Enface Thickness Mapping and Reflectance Imaging of Retinal Layers in Diabetic Retinopathy

Purpose To present a method for image segmentation and generation of enface thickness maps and reflectance images of retinal layers in healthy and diabetic retinopathy (DR) subjects. Methods High density spectral domain optical coherence tomography (SDOCT) images were acquired in 10 healthy and 4 DR subjects. Customized image analysis software identified 5 retinal cell layer interfaces and generated thickness maps and reflectance images of the total retina (TR), inner retina (IR), outer retina (OR), and the inner segment ellipsoid (ISe) band. Thickness maps in DR subjects were compared to those of healthy subjects by generating deviation maps which displayed retinal locations with thickness below, within, and above the normal 95% confidence interval. Results In healthy subjects, TR and IR thickness maps displayed the foveal depression and increased thickness in the parafoveal region. OR and ISe thickness maps showed increased thickness at the fovea, consistent with normal retinal anatomy. In DR subjects, thickening and thinning in localized regions were demonstrated on TR, IR, OR, and ISe thickness maps, corresponding to retinal edema and atrophy, respectively. TR and OR reflectance images showed reduced reflectivity in regions of increased thickness. Hard exudates appeared as hyper-reflective spots in IR reflectance images and casted shadows on the deeper OR and ISe reflectance images. The ISe reflectance image clearly showed the presence of focal laser scars. Conclusions Enface thickness mapping and reflectance imaging of retinal layers is a potentially useful method for quantifying the spatial and axial extent of pathologies due to DR.

[1]  Francesco Bandello,et al.  The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. , 2011, Ophthalmology.

[2]  H. Goto,et al.  Biological activity is the likely origin of the intersection between the photoreceptor inner and outer segments of the rat retina as determined by optical coherence tomography , 2011, Clinical ophthalmology.

[3]  Arthur D. Fu,et al.  EN FACE SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY ANALYSIS OF LAMELLAR MACULAR HOLES , 2014, Retina.

[4]  Justin Pedro,et al.  Multidimensional en-face OCT imaging of the retina. , 2009, Optics express.

[5]  Yasser M Helmy,et al.  Optical coherence tomography classification of diabetic cystoid macular edema , 2013, Clinical ophthalmology.

[6]  Q. Nguyen,et al.  Long-term outcomes of ranibizumab therapy for diabetic macular edema: the 36-month results from two phase III trials: RISE and RIDE. , 2013, Ophthalmology.

[7]  R. Forte,et al.  En face optical coherence tomography of macular holes in high myopia , 2007, Eye.

[8]  A. Kampik,et al.  Scanning laser 'en face' retinal imaging of epiretinal membranes. , 2014, Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society.

[9]  Xian Zhang,et al.  Development of a Semi-Automatic Segmentation Method for Retinal OCT Images Tested in Patients with Diabetic Macular Edema , 2013, PloS one.

[10]  Martin F. Kraus,et al.  En face enhanced-depth swept-source optical coherence tomography features of chronic central serous chorioretinopathy. , 2014, Ophthalmology.

[11]  Wolfgang Wieser,et al.  Real time en face Fourier-domain optical coherence tomography with direct hardware frequency demodulation. , 2008, Optics letters.

[12]  Simon P. Harding,et al.  Safety and Efficacy of Ranibizumab in Diabetic Macular Edema (RESOLVE Study) , 2010, Diabetes Care.

[13]  Jennifer K. Sun,et al.  Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema. , 2015, The New England journal of medicine.

[14]  N. Yoshimura,et al.  Association of pathomorphology, photoreceptor status, and retinal thickness with visual acuity in diabetic retinopathy. , 2011, American journal of ophthalmology.

[15]  Rashid Ansari,et al.  Feasibility of level-set analysis of enface OCT retinal images in diabetic retinopathy. , 2015, Biomedical optics express.

[16]  Nagahisa Yoshimura,et al.  Optical coherence tomographic reflectivity of photoreceptors beneath cystoid spaces in diabetic macular edema. , 2012, Investigative ophthalmology & visual science.

[17]  Peter K Kaiser,et al.  Optical coherence tomographic patterns of diabetic macular edema. , 2006, American journal of ophthalmology.

[18]  Jennifer I. Lim,et al.  Inner and outer retinal thickness mapping of nonproliferative diabetic retinopathy by spectral-domain optical coherence tomography. , 2015, Ophthalmic surgery, lasers & imaging retina.

[19]  Tetsuya Kano,et al.  Quantifying alterations of macular thickness before and after panretinal photocoagulation in patients with severe diabetic retinopathy and good vision. , 2003, Ophthalmology.

[20]  Laurie Dustin,et al.  Relationship between optical coherence tomography retinal parameters and visual acuity in diabetic macular edema. , 2010, Ophthalmology.

[21]  G. Ripandelli,et al.  Optical coherence tomography. , 1998, Seminars in ophthalmology.

[22]  Joseph A. Izatt,et al.  Automatic segmentation of seven retinal layers in SDOCT images congruent with expert manual segmentation , 2010, Optics express.

[23]  K. A. Vermeer,et al.  Automated segmentation by pixel classification of retinal layers in ophthalmic OCT images , 2011, Biomedical optics express.

[24]  T. Peto,et al.  A 2-year prospective randomized controlled trial of intravitreal bevacizumab or laser therapy (BOLT) in the management of diabetic macular edema: 24-month data: report 3. , 2012, Archives of ophthalmology.

[25]  Elham Hatef,et al.  Two-year outcomes of the ranibizumab for edema of the mAcula in diabetes (READ-2) study. , 2010, Ophthalmology.

[26]  W. Freeman,et al.  The association between percent disruption of the photoreceptor inner segment-outer segment junction and visual acuity in diabetic macular edema. , 2010, American journal of ophthalmology.

[27]  M. Rispoli,et al.  RETINAL SURFACE EN FACE OPTICAL COHERENCE TOMOGRAPHY: A New Imaging Approach in Epiretinal Membrane Surgery , 2012, Retina.

[28]  D. Fong,et al.  VISUAL SIDE EFFECTS OF SUCCESSFUL SCATTER LASER PHOTOCOAGULATION SURGERY FOR PROLIFERATIVE DIABETIC RETINOPATHY: A Literature Review , 2007, Retina.

[29]  S. Kishi,et al.  Patterns of diabetic macular edema with optical coherence tomography. , 1999, American journal of ophthalmology.

[30]  C. Curcio,et al.  ANATOMICAL CORRELATES TO THE BANDS SEEN IN THE OUTER RETINA BY OPTICAL COHERENCE TOMOGRAPHY: Literature Review and Model , 2011, Retina.

[31]  Yoshinori Mitamura,et al.  CORRELATION OF VISUAL RECOVERY AND PRESENCE OF PHOTORECEPTOR INNER/OUTER SEGMENT JUNCTION IN OPTICAL COHERENCE IMAGES AFTER SUCCESSFUL MACULAR HOLE REPAIR , 2008, Retina.

[32]  Catherine Egan,et al.  "En face" OCT imaging of the IS/OS junction line in type 2 idiopathic macular telangiectasia. , 2012, Investigative ophthalmology & visual science.

[33]  Pratul P. Srinivasan,et al.  Fully automatic software for retinal thickness in eyes with diabetic macular edema from images acquired by cirrus and spectralis systems. , 2013, Investigative ophthalmology & visual science.

[34]  Dawn A Sim,et al.  Quantitative analysis of diabetic macular ischemia using optical coherence tomography. , 2014, Investigative ophthalmology & visual science.

[35]  Sina Farsiu,et al.  Kernel regression based segmentation of optical coherence tomography images with diabetic macular edema. , 2015, Biomedical optics express.

[36]  Joseph A. Izatt,et al.  Automatic segmentation of closed-contour features in ophthalmic images using graph theory and dynamic programming , 2012, Biomedical optics express.

[37]  Justin Pedro,et al.  Combined confocal/en face T-scan-based ultrahigh-resolution optical coherence tomography in vivo retinal imaging. , 2006, Optics letters.

[38]  Xiaodong Wu,et al.  Automated 3-D Intraretinal Layer Segmentation of Macular Spectral-Domain Optical Coherence Tomography Images , 2009, IEEE Transactions on Medical Imaging.

[39]  J. Duker,et al.  Optical coherence tomography – current and future applications , 2013, Current Opinion in Ophthalmology.

[40]  R B Rosen,et al.  Evaluation of central serous retinopathy with en face optical coherence tomography , 2005, British Journal of Ophthalmology.

[41]  Hiroki Otsuka,et al.  Correlation between reflectivity of subretinal fluid in OCT images and concentration of intravitreal VEGF in eyes with diabetic macular edema. , 2013, Investigative ophthalmology & visual science.

[42]  Hyewon Chung,et al.  Association between photoreceptor integrity and visual outcome in diabetic macular edema , 2011, Graefe's Archive for Clinical and Experimental Ophthalmology.

[43]  R. Forte,et al.  Posterior retinal detachment without macular hole in high myopia: visualization with en face optical coherence tomography , 2007, Eye.

[44]  Mahnaz Shahidi,et al.  Feasibility of a method for en face imaging of photoreceptor cell integrity. , 2011, American journal of ophthalmology.

[45]  S. A. Meyer,et al.  RELATIONSHIP BETWEEN PHOTORECEPTOR OUTER SEGMENT LENGTH AND VISUAL ACUITY IN DIABETIC MACULAR EDEMA , 2009, Retina.

[46]  L. T. Lim,et al.  Advances in the management of diabetic macular oedema based on evidence from the Diabetic Retinopathy Clinical Research Network. , 2015, Singapore medical journal.

[47]  Boris Povazay,et al.  Choroidal thinning in diabetes type 1 detected by 3-dimensional 1060 nm optical coherence tomography. , 2012, Investigative ophthalmology & visual science.

[48]  A. Tsujikawa,et al.  Association between foveal photoreceptor status and visual acuity after resolution of diabetic macular edema by pars plana vitrectomy , 2009, Graefe's Archive for Clinical and Experimental Ophthalmology.

[49]  Richard B Rosen,et al.  IMAGING THE RETINA BY EN FACE OPTICAL COHERENCE TOMOGRAPHY , 2006, Retina.

[50]  S. Kishi,et al.  CORRELATION BETWEEN VISUAL ACUITY AND FOVEAL MICROSTRUCTURAL CHANGES IN DIABETIC MACULAR EDEMA , 2010, Retina.

[51]  James G. Fujimoto,et al.  CHOROIDAL IMAGING USING SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY , 2012, Retina.

[52]  N. Bressler,et al.  Comparative Effectiveness Trial for Diabetic Macular Edema: Three Comparisons for the Price of 1 Study From the Diabetic Retinopathy Clinical Research Network. , 2015, JAMA ophthalmology.

[53]  James G Fujimoto,et al.  CHOROIDAL THICKNESS IN PATIENTS WITH DIABETIC RETINOPATHY ANALYZED BY SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY , 2011, Retina.

[54]  Akitoshi Yoshida,et al.  Irregularity of photoreceptor layer after successful macular hole surgery prevents visual acuity improvement. , 2004, American journal of ophthalmology.

[55]  Bartosz L. Sikorski,et al.  The Diagnostic Function of OCT in Diabetic Maculopathy , 2013, Mediators of inflammation.

[56]  P. Nucci,et al.  En face optical coherence tomography of inner retinal defects after internal limiting membrane peeling for idiopathic macular hole. , 2011, Investigative ophthalmology & visual science.

[57]  D. Hood,et al.  The inner segment/outer segment border seen on optical coherence tomography is less intense in patients with diminished cone function. , 2011, Investigative ophthalmology & visual science.

[58]  N. Bressler,et al.  Intravitreal Ranibizumab for diabetic macular edema with prompt versus deferred laser treatment: 5-year randomized trial results. , 2015, Ophthalmology.

[59]  Boris Hermann,et al.  Mapping choroidal and retinal thickness variation in type 2 diabetes using three-dimensional 1060-nm optical coherence tomography. , 2011, Investigative ophthalmology & visual science.

[60]  Lawrence P. L. Iu,et al.  The inner segment/outer segment junction: what have we learnt so far? , 2012, Current opinion in ophthalmology.

[61]  Florence Coscas,et al.  En face enhanced depth imaging optical coherence tomography features in adult onset foveomacular vitelliform dystrophy , 2014, Graefe's Archive for Clinical and Experimental Ophthalmology.