appear in the MinIP image. In other cases, the ONL became sufficiently hyper-reflective or thinned such that the MinIP signal was in the inner nuclear layer. In these cases, a brighter lesion with well delineated borders typically was seen in the MinIP image.


MinIP images provide an en face view of abnormalities in the reflectivity and integrity of the ONL. Qualitative correlation of images of CNV as seen in fluorescein angiography with bright areas in MinIP images indicates that CNV is associated with observable alterations to retinal layers, particularly in the ONL.

Keywords: imaging/image analysis: clinical • age-related macular degeneration • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) 

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