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Different phenotypes of the appearance of the outer plexiform layer on optical coherence tomography

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To present a selected case series of different phenotypes of the normal outer plexiform layer (OPL) visualized by optical coherence tomography (OCT).

Methods

Five cases were selected to represent the spectrum of appearances of the OPL in this case series. Categorical descriptions of each manifestation were then developed. Additional SD-OCT scans were obtained from a normal volunteer to further support the hypothesis.

Results

The inner one-third of the OPL typically appears hyperreflective on OCT, while the outer two-thirds (Henle fiber layer) may have a more varied appearance. Six different phenotypes of Henle fiber layer reflectivity were noted in this series, and classified as: bright, columnar, dentate, delimited, indistinct, and dark. The brightness of the Henle fiber layer appears to depend on the geometric angle between the OCT light beam and the axonal fibers in this portion of the OPL. This angle appears to be a function of the natural orientation of the Henle fiber layer tissue (θN), the existence of subretinal pathology that alters the angle of the neurosensory retina (θP), and the tilt angle of the tissue on the B-scan (θT) due to decentered OCT acquisition.

Conclusions

Since accurate interpretation of the OPL/ONL boundary is of vital importance to study the thickness of ONL, location of cystoid lesions, hyperreflective crescents over drusen, et al., our case series may aid better understanding of the OPL appearance in SD-OCT. In the absence of clear delineation, it may be most correct to refer to indistinct OPL and ONL together as the photoreceptor nuclear axonal complex (PNAC).

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Abbreviations

OCT:

optical coherence tomography

SD-OCT:

spectral-domain optical coherence tomography

ONL:

outer nuclear layer

OPL:

outer plexiform layer

RPE:

retinal pigment epithelium

AMD:

age-related macular degeneration

CME:

cystoid macular edema

CSR:

central serous choroioretinopathy

ILM:

internal limiting membrane

IPL:

inner plexiform layer

INL:

inner nuclear layer

PED:

pigment epithelial detachment

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Disclosure

Drs. Walsh and Sadda are co-inventors of Doheny intellectual property related to optical coherence tomography that has been licensed by Topcon Medical Systems, and are members of the scientific advisory board for Heidelberg Engineering. Dr Sadda also receives research support from Carl Zeiss Meditec, Optos, and Optovue, Inc.

Supported in part by the Deutsche Forschungsgemeinschaft (DFG grant He 6094/1-1), and Research to Prevent Blindness.

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Authors and Affiliations

  1. Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine of the University of Southern California, 1450 San Pablo Street, Los Angeles, CA, 90033, USA

    Yanling Ouyang, Alexander C. Walsh, Florian M. Heussen, Rajeev K. R. Pappuru & Srinivas R. Sadda

  2. Department of Ophthalmology, Charité, University Medicine, Berlin, Germany

    Yanling Ouyang & Florian M. Heussen

  3. NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK

    Pearse A. Keane

Authors
  1. Yanling Ouyang
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  2. Alexander C. Walsh
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  3. Pearse A. Keane
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  4. Florian M. Heussen
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  5. Rajeev K. R. Pappuru
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  6. Srinivas R. Sadda
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Corresponding author

Correspondence to Srinivas R. Sadda.

Additional information

Yanling Ouyang and Alexander C. Walsh are co-first authors.

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Ouyang, Y., Walsh, A.C., Keane, P.A. et al. Different phenotypes of the appearance of the outer plexiform layer on optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 251, 2311–2317 (2013). https://doi.org/10.1007/s00417-013-2308-5

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  • DOI: https://doi.org/10.1007/s00417-013-2308-5

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