title: Different phenotypes of the appearance of the outer plexiform layer on optical coherence tomography.
abstract: OBJECTIVE
  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 (θ(P)), and the tilt angle of the tissue on the B-scan (θ(T)) 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).
authors: 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.
authors: Yanling
authors: Y
authors: Ouyang
authors: Alexander C
authors: AC
authors: Walsh
authors: Pearse A
authors: PA
authors: Keane
authors: Florian M
authors: FM
authors: Heussen
authors: Rajeev K R
authors: RK
authors: Pappuru
authors: Srinivas R
authors: SR
authors: Sadda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001369:Axons / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D051245:Retinal Bipolar Cells / Q000473:pathology*; D012162:Retinal Degeneration / Q000473:pathology*; D051248:Retinal Horizontal Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence; D055815:Young Adult
references: Am J Ophthalmol. 2008 Nov;146(5):679-87
references: 18707672
references: Ophthalmology. 2005 Oct;112(10):1734-46
references: 16140383
references: Semin Ophthalmol. 1999 Dec;14(4):223-32
references: 10758223
references: Ophthalmology. 2008 Jun;115(6):1071-1078.e7
references: 18061270
references: Ophthalmology. 1982 Aug;89(8):902-15
references: 7133637
references: Ophthalmology. 2009 Sep;116(9):1788-93
references: 19643494
references: Invest Ophthalmol Vis Sci. 2009 Jul;50(7):3366-73
references: 19168893
references: Retina. 2011 Mar;31(3):497-501
references: 21102368
references: Ophthalmology. 2005 Jun;112(6):1079-85
references: 15882904
references: Invest Ophthalmol Vis Sci. 2011 Jun 06;52(7):3943-54
references: 21421869
references: Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1981;216(2):85-101
references: 6910356
references: Arch Ophthalmol. 1995 Mar;113(3):325-32
references: 7887846
references: Lancet Neurol. 2012 Nov;11(11):963-72
references: 23041237
references: Br J Ophthalmol. 2009 May;93(5):603-9
references: 18662918
references: Invest Ophthalmol Vis Sci. 2005 Jun;46(6):2012-7
references: 15914617
references: Invest Ophthalmol Vis Sci. 2004 Jul;45(7):2399-406
references: 15223823
references: Arch Ophthalmol. 1997 Nov;115(11):1425-8
references: 9366674
references: Ophthalmic Res. 2004 Sep-Oct;36(5):241-9
references: 15583429
references: Am J Ophthalmol. 2009 Aug;148(2):242-248.e1
references: 19427620
references: Doc Ophthalmol. 1999;97(3-4):239-49
references: 10896337
references: Br J Ophthalmol. 2009 Mar;93(3):373-8
references: 19019942
references: Br J Ophthalmol. 2005 Feb;89(2):207-12
references: 15665354
references: Invest Ophthalmol Vis Sci. 2008 Apr;49(4):1571-9
references: 18385077
references: Ophthalmology. 2009 Mar;116(3):488-496.e2
references: 19167082
references: Retina. 2013 May;33(5):1011-9
references: 23455232
references: Clin Ophthalmol. 2008 Dec;2(4):919-30
references: 19668445
references: Ophthalmology. 2008 Jun;115(6):949-56
references: 17981334
references: Invest Ophthalmol Vis Sci. 2011 Mar 18;52(3):1486-92
references: 21071737