The Association Between Percent Disruption of the Photoreceptor Inner Segment-outer Segment Junction and Visual Acuity in Diabetic Macular Edema

Overview

Journal Am J Ophthalmol

Specialty Ophthalmology

Date 2010 May 11

PMID 20451897

Citations 121

Authors

Anjali S Maheshwary

Stephen F Oster

Ritchie M S Yuson

Lingyun Cheng

Francesca Mojana

William R Freeman

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the integrity of the photoreceptor inner segment/outer segment (IS/OS) junction using spectral-domain optical coherence tomography (SD OCT) in patients with diabetic macular edema and to correlate the relationship between the integrity of the IS/OS junction and visual acuity.

Design: Retrospective, comparative, consecutive case series.

Methods: Sixty-two eyes from 38 patients with diabetic macular edema underwent SD OCT imaging. For each patient, 2 experienced observers masked to visual acuity measured several SD OCT variables, including central macular thickness, retinal volume, global disruption scale of outer retina, percentage disruption of the outer retina, and history of previous treatments. Visual acuity recorded as number of Early Treatment Diabetic Retinopathy Study letters was used as the outcome variable in univariate and multivariate analysis testing the measured SD OCT variables as predictors.

Results: A statistically significant correlation between percentage disruption of the IS/OS junction and visual acuity was found (P = .0312). Additionally, there was a strong trend suggesting a relationship between macular volume and visual acuity, although borderline significance was found (P = .07).

Conclusions: Disruption of the photoreceptor IS/OS junction is an important predictor of visual acuity among diabetic macular edema patients.

Citing Articles

The Ellipsoid Zone Is a Structural Biomarker for Visual Outcomes in Diabetic Macular Edema and Macular Hole Management.

Chaturvedi S, Paul A, Singh S, Akduman L, Saxena S Vision (Basel). 2025; 9(1.

PMID: 39846620 PMC: 11755456. DOI: 10.3390/vision9010004.

Ultrastructural imaging biomarkers in diabetic macular edema: A major review.

Sen S, Khalid H, Udaya P, Raman R, Rajendram R, ElHousseini Z Indian J Ophthalmol. 2024; 73(Suppl 1):S7-S23.

PMID: 39723865 PMC: 11834929. DOI: 10.4103/IJO.IJO_878_24.

Photoreceptor assessment in age-related macular degeneration.

Domalpally A, Haas A, Chandra S, VanderZee B, S Dimopoulos I, Keenan T Eye (Lond). 2024; 39(2):284-295.

PMID: 39578549 PMC: 11751396. DOI: 10.1038/s41433-024-03462-x.

Visual training for the treatment of retinal photoreceptor inner and outer segment connection (IS/OS) fracture: A case report.

Jiang P, Xu S, Chen Q, Pan B Medicine (Baltimore). 2024; 103(22):e38109.

PMID: 39259077 PMC: 11142790. DOI: 10.1097/MD.0000000000038109.

[OCT biomarkers in diabetic maculopathy and artificial intelligence].

Lorenz A, Pollreisz A, Schmidt-Erfurth U, Szurman P, Stanzel B Ophthalmologie. 2024; 121(8):623-630.

PMID: 39012371 DOI: 10.1007/s00347-024-02065-x.

References

Otani T, Kishi S . Tomographic findings of foveal hard exudates in diabetic macular edema. Am J Ophthalmol. 2001; 131(1):50-4. DOI: 10.1016/s0002-9394(00)00661-9. View

Schocket L, Witkin A, Fujimoto J, Ko T, Schuman J, Rogers A . Ultrahigh-resolution optical coherence tomography in patients with decreased visual acuity after retinal detachment repair. Ophthalmology. 2006; 113(4):666-72. PMC: 1940045. DOI: 10.1016/j.ophtha.2006.01.003. View

Browning D, Glassman A, Aiello L, Beck R, Brown D, Fong D . Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology. 2006; 114(3):525-36. PMC: 2585542. DOI: 10.1016/j.ophtha.2006.06.052. View

Sakamoto A, Nishijima K, Kita M, Oh H, Tsujikawa A, Yoshimura N . Association between foveal photoreceptor status and visual acuity after resolution of diabetic macular edema by pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol. 2009; 247(10):1325-30. DOI: 10.1007/s00417-009-1107-5. View

Pendergast S, Hassan T, Williams G, Cox M, Margherio R, Ferrone P . Vitrectomy for diffuse diabetic macular edema associated with a taut premacular posterior hyaloid. Am J Ophthalmol. 2000; 130(2):178-86. DOI: 10.1016/s0002-9394(00)00472-4. View

Murakami T, Tsujikawa A, Ohta M, Miyamoto K, Kita M, Watanabe D . Photoreceptor status after resolved macular edema in branch retinal vein occlusion treated with tissue plasminogen activator. Am J Ophthalmol. 2006; 143(1):171-3. DOI: 10.1016/j.ajo.2006.08.030. View

Goebel W . Retinal thickness in diabetic retinopathy: a study using optical coherence tomography (OCT). Retina. 2002; 22(6):759-67. DOI: 10.1097/00006982-200212000-00012. View

Jahn C, Topfner von Schutz K, Richter J, Boller J, Kron M . Improvement of visual acuity in eyes with diabetic macular edema after treatment with pars plana vitrectomy. Ophthalmologica. 2004; 218(6):378-84. DOI: 10.1159/000080940. View

Shah S, Patel M, Thomas D, Aldington S, Laidlaw D . Factors predicting outcome of vitrectomy for diabetic macular oedema: results of a prospective study. Br J Ophthalmol. 2005; 90(1):33-6. PMC: 1856901. DOI: 10.1136/bjo.2005.072934. View

10.

Cardillo Piccolino F, Rigault de la Longrais R, Ravera G, Eandi C, Ventre L, Abdollahi A . The foveal photoreceptor layer and visual acuity loss in central serous chorioretinopathy. Am J Ophthalmol. 2005; 139(1):87-99. DOI: 10.1016/j.ajo.2004.08.037. View

11.

Falkenstein I, Cochran D, Azen S, Dustin L, Tammewar A, Kozak I . Comparison of visual acuity in macular degeneration patients measured with snellen and early treatment diabetic retinopathy study charts. Ophthalmology. 2007; 115(2):319-23. PMC: 2709293. DOI: 10.1016/j.ophtha.2007.05.028. View

12.

Oster S, Mojana F, Brar M, Yuson R, Cheng L, Freeman W . Disruption of the photoreceptor inner segment/outer segment layer on spectral domain-optical coherence tomography is a predictor of poor visual acuity in patients with epiretinal membranes. Retina. 2009; 30(5):713-8. DOI: 10.1097/IAE.0b013e3181c596e3. View

13.

Otani T, Kishi S . A controlled study of vitrectomy for diabetic macular edema. Am J Ophthalmol. 2002; 134(2):214-9. DOI: 10.1016/s0002-9394(02)01548-9. View

14.

Eandi C, Chung J, Cardillo-Piccolino F, Spaide R . Optical coherence tomography in unilateral resolved central serous chorioretinopathy. Retina. 2005; 25(4):417-21. DOI: 10.1097/00006982-200506000-00004. View

15.

Browning D, Glassman A, Aiello L, Bressler N, Bressler S, Danis R . Optical coherence tomography measurements and analysis methods in optical coherence tomography studies of diabetic macular edema. Ophthalmology. 2008; 115(8):1366-71, 1371.e1. PMC: 2748270. DOI: 10.1016/j.ophtha.2007.12.004. View

16.

Klein R, Klein B, Moss S, Linton K . The Beaver Dam Eye Study. Retinopathy in adults with newly discovered and previously diagnosed diabetes mellitus. Ophthalmology. 1992; 99(1):58-62. DOI: 10.1016/s0161-6420(92)32011-1. View

17.

Sandberg M, Brockhurst R, Gaudio A, Berson E . The association between visual acuity and central retinal thickness in retinitis pigmentosa. Invest Ophthalmol Vis Sci. 2005; 46(9):3349-54. DOI: 10.1167/iovs.04-1383. View

18.

Do D, Cho M, Nguyen Q, Shah S, Handa J, Campochiaro P . Impact of optical coherence tomography on surgical decision making for epiretinal membranes and vitreomacular traction. Retina. 2007; 27(5):552-6. DOI: 10.1097/IAE.0b013e31802c518b. View