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J. T. Nezgoda, G. Landa, E. Su, P. M. T. Garcia, R. B. Rosen; Correlation Between Retinal Sensitivity, Tested by Microperimetry, and the Status of Underlying Inner/outer Segment Junctional Photoreceptor Layer, Assessed by Spectral Domain Optical Coherence Tomography in Central Serous Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):333.
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Central serous retinopathy (CSR) is a disease in which a serous detachment of the neurosensory retina occurs over an area of leakage from the choriocapillaris through the retinal pigment epithelium (RPE). It can cause vision loss in young patients without any other ocular pathology. Our purpose was to investigate the relationship between the status of the inner segment-outer segment (IS-OS) junction layer of the retina and overlying retinal sensitivity as a feature of Microperimetry testing (MP). This is assessed by using Spectral Domain Scanning Laser Ophthalmoscope with MP and Optical Coherence Tomography (SLO-OCT).
SLO-OCT exam, used to acquire high-resolution images of the retina, and Microperimetry Testing, used for detection of retinal function deficit, was performed in patients diagnosed with CSR. MP results were then superimposed on retinal topography maps and point-to-point analysis of correlation between microperimetric retinal sensitivity and corresponding underlying status of IS-OS junctional layer was performed.
835 retinal points of 8 consecutive CSR patients during a follow-up period of 6 months were analyzed. Decreased mean retinal sensitivity when cysts or fluid were not present in the underlying retina was inversely and strongly correlated with the integrity of the IS-OS layer (correlation coefficient R2=.65, P<0.001). Retinal thickness was weakly correlated (R2=.25 P<0.001) with decreased retinal sensitivity.
In CSR patients, retinal sensitivity is more highly correlated with the status of the underlying IS-OS junctional layer than with the macular thickness. The integrity of the IS-OS junctional layer on Spectral Domain OCT appears to be more significant than retinal thickness in evaluation of retinal function. Thus it is possible that prognosis and decision for therapy (in particular in patients with past episodes involving vision loss) in CSR can be assessed by evaluating this marker at an earlier stage in the disease process and as well as during the follow-up period.
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