title: Relationship between outer retinal thickness substructures and visual acuity in eyes with dry age-related macular degeneration.
abstract: OBJECTIVE
  To explore the correlation between outer retinal substructures and visual acuity in dry age-related macular degeneration (AMD).
  
  
  METHODS
  Analysis of spectral domain optical coherence tomography datasets from 100 eyes of 100 consecutive patients with dry AMD was performed. The internal limiting membrane, outer nuclear layer (ONL), external limiting membrane (ELM), inner segment-outer segment (IS-OS) junction, outer photoreceptor border, inner and outer retinal pigment epithelium (RPE) borders, and Bruch's membrane, were manually segmented by Doheny Image Reading Center (DIRC) graders. Areas, thicknesses, and volumes of RPE, IS, OS, ONL, and the total retina in the foveal central subfield were correlated with the logarithm of minimal angle of resolution (logMAR) visual acuity using univariable and multivariable regression analysis.
  
  
  RESULTS
  The visual acuity in this group ranged from logMAR 0 to 1.3 with a mean of 0.23. Areas, thicknesses, and volumes of ONL, IS and OS, thicknesses of total retinal and RPE, and intensities of IS, OS, and RPE, showed statistically significant association (P < 0.05) with logMAR best corrected visual acuity. The highest correlations were observed for the ONL (thickness: r = -0.49, volume: -0.47, area: -0.50) and photoreceptor IS (thickness: -0.59, area: -0.63, volume: -0.53). The model with the highest correlation in this study included thicknesses of ONL, IS, OS and RPE, as well as area of ONL, IS, OS, RPE, and intensity of RPE. CONCLUSIONS. Although integrity of outer retinal substructures in the foveal central subfield correlates with visual acuity in the eyes of patients with dry AMD, the correlation is only moderate and does not fully explain the variability in acuity in these cases.
authors.affiliation: Department of Ophthalmology, University of Southern California, Los Angeles, California, USA.
authors.forename: Rajeev R
authors.initials: RR
authors.lastname: Pappuru
authors.forename: Yanling
authors.initials: Y
authors.lastname: Ouyang
authors.forename: Muneeswar Gupta
authors.initials: MG
authors.lastname: Nittala
authors.forename: Houman D
authors.initials: HD
authors.lastname: Hemmati
authors.forename: Pearse A
authors.initials: PA
authors.lastname: Keane
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Walsh
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Sadda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005584:Fovea Centralis / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008268:Macular Degeneration / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods / Q000592:standards; D014792:Visual Acuity / Q000502:physiology*