Quantitative analysis of retinal layers' optical intensities on 3D optical coherence tomography for central retinal artery occlusion

Abstract

Optical coherence tomography (OCT) provides not only morphological information but also information about layer-specific optical intensities, which may represent the underlying tissue properties. The purpose of this study is to quantitatively investigate the optical intensity of each retinal layers in central retinal artery occlusion (CRAO). Twenty-nine CRAO cases at acute phase and 33 normal controls were included. Macula-centered 3D OCT images were segmented with a fully-automated Iowa Reference Algorithm into 10 layers. Layer-specific mean intensities were determined and compared between the patient and control groups using multiple regression analysis while adjusting for age and optical intensity of the entire region. The optical intensities were higher in CRAO than in controls in layers spanning from the retinal ganglion cell layer to outer plexiform layer (standardized beta = 0.657 to 0.777, all p < 0.001), possibly due to ischemia. Optical intensities were lower at the photoreceptor, retinal pigment epithelium (RPE), and choroid layers (standardized beta = −0.412 to −0.611, all p < 0.01), possibly due to shadowing effects. Among the intraretinal layers, the inner nuclear layer was identified as the best indicator of CRAO. Our study provides in vivo information of the optical intensity changes in each retinal layer in CRAO patients.

Reversibility of retinal ischemia due to central retinal artery occlusion by hyperbaric oxygen

“…Recently, optical coherence tomography (OCT) confirmed that this opacification and swelling of the posterior pole, sparing the foveola (CRS), represent an ischemic infarction of the inner retinal tissues 28. When the inner retinal tissues suffer an irreversible infarct, their optical density increases and shadows over the lower optical intensity of the outer retina 28…”

Evidence for an enduring ischaemic penumbra following central retinal artery occlusion, with implications for fibrinolytic therapy

“…1). Likewise, all agree that the opacification and swelling of the posterior fundus, sparing the foveola, represents ischaemic infarction of the inner retinal tissues, as confirmed by the thickening and hyperreflectivity of the inner retinal layers seen on optical coherence tomography (OCT) (Chen et al, 2015). Significant differences of opinion have arisen, however, regarding the 3-dimensional extent of infarction induced by CRAO.…”

Purtscher’s retinopathy – case report and literature review

“…The majority of researchers recommend the administration of steroids during treatment. There are reports concerning improvement of visual acuity after the use of steroid therapy; however, there are no randomised studies confirming the effectiveness of such a management [18,[26][27][28]. In our case, after steroids treatment visual acuity in the right eye improved from the level of counting fingers at 0.5 m to 0.3 m according to the Snellen scale.…”

“…In the presented case, the SD-OCT also revealed hyperreflective inner retinal layers, including the INL (Figure 3). It is presumed that increased reflectivity of the INL may be a marker of the extent of the ischaemia [18].…”