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      The structure-function relationship measured with optical coherence tomography and a microperimeter with auto-tracking: the MP-3, in patients with retinitis pigmentosa

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          Abstract

          The purpose of the current study was to investigate the structure-function relationship in patients with retinitis pigmentosa (RP) using optical coherence tomography and the MP-3 microperimeter. Visual field (VF) measurements were carried out using MP-3 microperimetry and the Humphrey Field Analyzer (HFA, Carl-Zeiss, CA), 22 eyes of 11 patients with a clinical diagnosis of RP, both with the 10-2 test grid pattern. Optical coherence tomography (OCT, Spectralis, Heidelberg, Germany) was also performed and the ellipsoid zone (EZ) was identified in the OCT image. The mean (±SD) number of test points located within the EZ edge was 11.6 (±5.9). There was a significant relationship between mean retinal sensitivity measured with MP-3 and the area surrounded by the EZ circular line: AEZ (p < 0.05), but this was not the case with HFA (p > 0.05). The difference between retinal sensitivity inside and outside the EZ edge was significantly larger with MP-3 than with HFA (p < 0.001). Our findings suggest that retinal sensitivity measured with MP-3 better reflects the magnitude of structural damage observed with OCT, compared with HFA. Further, the difference in retinal sensitivity between the inside and outside EZ edge is significantly larger for the MP-3 test, compared with the HFA.

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          Properties of perimetric threshold estimates from Full Threshold, SITA Standard, and SITA Fast strategies.

          Aiko Iwase, Yoshiaki Kitazawa, Devkunj Chauhan … (2002)
          To investigate the distributions of threshold estimates with the Swedish Interactive Threshold Algorithms (SITA) Standard, SITA Fast, and the Full Threshold algorithm (Humphrey Field Analyzer; Zeiss-Humphrey Instruments, Dublin, CA) and to compare the pointwise test-retest variability of these strategies. One eye of 49 patients (mean age, 61.6 years; range, 22-81) with glaucoma (Mean Deviation mean, -7.13 dB; range, +1.8 to -23.9 dB) was examined four times with each of the three strategies. The mean and median SITA Standard and SITA Fast threshold estimates were compared with a "best available" estimate of sensitivity (mean results of three Full Threshold tests). Pointwise 90% retest limits (5th and 95th percentiles of retest thresholds) were derived to assess the reproducibility of individual threshold estimates. The differences between the threshold estimates of the SITA and Full Threshold strategies were largest ( approximately 3 dB) for midrange sensitivities ( approximately 15 dB). The threshold distributions of SITA were considerably different from those of the Full Threshold strategy. The differences remained of similar magnitude when the analysis was repeated on a subset of 20 locations that are examined early during the course of a Full Threshold examination. With sensitivities above 25 dB, both SITA strategies exhibited lower test-retest variability than the Full Threshold strategy. Below 25 dB, the retest intervals of SITA Standard were slightly smaller than those of the Full Threshold strategy, whereas those of SITA Fast were larger. SITA Standard may be superior to the Full Threshold strategy for monitoring patients with visual field loss. The greater test-retest variability of SITA Fast in areas of low sensitivity is likely to offset the benefit of even shorter test durations with this strategy. The sensitivity differences between the SITA and Full Threshold strategies may relate to factors other than reduced fatigue. They are, however, small in comparison to the test-retest variability.
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            The transition zone between healthy and diseased retina in patients with retinitis pigmentosa.

            Donald Hood, Margot Lazow, S Locke … (2010)
            To describe the structural changes in the transition zone from relatively healthy retinal regions to severely affected regions in patients with retinitis pigmentosa (RP) using frequency domain optical coherence tomography (fdOCT). FdOCT line scans of the horizontal meridian were obtained from one eye of 13 patients with RP and 30 control subjects. The patients had normal or near normal foveal sensitivities and visual field diameters ≥10°. Using a computer-aided manual segmentation procedure, the locations at which the outer segment (OS) and outer nuclear layer plus outer plexiform layer (ONL+) thicknesses fell below the 95% confidence interval of the controls were measured, as were the locations at which the OS layer disappeared and the locations at which the ONL+ was reduced to an asymptotically small thickness. The progression from healthy to severely affected regions followed a common pattern in most patients. Region A, the central region including the foveal center, had normal OS and ONL+ thickness. Region B had abnormal OS but normal ONL+ thickness. Region C had abnormal but measurable OS and ONL+ thicknesses. In Region D, the OS layer disappeared, as did the IS/OS line, and the ONL+ thickness decreased further. In Region E, the ONL+ reached an asymptotic thickness. The structural changes in the transition zone followed an orderly progression from a thinning of the OS layer, to a thinning of the ONL+, to a loss of the OS layer, to an ONL+ reduced to an asymptotically small level.
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              A comparison of visual field sensitivity to photoreceptor thickness in retinitis pigmentosa.

              M. Patel, S Locke, V. Rangaswamy … (2010)
              To explore the relationship between visual field sensitivity and photoreceptor layer thickness in patients with retinitis pigmentosa (RP). Static automated perimetry (central 30-2 threshold program with spot size III; Humphrey Field Analyzer; Carl Zeiss Meditec, Inc., Dublin, CA) and frequency domain optical coherence tomography (Fd-OCT) scans (Spectralis HRA+OCT; Heidelberg Engineering, Vista, CA) were obtained from 10 age-matched normal control subjects and 20 patients with RP who had retained good central vision (better than 20/32). The outer segment (OS+) thickness (the distance between retinal pigment epithelium [RPE])/Bruch's membrane [BM] to the photoreceptor inner-outer segment junction), outer nuclear layer (ONL), and total retinal thickness were measured at locations corresponding to visual field test loci up to 21 degrees eccentricity. The average OS+ thickness in the control eyes was 63.1 +/- 5.2 microm, varying from approximately 69 microm in the foveal center to 56 microm at 21 degrees eccentricity. In patients with RP, OS+ thickness was below normal limits outside the fovea, and thickness decreased with loss in local field sensitivity, reaching an asymptotic value of 21.5 microm at approximately -10 dB. The ONL thickness also decreased with local field sensitivity loss. Although relative OS thickness was linearly related to visual field loss at all locations examined, a slightly better correlation was found between the product of OS and ONL thickness and visual field loss. In patients with RP with good foveal sensitivity, the OS thickness and the product of OS thickness and ONL thickness (assumed to represent the number of photoreceptors) decreases linearly with loss of local field sensitivity. In general, in regions where perimetric sensitivity loss is -10 dB or worse, the OS+ thickness approaches the thickness of the RPE/BM complex.
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                Author and article information

                Contributors
                Ryo Asaoka: rasaoka-tky@umin.ac.jp
                Journal
                Journal ID (nlm-ta): Sci Rep
                Journal ID (iso-abbrev): Sci Rep
                Title: Scientific Reports
                Publisher: Nature Publishing Group UK (London )
                ISSN (Electronic): 2045-2322
                Publication date (Electronic): 17 November 2017
                Publication date PMC-release: 17 November 2017
                Publication date Collection: 2017
                Volume: 7
                Electronic Location Identifier: 15766
                Affiliations
                [1 ]ISNI 0000 0001 2151 536X, GRID grid.26999.3d, Department of Ophthalmology, The University of Tokyo, ; Tokyo, Japan
                [2 ]ISNI 0000 0001 2151 536X, GRID grid.26999.3d, Department of Ophthalmology, the University of Tokyo, Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, ; Tokyo, Japan
                Article
                Publisher ID: 16143
                DOI: 10.1038/s41598-017-16143-5
                PMC ID: 5693920
                PubMed ID: 29150681
                SO-VID: 943a6a66-de32-4337-8a06-2629522499ab
                Copyright © © The Author(s) 2017
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 27 April 2017
                Date accepted : 3 November 2017
                Categories
                Subject: Article
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                issue-copyright-statement © The Author(s) 2017

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