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Ellipsoid Zone Reflectivity: Exploring its Potential as a Novel Non-Invasive Biomarker for Assessing Mitochondrial

I Kleerekooper1,2,3, D V Verschueren1,2,3,4,5,6, S A Trip2,4

  • 1Department of Brain Repair and Rehabilitation, Moorfields Eye Hospital NHS Foundation Trust, UCL, London, UK.

Neuro-Ophthalmology (Aeolus Press)
|November 25, 2024
PubMed
Summary
This summary is machine-generated.

Optical coherence tomography (OCT) can reliably measure ellipsoid zone (EZ) reflectivity, a marker of mitochondrial function. This reflectivity is reduced in neuroinflammatory and mitochondrial optic neuropathies, suggesting its potential as a diagnostic biomarker.

Keywords:
MitochondriaOCTbiomarkermultiple sclerosisneuroinflammatory diseaseretinal imaging

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Biomarker Discovery

Background:

  • The ellipsoid zone (EZ) in optical coherence tomography (OCT) scans shows high intensity due to light-scattering mitochondria.
  • EZ reflectivity is a potential indicator of mitochondrial function and health.
  • Developing reliable methods to quantify EZ reflectivity is crucial for its use as a biomarker.

Purpose of the Study:

  • To develop a reliable tool for quantifying relative EZ reflectivity from OCT scans.
  • To investigate the potential of EZ reflectivity as a biomarker in optic neuritis (ON), primary progressive optic neuropathy (PPON), chronic progressive external ophthalmoplegia (CPEO), and dominant optic atrophy (DOA).
  • To assess the test-retest reliability and diagnostic value of EZ reflectivity in various optic neuropathies.

Main Methods:

  • Developed and validated an analysis tool to extract relative EZ reflectivity, normalized to the retinal pigment epithelium (RPE) and outer nuclear layer (ONL).
  • Analyzed OCT scans from 12 healthy controls and 66 patients with ON, PPON, CPEO, or DOA.
  • Assessed reliability using intraclass correlation coefficients (ICC) and analyzed group differences using multivariable linear regression.

Main Results:

  • EZ reflectivity (EZ/RPE20% and EZ/ONL ratios) demonstrated good test-retest reliability (ICCs 0.76 and 0.63, respectively).
  • Significantly lower EZ/RPE20% and EZ/ONL ratios were observed in patients with CPEO, DOA, PPON, and ON compared to healthy controls.
  • These reductions suggest impaired mitochondrial function in these neuroinflammatory and mitochondrial optic neuropathies.

Conclusions:

  • EZ reflectivity can be reliably quantified using OCT scans.
  • Reduced EZ reflectivity is associated with neuroinflammatory and mitochondrial optic neuropathies.
  • EZ reflectivity shows promise as a non-invasive, in-vivo biomarker for mitochondrial health in the retina.