Korean J Ophthalmol.  2015 Apr;29(2):92-101. 10.3341/kjo.2015.29.2.92.

Association between Microperimetric Parameters and Optical Coherent Tomographic Findings in Various Macular Diseases

• Kim DY
• Yang HS
• Kook YJ
• Lee JY

• KMID: 2363714
• DOI: http://doi.org/10.3341/kjo.2015.29.2.92

Abstract

PURPOSE
To analyze the correlation between microperimetric parameters and optical coherent tomographic findings in the eyes of patients with macular diseases.
METHODS
A total of 64 eyes were included in this retrospective cross-sectional study. Differences in the macular integrity index and microperimetric parameters were analyzed according to types of outer retinal band defects. Correlations between average threshold values and retinal thickness in the corresponding areas were analyzed. Finally, microperimetric parameters were compared between inner and outer retinal lesions.
RESULTS
Measures of best-corrected visual acuity, macular integrity index, and average threshold values were significantly worse in eyes with defects in the ellipsoid portion of the photoreceptor inner segment (ISe), the cone outer segment tip (COST), and the external limiting membrane (ELM) than in eyes without ISe, COST, and ELM defects. Also, visual functionality is more significantly impacted by ELM defects than by other hyper-reflective band defects. There was a significant negative correlation between retinal thickness and the average threshold of the corresponding area in the Early Treatment Diabetic Retinopathy Study grid. Microperimetric parameters in the eyes of patients with inner retinal lesions were better than in the eyes of patients with outer retinal lesions.
CONCLUSIONS
The macular integrity index may be a useful factor for reflecting the functional aspects of macular diseases. Specifically, ELM, ISe, and COST defects are significantly associated with poor retinal sensitivity and macular integrity index values that suggest abnormalities. Among eyes with these particular defects, the visual functionality of patients is most sensitively impacted by ELM defects. This finding suggests that microperimetric parameters are sensitive and useful for evaluating functional abnormalities in the eyes of patients with macular disease, particularly in patients with outer retinal pathology.

Keyword

Ellipsoid portion of the photoreceptor inner segment; Microperimetry; Optical coherent tomography; Retinal thickness; Visual functionality

MeSH Terms

Cross-Sectional Studies
Female
Fluorescein Angiography
Fundus Oculi
Humans
Macula Lutea/*pathology
Macular Edema/*diagnosis
Male
Middle Aged
Retrospective Studies
Tomography, Optical Coherence/*methods
Visual Field Tests/*methods

Figure

• 

  Fig. 1 Outer hyper-reflective bands on spectral domain optical coherent tomography. Band 1, external limiting membrane; band 2, ellipsoid portion of the photoreceptor inner segment; band 3, cone outer segment tip; band 4, retinal pigment epithelium.

• 

  Fig. 2 Retinal thickness map (A) and average threshold of the corresponding area (B). (a) Fovea center within a 1,000-µm diameter, (b) superior to fovea center (1,000 to 3,000 µm), (c) nasal to fovea center (1,000 to 3,000 µm), (d) inferior to fovea center (1,000 to 3,000 µm), and (e) temporal to fovea center (1,000 to 3,000 µm).

• 

  Fig. 3 Receiver operating characteristic (ROC) curves for average threshold within a 1,000-µm diameter and minus logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) according to (A) ellipsoid portion of the photoreceptor inner segment (ISe), (B) cone outer segment tip (COST), and (C) external limiting membrane (ELM) defects. The areas under the ROC curve (AUROC curve values) for the average threshold within a 1,000-µm diameter and minus logMAR BCVA according to ISe defects were 0.927 (95% confidence interval [CI], 0.860 to 0.995; p < 0.001) and 0.940 (95% CI, 0.861 to 1.020; p < 0.001), respectively. AUROC curve values for the average threshold within a 1,000-µm diameter and minus logMAR BCVA according to COST defects were 0.938 (95% CI, 0.884 to 0.992; p < 0.001) and 0.844 (95% CI, 0.747 to 0.941; p < 0.001), respectively. AUROC curve values for the average threshold within a 1,000-µm diameter and minus logMAR BCVA according to ELM defects were 0.968 (95% CI, 0.928 to 1.001; p < 0.001) and 0.988 (95% CI, 0.963 to 1.013; p < 0.001), respectively.

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