title: Quantitative analysis of OCT characteristics in patients with achromatopsia and blue-cone monochromatism.
abstract: OBJECTIVE
  To quantify optical coherence tomography (OCT) images of the central retina in patients with blue-cone monochromatism (BCM) and achromatopsia (ACH) compared with healthy control individuals.
  
  
  METHODS
  The study included 15 patients with ACH, 6 with BCM, and 20 control subjects. Diagnosis of BCM and ACH was established by visual acuity testing, morphologic examination, color vision testing, and Ganzfeld ERG recording. OCT images were acquired with the Stratus OCT 3 (Carl Zeiss Meditec AG, Oberkochen, Germany). Foveal OCT images were analyzed by calculating longitudinal reflectivity profiles (LRPs) from scan lines. Profiles were analyzed quantitatively to determine foveal thickness and distances between reflectivity layers.
  
  
  RESULTS
  Patients with ACH and BCM had a mean visual acuity of 20/200 and 20/60, respectively. Color vision testing results were characteristic of the diseases. The LRPs of control subjects yielded four peaks (P1-P4), presumably representing the RPE (P1), the ovoid region of the photoreceptors (P2), the external limiting membrane (ELM) (P3), and the internal limiting membrane (P4). In patients with ACH, P2 was absent, but foveal thickness (P1-P4) did not differ significantly from that in the control subjects (187 +/- 20 vs. 192 +/- 14 microm, respectively). The distance from P1 to P3 did not differ significantly (78 +/- 10 vs. 82 +/- 5 microm) between ACH and controls subjects. In patients with BCM, P3 was lacking, and P2 advanced toward P1 compared with the control subjects (32 +/- 6 vs. 48 +/- 4 microm). Foveal thickness (153 +/- 16 microm) was significantly reduced compared with that in control subjects and patients with ACH.
  
  
  CONCLUSIONS
  Quantitative OCT image analysis reveals distinct patterns for controls subjects and patients with ACH and BCM, respectively. Quantitative analysis of OCT imaging can be useful in differentiating retinal diseases affecting photoreceptors. Foveal thickness is similar in both normal subjects and patients with ACH but is decreased in patients with BCM.
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Barthelmes
authors.forename: Florian K
authors.initials: FK
authors.lastname: Sutter
authors.forename: Malaika M
authors.initials: MM
authors.lastname: Kurz-Levin
authors.forename: Martina M
authors.initials: MM
authors.lastname: Bosch
authors.forename: Horst
authors.initials: H
authors.lastname: Helbig
authors.forename: Günter
authors.initials: G
authors.lastname: Niemeyer
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Fleischhauer
mesh_terms: D000328:Adult; D003119:Color Perception Tests; D003117:Color Vision Defects / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological; D006801:Humans; D017949:Retinal Cone Photoreceptor Cells / Q000378:metabolism / Q000473:pathology*; D017299:Rod Opsins / Q000378:metabolism; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity
chemical_list: D017299:Rod Opsins; C095853:short-wavelength opsin