Assessing reproducibility and the effects of demographic variables on the normal macular layers using the Spectralis SD-OCT

Hashmani, Nauman; Hashmani, Sharif; Murad, Asif; Shah, Sharaf Ali; Hashmani, Maria

doi:10.2147/opth.s172109

Cited by 4 publications

(11 citation statements)

References 28 publications

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“…The observed age-related TRT decline portrays the retina as an evolving structure, a finding that is well supported in the literature [ 9 , 15 , 18 – 21 ]. In particular, one review of the literature described the age-related thinning pattern as spatially-dependent, with an unchanged or thickened central retina, and a maximum thickness loss in the parafoveal region [ 9 ].…”

Section: Discussionsupporting

confidence: 82%

“…In contrast, we found that the RNFL remained unchanged or even became thicker in some temporal regions. This discrepancy is also present in the literature, with different studies reporting thinning [ 22 , 38 ], no effect [ 18 , 19 ], or thickening [ 20 , 39 ]. These mixed results might be explained by the thinness of the RNFL in relation to the axial resolution, which makes thickness measurements more prone to segmentation errors.…”

Section: Discussionmentioning

confidence: 95%

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Spatial characterization of the effect of age and sex on macular layer thicknesses and foveal pit morphology

et al. 2022

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Characterizing the effect of age and sex on macular retinal layer thicknesses and foveal pit morphology is crucial to differentiating between natural and disease-related changes. We applied advanced image analysis techniques to optical coherence tomography (OCT) to: 1) enhance the spatial description of age and sex effects, and 2) create a detailed open database of normative retinal layer thickness maps and foveal pit shapes. The maculae of 444 healthy subjects (age range 21–88) were imaged with OCT. Using computational spatial data analysis, thickness maps were obtained for retinal layers and averaged into 400 (20 x 20) sectors. Additionally, the geometry of the foveal pit was radially analyzed by computing the central foveal thickness, rim height, rim radius, and mean slope. The effect of age and sex on these parameters was analyzed with multiple regression mixed-effects models. We observed that the overall age-related decrease of the total retinal thickness (TRT) (-1.1% per 10 years) was mainly driven by the ganglion cell-inner plexiform layer (GCIPL) (-2.4% per 10 years). Both TRT and GCIPL thinning patterns were homogeneous across the macula when using percentual measurements. Although the male retina was 4.1 μm thicker on average, the greatest differences were mainly present for the inner retinal layers in the inner macular ring (up to 4% higher TRT than in the central macula). There was an age-related decrease in the rim height (1.0% per 10 years) and males had a higher rim height, shorter rim radius, and steeper mean slope. Importantly, the radial analysis revealed that these changes are present and relatively uniform across angular directions. These findings demonstrate the capacity of advanced analysis of OCT images to enhance the description of the macula. This, together with the created dataset, could aid the development of more accurate diagnosis models for macular pathologies.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 95%

Spatial characterization of the effect of age and sex on macular layer thicknesses and foveal pit morphology

et al. 2022

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“…Clinical results have reported that women have thinner retinas than men, without any differences in the foveal pit morphology ( Wagner-Schuman et al, 2011 ), whereas the amplitudes of scotopic and photopic electroretinograms (ERGs) of female subjects have been reported to be on average 29% larger than those of males ( Brûlé et al, 2007 ). Morphological studies have shown gender-related structural differences in thickness of the macular retinal layers by spectral-domain optical coherence tomography (SD-OCT) ( Adhi et al, 2012 ; Hashamani et al, 2018 ). Additionally, the outer nuclear layers and the inner nuclear layer (INL) have been determined to be thicker in men, whereas the nerve fiber layer (NFL) is thicker in women ( Ooto et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Changes in Retinal Structure and Ultrastructure in the Aged Mice Correlate With Differences in the Expression of Selected Retinal miRNAs

et al. 2021

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Age and gender are two important factors that may influence the function and structure of the retina and its susceptibility to retinal diseases. The aim of this study was to delineate the influence that biological sex and age exert on the retinal structural and ultrastructural changes in mice and to identify the age-related miRNA dysregulation profiles in the retina by gender. Experiments were undertaken on male and female Balb/c aged 24 months (approximately 75–85 years in humans) compared to the control (3 months). The retinas were analyzed by histology, transmission electron microscopy, and age-related miRNA expression profile analysis. Retinas of both sexes showed a steady decline in retinal thickness as follows: photoreceptor (PS) and outer layers (p < 0.01 for the aged male vs. control; p < 0.05 for the aged female vs. control); the inner retinal layers were significantly affected by the aging process in the males (p < 0.01) but not in the aged females. Electron microscopy revealed more abnormalities which involve the retinal pigment epithelium (RPE) and Bruch’s membrane, outer and inner layers, vascular changes, deposits of amorphous materials, and accumulation of lipids or lipofuscins. Age-related miRNAs, miR-27a-3p (p < 0.01), miR-27b-3p (p < 0.05), and miR-20a-5p (p < 0.05) were significantly up-regulated in aged male mice compared to the controls, whereas miR-20b-5p was significantly down-regulated in aged male (p < 0.05) and female mice (p < 0.05) compared to the respective controls. miR-27a-3p (5.00 fold; p < 0.01) and miR-27b (7.58 fold; p < 0.01) were significantly up-regulated in aged male mice vs. aged female mice, whereas miR-20b-5p (−2.10 fold; p < 0.05) was significantly down-regulated in aged male mice vs. aged female mice. Interestingly, miR-27a-3p, miR-27b-3p, miR-20a-5p, and miR-20b-5p expressions significantly correlated with the thickness of the retinal PS layer (p < 0.01), retinal outer layers (p < 0.01), and Bruch’s membrane (p < 0.01). Our results showed that biological sex can influence the structure and function of the retina upon aging, suggesting that this difference may be underlined by the dysregulation of age-related mi-RNAs.

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“…Previous studies have suggested good reproducibility for SPECTRALIS (Heidelberg Engineering Inc, Heidelberg, Germany) OCT for both intraobserver and interobserver studies. These studies have provided general interclass correlated coefficients and have not provided quantifiable data to assist clinicians to detect significant change outside normative variability (2,3).…”

mentioning

confidence: 99%

“…In addition, serial GCL monitoring may identify disease change (2). A normative database of the average thickness of the GCL and/or inner plexiform layer (IPL) and intratest reliability of the mean GCL/IPL thickness for some spectral domain OCT machines exist (3). However, OCT machines use different algorithms to identify the GCL/IPL complex vs the GCL volume, and their findings are not interchangeable.…”

mentioning

confidence: 99%

Ganglion Cell Layer Thickness Variance Using SPECTRALIS Optical Coherence Tomography

Mallory

Wagley²,

Chen³

et al. 2022

Journal of Neuro-Ophthalmology

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Background: To determine the normal variance of the mean macular ganglion cell layer (GCL) volume among subjects without significant ocular pathology using SPECTRALIS optical coherence tomography (OCT). Methods: Fifty subjects underwent a baseline scan using SPECTRALIS OCT followed by 2 more studies with (reg-ON) and without (reg-OFF) eye registration all taken at the same session. The mean GCL volume was measured using built-in SPECTRALIS software. Eyes with macular pathology were excluded. The reproducibility of the measurements of the GCL volume was evaluated with Bland-Altman plots and limits of agreement, intraclass correlation coefficient (ICC), and the coefficient of repeatability (CR). Results: A total of 98 eyes met criteria for the analysis. The mean GCL volume difference was 0.0002 ± 0.029 and 20.0005 ± 0.035 mm 3 for scans 1 versus 2 (baseline vs reg-ON) and 3 (baseline vs reg-OFF), respectively. The ICCs were 0.985 and 0.977 for the baseline vs reg-ON and reg-OFF groups. The CR for baseline vs reg-ON was 0.056 while CR for baseline vs reg-OFF was 0.069. Ninety percent of eyes fell within 0.04 mm 3 of test-retest reliability. Conclusions: Our model found a predictable threshold of 0.07 mm 3 or less for SPECTRALIS OCT mean GCL volume variance, which did not significantly change with eye registration in eyes without macular pathology. Clinicians may also consider a threshold of 0.04 mm 3 when determining stable vs progressive changes in mean GCL volume using this device.

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Assessing reproducibility and the effects of demographic variables on the normal macular layers using the Spectralis SD-OCT

Cited by 4 publications

References 28 publications

Spatial characterization of the effect of age and sex on macular layer thicknesses and foveal pit morphology

Spatial characterization of the effect of age and sex on macular layer thicknesses and foveal pit morphology

Changes in Retinal Structure and Ultrastructure in the Aged Mice Correlate With Differences in the Expression of Selected Retinal miRNAs

Ganglion Cell Layer Thickness Variance Using SPECTRALIS Optical Coherence Tomography

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