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Journal of Ophthalmology
Volume 2013 (2013), Article ID 518170, 7 pages
Review Article

Photoreceptor Impairment and Restoration on Optical Coherence Tomographic Image

1Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima 770-8503, Japan
2Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan

Received 8 January 2013; Accepted 17 March 2013

Academic Editor: Masanori Hangai

Copyright © 2013 Yoshinori Mitamura et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


With recent development of spectral-domain optical coherence tomography (SD-OCT), the pathological changes of retina can be observed in much greater detail. SD-OCT clearly delineates three highly reflective lines in the outer retina, which are external limiting membrane (ELM), photoreceptor inner and outer segment (IS/OS) junction, and cone outer segment tips (COST) in order from inside. These lines can serve as hallmarks for the evaluation of photoreceptor condition. In retinitis pigmentosa (RP) leading to photoreceptor degeneration, the ELM, IS/OS, and COST lines are shortened with the progression of the disease. In addition, shortening of the ELM, IS/OS and COST lines is significantly associated with each other. The line length is longest in the ELM, followed by the IS/OS, and COST, suggesting that retinal layer becomes disorganized first at the COST, followed by the IS/OS and finally the ELM. This finding is consistent with the previous report that the earliest histopathological change in RP is a shortening of the photoreceptor outer segments. On the other hand, retinal layer becomes restored first at the ELM, followed by the IS/OS and finally the COST after macular hole surgery. There may be a directionality of photoreceptor impairment or restoration on optical coherence tomographic image.