Quantitative Analysis of the Ellipsoid Zone Intensity in Phenotypic Variations of Intermediate Age-Related Macular Degeneration

Abstract

Citation: Gin TJ, Wu Z, Chew SKH, Guymer RH, Luu CD. Quantitative analysis of the ellipsoid zone intensity in phenotypic variations of intermediate age-related macular degeneration. Invest Ophthalmol Vis Sci. 2017;58:207958: -208658: . DOI:10.1167 PURPOSE. Reduction of the ellipsoid zone (EZ) intensity has been reported in eyes with agerelated macular degeneration (AMD). This study determined whether overall EZ intensity, in retinal locations undisturbed by pathologic features, is associated with the presence of clinical features, which are known important phenotypic risk factors for disease progression, large drusen, reticular pseudodrusen (RPD), and pigmentary abnormalities. METHODS.A horizontal B-scan through the foveola on spectral-domain optical coherence tomography (SD-OCT) was performed in both eyes of 75 participants with bilateral intermediate AMD and 10 age-similar control participants. Eyes with AMD were classified as per the presence of large drusen, RPD, and hyperpigmentary changes. The relative EZ intensity profile, up to an eccentricity of 3400 lm, was averaged over seven 1000-lm retinal segments. The association between relative EZ intensity profile over seven retinal segments and AMD pathologic features was analyzed.RESULTS. The average relative EZ intensities were significantly reduced in eyes with intermediate AMD compared to normal eyes (P 0.025) and with increasing age (P 0.020). On multivariate analyses, only the presence of hyperpigmentary changes and increasing age were significantly associated with reduced overall relative intensities (P 0.024), but not the presence of large drusen or RPD (P ‡ 0.115).CONCLUSIONS. The presence of hyperpigmentary change in the macula in association with large drusen, not large drusen alone, nor large drusen with RPD, was significantly associated with a generalised reduction in EZ intensity. Quantitative assessment of the relative EZ intensity may serve as an effective biomarker of disease severity and progression.

Outer Retina and Choroidal Thickness in Intermediate Age-Related Macular Degeneration: Reticular Pseudodrusen Findings

“…In agreement with changes reported in the ellipsoid zone in AMD [22], it would make sense to expect changes in the outer layers [44] such as the MZ and OS. With a decrease in MZ thickness in the RPD group compared to in the drusen ≥125-µm group, the greatest differences were found in the total mean values and in the nasal region.…”

“…With improved imaging techniques, the deposits located in the subretinal or pre-RPE space [19], termed "reticular pseudodrusen" (RPD) or "subretinal drusenoid deposits," are more frequently identified [18,19,22]. With an apparent predominance in the superotemporal region of the macula, and clearly identifiable on spectraldomain optical coherence tomography (SD-OCT) [23] in a position anterior to the RPE cell monolayer [18], RPD appear to be relevant in the prognosis and evolution of AMD [24][25][26][27][28].…”

Maculopathy from an accidental exposure to welding arc

“…Although the prognosis of welding-induced photic retinal injury is usually good, permanent complications are sometimes reported,9 and this difference in sequelae may reflect the severity of exposure and injury. Absence or disruption of the ellipsoid zone is known to be closely correlated with prognosis of visual acuity and disease severity 13 14. In solar retinopathy cases, decreased central foveal thickness and full-thickness disruption beneath the fovea observed on OCT could be associated with permanent visual acuity loss 15.…”

Validation of an Automated Quantification of Relative Ellipsoid Zone Reflectivity on Spectral Domain-Optical Coherence Tomography Images

“…For the conventional manual quantification approach, both the EZ and the ELM peak was visually identified from the reflectivity profile in each predetermined ROI and their peak intensity values were obtained manually. 16 , 17 , 20 The manual method was performed by a single examiner (S.T.). For the automated method, the EZ and the ELM peak intensity was determined using an algorithm developed in MatLab software.…”

“…The same group also showed that the rEZR was significantly reduced in eyes with intermediate (i) AMD, particularly in eyes with reticular pseudodrusen and pigmentary changes, compared with the normal control eyes. 15 , 16 These findings suggest that rEZR might have a role in AMD characterization and monitoring disease progression. However, the rEZR data in those studies were obtained manually from a limited number of locations on a single OCT line scans (B-scan) through the fovea.…”