Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry Overlay

Objective: To perform a pointwise structure–function analysis of the ellipsoid zone (EZ) in retinitis pigmentosa (RP) using an artificial intelligence–based overlay to understand EZ structure–function relationships. Design: A single-center retrospective study. Subjects: Patients with clinically conf...

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Main Authors: Jesse A. Most, BA, An D. Le, MS, PhD, Melanie D. Tran, BS, Evan H. Walker, MS, Aneesh Swamy, Dirk-Uwe G. Bartsch, PhD, William R. Freeman, MD, Truong Nguyen, PhD, Cheolhong An, PhD, Shyamanga Borooah, MBBS, PhD
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Language:English
Published: Elsevier 2025-11-01
Series:Ophthalmology Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666914525001873
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author Jesse A. Most, BA
An D. Le, MS, PhD
Melanie D. Tran, BS
Evan H. Walker, MS
Aneesh Swamy
Dirk-Uwe G. Bartsch, PhD
William R. Freeman, MD
Truong Nguyen, PhD
Cheolhong An, PhD
Shyamanga Borooah, MBBS, PhD
author_facet Jesse A. Most, BA
An D. Le, MS, PhD
Melanie D. Tran, BS
Evan H. Walker, MS
Aneesh Swamy
Dirk-Uwe G. Bartsch, PhD
William R. Freeman, MD
Truong Nguyen, PhD
Cheolhong An, PhD
Shyamanga Borooah, MBBS, PhD
author_sort Jesse A. Most, BA
collection DOAJ
description Objective: To perform a pointwise structure–function analysis of the ellipsoid zone (EZ) in retinitis pigmentosa (RP) using an artificial intelligence–based overlay to understand EZ structure–function relationships. Design: A single-center retrospective study. Subjects: Patients with clinically confirmed RP. Methods: Same-day spectral-domain OCT (SD-OCT) and microperimetry near-infrared images were overlaid in patients with confirmed RP. Overlay used a coarse alignment artificial intelligence model. Each locus, on a 68-point microperimetry grid spanning the central 20° of the macula, was identified on individual SD-OCT B-scans. Ellipsoid zone structure was graded at each locus on a 3-point scale: grade 0 = EZ not visible; grade 1 = EZ attenuated; grade 2 = EZ normal. Ellipsoid zone grades were correlated with microperimetry sensitivity scores recorded in decibels (dB). Main Outcome Measures: Correlation of EZ integrity on SD-OCT with microperimetric retinal sensitivity. Results: Fifty-one eyes from thirty-one patients with RP were included in the analysis, with 60 total overlays, including follow-up studies, resulting in 3985 test loci being graded. Patients had a mean age of 39.4 (32.8–46.0) years, with 41.9% being female. Mean best-corrected visual acuity was 0.166 (0.129–0.203) logarithm of the minimum angle of resolution. The overall mean sensitivity (MS) was 9.72 (7.32–12.12) dB, whereas MS was 6.02 (4.06–7.98) dB for grade 0 loci, 18.36 (16.35–20.36) dB for grade 1 loci, and 20.90 (18.87–22.93) dB for grade 2 loci. Differences in MS were significant between graded groups (P < 0.001). Correlation between EZ grade and sensitivity was 0.65 (0.64–0.67), whereas correlation of sensitivity with distance from the fovea was −0.41 (−0.43 to −0.39). Focusing on grade 0 loci, 57.5% had sensitivity scores >0 dB, and 4% had scores ≥20 dB, suggesting that these points had function despite no observable EZ on SD-OCT. Conclusions: We identified local EZ structure–function incongruencies in RP using a pointwise analysis of structure–function overlay. These loci of interest may be overlooked in analyses that average across the visual field. Preserved photoreceptor function, in the absence of visibly intact EZ, warrants further investigation. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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spelling doaj-art-2b70083c5a974a289dfd0fa4107f3f0d2025-08-24T05:14:53ZengElsevierOphthalmology Science2666-91452025-11-015610088910.1016/j.xops.2025.100889Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry OverlayJesse A. Most, BA0An D. Le, MS, PhD1Melanie D. Tran, BS2Evan H. Walker, MS3Aneesh Swamy4Dirk-Uwe G. Bartsch, PhD5William R. Freeman, MD6Truong Nguyen, PhD7Cheolhong An, PhD8Shyamanga Borooah, MBBS, PhD9Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, California; School of Medicine, University of California San Diego, La Jolla, CaliforniaDepartment of Electrical and Computer Engineering, University of California San Diego, La Jolla, CaliforniaJacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, California; School of Medicine, University of California San Diego, La Jolla, CaliforniaViterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CaliforniaUniversity of California San Diego, La Jolla, CaliforniaJacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, CaliforniaJacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, CaliforniaDepartment of Electrical and Computer Engineering, University of California San Diego, La Jolla, CaliforniaDepartment of Electrical and Computer Engineering, University of California San Diego, La Jolla, CaliforniaJacobs Retina Center, Shiley Eye Institute, University of California San Diego, La Jolla, California; Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Correspondence: Shyamanga Borooah, MBBS, PhD, Associate Professor of Ophthalmology, Retinal Division, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA 92037.Objective: To perform a pointwise structure–function analysis of the ellipsoid zone (EZ) in retinitis pigmentosa (RP) using an artificial intelligence–based overlay to understand EZ structure–function relationships. Design: A single-center retrospective study. Subjects: Patients with clinically confirmed RP. Methods: Same-day spectral-domain OCT (SD-OCT) and microperimetry near-infrared images were overlaid in patients with confirmed RP. Overlay used a coarse alignment artificial intelligence model. Each locus, on a 68-point microperimetry grid spanning the central 20° of the macula, was identified on individual SD-OCT B-scans. Ellipsoid zone structure was graded at each locus on a 3-point scale: grade 0 = EZ not visible; grade 1 = EZ attenuated; grade 2 = EZ normal. Ellipsoid zone grades were correlated with microperimetry sensitivity scores recorded in decibels (dB). Main Outcome Measures: Correlation of EZ integrity on SD-OCT with microperimetric retinal sensitivity. Results: Fifty-one eyes from thirty-one patients with RP were included in the analysis, with 60 total overlays, including follow-up studies, resulting in 3985 test loci being graded. Patients had a mean age of 39.4 (32.8–46.0) years, with 41.9% being female. Mean best-corrected visual acuity was 0.166 (0.129–0.203) logarithm of the minimum angle of resolution. The overall mean sensitivity (MS) was 9.72 (7.32–12.12) dB, whereas MS was 6.02 (4.06–7.98) dB for grade 0 loci, 18.36 (16.35–20.36) dB for grade 1 loci, and 20.90 (18.87–22.93) dB for grade 2 loci. Differences in MS were significant between graded groups (P < 0.001). Correlation between EZ grade and sensitivity was 0.65 (0.64–0.67), whereas correlation of sensitivity with distance from the fovea was −0.41 (−0.43 to −0.39). Focusing on grade 0 loci, 57.5% had sensitivity scores >0 dB, and 4% had scores ≥20 dB, suggesting that these points had function despite no observable EZ on SD-OCT. Conclusions: We identified local EZ structure–function incongruencies in RP using a pointwise analysis of structure–function overlay. These loci of interest may be overlooked in analyses that average across the visual field. Preserved photoreceptor function, in the absence of visibly intact EZ, warrants further investigation. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.http://www.sciencedirect.com/science/article/pii/S2666914525001873Retinitis pigmentosaEllipsoid zoneSpectral domain optical coherence tomographyStructure–function
spellingShingle Jesse A. Most, BA
An D. Le, MS, PhD
Melanie D. Tran, BS
Evan H. Walker, MS
Aneesh Swamy
Dirk-Uwe G. Bartsch, PhD
William R. Freeman, MD
Truong Nguyen, PhD
Cheolhong An, PhD
Shyamanga Borooah, MBBS, PhD
Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry Overlay
Ophthalmology Science
Retinitis pigmentosa
Ellipsoid zone
Spectral domain optical coherence tomography
Structure–function
title Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry Overlay
title_full Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry Overlay
title_fullStr Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry Overlay
title_full_unstemmed Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry Overlay
title_short Pointwise Structure–Function Analysis of the Ellipsoid Zone in Retinitis Pigmentosa Using an Artificial Intelligence-Assisted OCT and Microperimetry Overlay
title_sort pointwise structure function analysis of the ellipsoid zone in retinitis pigmentosa using an artificial intelligence assisted oct and microperimetry overlay
topic Retinitis pigmentosa
Ellipsoid zone
Spectral domain optical coherence tomography
Structure–function
url http://www.sciencedirect.com/science/article/pii/S2666914525001873
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