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Christine A. Curcio; SD-OCT's four outer retinal hyper-reflective bands (ORHRB) in health and age-related macular degeneration (AMD). Journal of Vision 2012;12(14):29. doi: 10.1167/12.14.29.
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© ARVO (1962-2015); The Authors (2016-present)
SDOCT available to clinical ophthalmology reveals four ORHRB formed by the photoreceptors and their support system, the retinal pigment epithelium (RPE), and Bruch's membrane of the choroidal vasculature. The neurosensory retina is an array of molecular machines aligned with sub-micrometer precision in the vertical axis. The retinal pigment epithelium (RPE) is as compartmentalized as the photoreceptors, on a greatly compressed vertical scale (14 µm). An anatomically correct outer retinal model 1 aligns securely with the external limiting membrane (junctional complexes), inner segment ellipsoid (ISel), interdigitation level formed by photoreceptors and RPE (cell-cell contacts), and RPE/Bruch's membrane (BrM, metabolic and vascular support). ISel in turn is packed with high light scattering mitochondria, offering promise of monitoring mitochondrial health in vivo through SD-OCT. The ORHRB are on the road to base camp for another imaging peak of public health significance: the sub-retinal and sub-RPE pathology of age-related macular degeneration (AMD). How the photoreceptors read-out their deteriorating support system will be learned through better understanding of RPE status and lesion size/ composition during early AMD. Eight layers of pathology, reflecting different chemical compositions, biogenesis, and degrees of pathogenic significance localize to a <50-µm span. Major components of drusen and basal linear deposit molecularly overlap with the lipidic core of coronary artery plaque. SD-OCT and a myriad of intravascular imaging techniques developed for cardiovascular disease may be exploited to quantify the true burden of AMD's lesions.
Meeting abstract presented at OSA Fall Vision 2012
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