Reflectivity of the Outer Retina on Spectral-Domain Optical Coherence Tomography as a Predictor of Photoreceptor Cone Density

PURPOSE: To investigate the relationship between outer retinal reflectivity on spectral-domain optical coherence tomography and cone density in the corresponding area. DESIGN: Prospective cross-sectional observational study. METHODS: In this institutional-based study, 20 eyes of 10 patients presenting maculopathies with various degrees of impairment of the photoreceptor layer (central serous chorioretinopathy, chronic central serous chorioretinopathy, maculopathy associated with hydroxychloroquine, and healthy eyes) were studied. Selection criteria were intended to ensure good image quality. Inner segment ellipsoid band reflectivity, global retinal reflectivity, and relative inner segment ellipsoid reflectivity (defined as the ratio of inner segment ellipsoid band reflectivity on overall retinal reflectivity) were measured on a longitudinal reflectance profile extracted from the spectral-domain optical coherence tomography B-scan. The cone metrics were measured in the same region of interest, located in the perifoveal area, using an adaptive optics retinal camera. RESULTS: Inner segment ellipsoid and relative ellipsoid reflectivity were closely correlated with cone density (Pearson r: 0.72 and 0.70, respectively, P<.01). CONCLUSION: Outer retinal reflectivity on the transversal optical coherence tomography scan can be correlated to adaptive optics in terms of photoreceptor density. This quantitative approach using optical coherence tomography images could have important implications in the management of maculopathies. (C) 2015 by Elsevier Inc. All rights reserved.