Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Invest Ophthalmol Vis Sci. 2014 May 8;55(5):3361-7. doi: 10.1167/iovs.14-13948.
To propose a new method to quantitatively and comprehensively evaluate photoreceptor-RPE complex alterations on spectral-domain optical coherence tomography (SD-OCT) imaging in eyes with diabetic macular edema (DME).
Spectral-domain OCT images from a consecutive series of 90 eyes in 79 patients with DME and 30 healthy eyes in 30 volunteers were analyzed retrospectively. The subfoveal area covering the photoreceptor layers was skeletonized and the orientation of the segmented lines was termed "parallelism," which reflects image complexity. Photoreceptor layer status at the fovea was categorized by graders, including continuity of the external limiting membrane (ELM) line, inner segment ellipsoid line, and the presence of hyperreflective foci in the outer retinal layers. The relationships among parallelism, visual acuity, and photoreceptor layer status were evaluated.
Parallelism was significantly lower in eyes with DME than in normal eyes (P < 0.0001), and correlated strongly with visual acuity in eyes with DME (R = -0.592; P < 0.0001). Eyes with an intact inner segment ellipsoid line or ELM line had significantly better visual acuity (VA) and higher parallelism than eyes with a discontinuous or absent inner segment ellipsoid line or ELM line. Parallelism was significantly higher (P < 0.0001) and logMAR VA significantly better (P < 0.0001) in the group without hyperreflective foci in the outer retinal layers than in the group with hyperreflective foci in the outer retinal layers.
Parallelism has the potential to reflect structural changes of the photoreceptor layers in DME.
提出一种新的方法，以定量和全面地评估糖尿病性黄斑水肿（DME）患者的光谱域光相干断层扫描（SD-OCT）图像中的光感受器-RPE 复合体改变。
回顾性分析了 79 例 DME 患者的 90 只眼和 30 名健康志愿者的 30 只眼的连续系列 SD-OCT 图像。对包含光感受器层的中心凹下区域进行骨架化，分割线的方向称为“平行度”，反映图像的复杂性。由分级员对黄斑区的光感受器层状态进行分类，包括外节限膜（ELM）线、内节椭圆体线的连续性和外视网膜层中高反射焦点的存在。评估了平行度与视力和光感受器层状态之间的关系。
DME 眼的平行度明显低于正常眼（P<0.0001），并且与 DME 眼的视力呈强相关性（R=-0.592；P<0.0001）。具有完整的内节椭圆体线或 ELM 线的眼的视力（VA）和平行度明显优于内节椭圆体线或 ELM 线不连续或缺失的眼。无外视网膜层高反射焦点的眼的平行度明显更高（P<0.0001），logMAR VA 明显更好（P<0.0001），外视网膜层有高反射焦点的眼。
平行度有可能反映 DME 中光感受器层的结构变化。
