En face spectral-domain optical coherence tomography outer retinal analysis and relation to visual acuity

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Imaging

Background:

• Spectral-domain optical coherence tomography (SD-OCT) is crucial for retinal imaging.
• Assessing photoreceptor integrity is key to understanding visual acuity.
• Current OCT metrics may not fully capture visual function.

Purpose of the Study:

• To introduce and validate an en face visualization and quantification method for the photoreceptor inner segment/outer segment (IS/OS) junction area using SD-OCT.
• To investigate the association between the IS/OS junction area and visual acuity.

Main Methods:

• A case series of 74 eyes from 53 patients was analyzed.
• A computer algorithm was used to quantify central 1-mm and 400-μm en face areas of the IS/OS junction.
• En face images were compared with retinal cross-sections and visual acuity measurements.

Main Results:

• The IS/OS junction was visible on en face SD-OCT and retinal cross-sections.
• Quantified en face IS/OS areas (1-mm and 400-μm) strongly correlated with visual acuity (r = -0.66 and -0.56, respectively; P < 0.001).
• This correlation surpassed that of central subfield thickness, macular volume, and average macular thickness with visual acuity.

Conclusions:

• Central en face IS/OS junction area measurements correlate significantly with visual acuity, reflecting photoreceptor integrity.
• This en face metric may offer a superior correlation with visual acuity compared to other SD-OCT parameters.
• Further advancements in SD-OCT may enable routine clinical use of en face IS/OS junction analysis.