Disorganization of retinal inner layers: diagnostic and clinical characteristics

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

This review describes the current state of knowledge of the phenomenon of disorganization of retinal inner layers. DRIL is characterized by alteration of microcirculation in retinal capillary plexuses detected with optical coherence tomography angiography, alteration of several inner layers of the retina with the inability to differentiate them on optical coherence tomography, and by an impact on the quality of vision. Disorganization of retinal inner layers occurs in a number of different vascular retinal disorders, which indicates its importance as a clinical biomarker and clinical significance. However, the literature data on disorganization of retinal inner layers are still limited, and questions about the pathogenesis of this disease warrant further investigations.

Full Text

Restricted Access

About the authors

Maria A. Burnasheva

S.M. Kirov Military Medical Academy

Email: maria.andreevna1@gmail.com
ORCID iD: 0000-0001-7384-2223
SPIN-code: 5574-3595

Ophthalmologist

Russian Federation, Saint Petersburg

Alexei N. Kulikov

S.M. Kirov Military Medical Academy

Email: alexey.kulikov@mail.ru
ORCID iD: 0000-0002-5274-6993
SPIN-code: 6440-7706

MD, Dr. Sci. (Med.), Professor, Head of the Ophthalmology Department

Russian Federation, Saint Petersburg

Dmitrii S. Maltsev

S.M. Kirov Military Medical Academy

Author for correspondence.
Email: glaz.med@yandex.ru
ORCID iD: 0000-0001-6598-3982
SPIN-code: 4903-2333

MD, Dr. Sci. (Med.), Head of Medical Retina Division of Ophthalmology Department

Russian Federation, Saint Petersburg

References

  1. Onishi AC, Ashraf M, Soetikno BT, Fawzi AA. Multilevel ischemia in disorganization of the retinal inner layers on projection-resolved optical coherence tomography angiography. Retina. 2019;39(8): 1588–1594. doi: 10.1097/IAE.0000000000002179
  2. Sun JK, Radwan SH, Soliman AZ, et al. Neural Retinal Disorganization as a Robust Marker of Visual Acuity in Current and Resolved Diabetic Macular Edema. Diabetes. 2015;64(7):2560–2570. doi: 10.2337/db14-0782
  3. Nicholson L, Ramu J, Triantafyllopoulou I, et al. Diagnostic accuracy of disorganization of the retinal inner layers in detecting macular capillary non-perfusion in diabetic retinopathy. Clin Exp Ophthalmol. 2015;43(8):735–741. doi: 10.1111/ceo.12557
  4. Cennamo G, Montorio D, Fossataro F, et al. Evaluation of vessel density in disorganization of retinal inner layers after resolved diabetic macular edema using optical coherence tomography angiography. PLoS One. 2021;16(1): e0244789. doi: 10.1371/journal.pone.0244789
  5. Yu JJ, Thomas AS, Berry D, et al. Association of Retinal Inner Layer Disorganization with Ultra-Widefield Fluorescein Angiographic Features and Visual Acuity in Branch Retinal Vein Occlusion. OSLI Retina. 2019;50(6):354–364. doi: 10.3928/23258160-20190605-03
  6. Nakano E, Ota T, Jingami Y, et al. Disorganization of the Retinal Inner Layers after Anti-VEGF Treatment for Macular Edema due to Branch Retinal Vein Occlusion. Ophthalmologica. 2018;240(4): 229–234. doi: 10.1159/000490809
  7. Grewal DS, O’Sullivan ML, Kron M, Jaffe GJ. Association of Disorganization of Retinal Inner Layers with Visual Acuity In Eyes With Uveitic Cystoid Macular Edema. Am J Ophthalmol. 2017;177:116–125. doi: 10.1016/j.ajo.2017.02.017
  8. Kulikov AN, Maltsev DS, Leongardt TA. Retinal microvasculature alteration in paracentral acute middle maculopathy and acute macular neuroretinopathy: a quantitative optical coherence tomography-angiography study. Retin Cases Brief Rep. 2020;14(4):343–351. doi: 10.1097/ICB.0000000000000709
  9. Maltsev DS, Kulikov AN, Burnasheva MA, Chhablani J. Prevalence of resolved paracentral acute middle maculopathy lesions in fellow eyes of patients with unilateral retinal vein occlusion. Acta Ophthalmol. 2020;98(1): e22–e28. doi: 10.1111/aos.14196
  10. Joltikov KA, Sesi CA, de Castro VM, et al. Disorganization of Retinal Inner Layers (DRIL) and Neuroretinal Dysfunction in Early Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2018;59:5481–5486. doi: 10.1167/iovs.18-24955
  11. Nakano E, Ota T, Jingami Y, et al. Correlation between metamorphopsia and disorganization of the retinal inner layers in eyes with diabetic macular edema. Graefes Arch Clin Exp Ophthalmol. 2019;257:187–188. doi: 10.1007/s00417-019-04393-0
  12. Schmidt-Erfurth U, Michl M. Disorganization of Retinal Inner Layers and the Importance of Setting Boundaries. JAMA Ophthalmol. 2019;137(1):46–47. doi: 10.1001/jamaophthalmol.2018.4516
  13. Sampani K, Abdulaal M, Peiris T, et al. Comparison of SDOCT Scan Types for Grading Disorganization of Retinal Inner Layers and Other Morphologic Features of Diabetic Macular Edema. Transl Vis Sci Technol. 2020;9(8):45. doi: 10.1167/tvst.9.8.45
  14. Radwan SH, Soliman AZ, Tokarev J, et al. Association of Disorganization of Retinal Inner Layers With Vision After Resolution of Center-Involved Diabetic Macular Edema. JAMA Ophthalmol. 2015;133(7):820–825. doi: 10.1001/jamaophthalmol.2015.0972
  15. Nadri G, Saxena S, Stefanickova J, et al. Disorganization of retinal inner layers correlates with ellipsoid zone disruption and retinal nerve fiber layer thinning in diabetic retinopathy. J Diabetes Complications. 2019;33(8):550–553. doi: 10.1016/j.jdiacomp.2019.05.006
  16. Radwan SH, Soliman AZ, Tokarev J, et al. Association of Disorganization of Retinal Inner Layers with Vision After Resolution of Center-Involved Diabetic Macular Edema. JAMA Ophthalmol. 2015;133(7):820–825. doi: 10.1001/jamaophthalmol.2015.0972
  17. Das R, Spence G, Hogg RE, et al. Disorganization of Inner Retina and Outer Retinal Morphology in Diabetic Macular Edema. JAMA Ophthalmol. 2018;136(2):202–208. doi: 10.1001/jamaophthalmol.2017.6256
  18. Pelosini L, Hull CC, Boyce JF, et al. Optical coherence tomography may be used to predict visual acuity in patients with macular edema. Invest Ophthalmol Vis Sci. 2011;52(5):2741–2748. doi: 10.1167/iovs.09-4493
  19. Sun JK, Lin MM, Lammer J, et al. Disorganization of the retinal inner layers as a predictor of visual acuity in eyes with center-involved diabetic macular edema. JAMA Ophthalmol. 2014;132(11):1309–1316. doi: 10.1001/jamaophthalmol.2014.2350
  20. Kulikov AN, Maltsev DS, Burnasheva MA. Improved analysis of foveal avascular zone area with optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol. 2018;256:2293–2299. doi: 10.1007/s00417-018-4139-x
  21. Ishibashi T, Sakimoto S, Shiraki N, et al. Association between disorganization of retinal inner layers and visual acuity after proliferative diabetic retinopathy surgery. Sci Rep. 2019;9:12230. doi: 10.1038/s41598-019-48679-z
  22. Zur D, Iglicki M, Sala-Puigdollers A, et al. Disorganization of retinal inner layers as a biomarker in patients with diabetic macular oedema treated with dexamethasone implant. Acta Ophthalmol. 2020;98(2): e217–e223. doi: 10.1111/aos.14230
  23. Berry D, Thomas AS, Fekrat S, Grewal DS. Association of Disorganization of Retinal Inner Layers with Ischemic Index and Visual Acuity in Central Retinal Vein Occlusion. Ophthalmol Retina. 2018;2(11):1125–1132. doi: 10.1016/j.oret.2018.04.019
  24. Yilmaz H, Durukan AH. Disorganization of the retinal inner layers as a prognostic factor in eyes with central retinal artery occlusion. Int J Ophthalmol. 2019;12(6):990–995. doi: 10.18240/ijo.2019.06.18
  25. Babiuch AS, Han M, Conti FF, et al. Association of Disorganization of Retinal Inner Layers with Visual Acuity Response to Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema Secondary to Retinal Vein Occlusion. JAMA Ophthalmol. 2019;137(1):38–46. doi: 10.1001/jamaophthalmol.2018.4484
  26. Mimouni M, Segev O, Dori D, et al. Disorganization of the Retinal Inner Layers as a Predictor of Visual Acuity in Eyes with Macular Edema Secondary to Vein Occlusion. Am J Ophthalmol. 2017;182:160–167. doi: 10.1016/j.ajo.2017.08.005
  27. Chan EW, Eldeeb M, Sun V, et al. Disorganization of Retinal Inner Layers and Ellipsoid Zone Disruption Predict Visual Outcomes in Central Retinal Vein Occlusion. Ophthalmol Retina. 2019;3(1):83–92. doi: 10.1016/j.oret.2018.07.008
  28. Zur D, Iglicki M, Feldinger L, et al. Disorganization of Retinal Inner Layers as a Biomarker for Idiopathic Epiretinal Membrane After Macular Surgery — The DREAM Study. Am J Ophthalmol. 2018;196:129–135. doi: 10.1016/j.ajo.2018.08.037
  29. Garnavou-Xirou C, Xirou T, Gkizis I, et al. The Role of Disorganization of Retinal Inner Layers as Predictive Factor of Postoperative Outcome in Patients with Epiretinal Membrane. Ophthalmic Res. 2020;63(1):13–17. doi: 10.1159/000499370
  30. Guo J, Tang WY, Ye X, et al. Predictive multi-imaging biomarkers relevant for visual acuity in idiopathic macular telangiectasis type 1. BMC Ophthalmol. 2018;18:69. doi: 10.1186/s12886-018-0737-y

Supplementary files

Supplementary Files
Action
1. Fig. 1. Multimodal imaging of the left eye of a 65 year old female with diabetic retinopathy: a – cross-sectional scan through the center of the macula; b – cross-sectional optical coherence tomography scan through the area of DRIL (arrowheads); c – vessel density map of superficial capillary plexus; d – vessel density map of deep vascular complex. Note a more substantial loss of vessel density in superficial capillary plexus than in deep vascular complex; e – cross-sectional scan through the area of disorganization of inner retinal layers (arrowheads). Note the preservation of nerve fiber layer; f – distribution of flow signal within cross-sectional scan. The lesion (arrowheads) demonstrates flow void mostly in the inner and middle retinal layers while the innermost retinal vessels are preserved

Download (313KB)
2. Fig. 2. Disorganization of retinal inner layers in 68 year old patient with severe non-proliferative diabetic retinopathy: a – scanning laser ophthalmoscopy with green light showing no acute ischemic lesions; b – fluorescein angiography showing a non-perfused area exactly corresponding to the disorganization of retinal inner layers; c – optical coherence tomography angiography projection of the superficial capillary plexus showing nonperfused areas of the retina. The dotted line shows the position of the scan in В; d – cross-sectional optical coherence tomography scan showing disorganization of retinal inner layers (arrowheads)

Download (275KB)

Copyright (c) 2022 Burnasheva M.A., Kulikov A.N., Maltsev D.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-65574 от 04 мая 2016 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies