Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 1;41(11):2193-2207.
doi: 10.1097/IAE.0000000000003217.

BACILLARY LAYER DETACHMENT: MULTIMODAL IMAGING AND HISTOLOGIC EVIDENCE OF A NOVEL OPTICAL COHERENCE TOMOGRAPHY TERMINOLOGY: Literature Review and Proposed Theory

Prithvi Ramtohul  1 , Michael Engelbert  2   3 , Ariane Malclès  4 , Edward Gigon  4 , Elisabetta Miserocchi  5 , Giulio Modorati  5 , Eduardo Cunha de Souza  6 , Cagri G Besirli  7 , Christine A Curcio  8 , K Bailey Freund  2   3
Affiliations

BACILLARY LAYER DETACHMENT: MULTIMODAL IMAGING AND HISTOLOGIC EVIDENCE OF A NOVEL OPTICAL COHERENCE TOMOGRAPHY TERMINOLOGY: Literature Review and Proposed Theory

Prithvi Ramtohul et al. Retina. .

Abstract

Purpose: To clarify the histologic basis of bacillary layer detachment (BALAD) through a review of the current literature and an analysis of retinal imaging.

Methods: The literature for previous reports of BALAD were reviewed. An analysis of retinal images was performed to support anatomical conclusions.

Results: A total of 164 unique patients with BALAD on optical coherence tomography (OCT) were identified from the published literature. Twenty-two underlying etiologies, all associated with subretinal exudation, were identified. Forty-one different OCT terminologies were found. The defining OCT feature of BALAD was a split at the level of the photoreceptor inner segment myoid creating a distinctive intraretinal cavity. Resolution of BALAD was followed by a rapid restoration of the ellipsoid zone. Histology of age-related macular degeneration eyes suggests that individual photoreceptors can shed inner segments. Furthermore, detachment of the entire layer of inner segments is a common postmortem artifact. It is proposed that BALAD occurs when outwardly directed forces promoting attachment of photoreceptor outer segments to the retinal pigment epithelium exceed the tensile strength of the photoreceptor inner segment myoid.

Conclusion: This review serves to strengthen the OCT nomenclature "bacillary layer detachment," based on specific reflectance information obtained by OCT and previously published histologic observations.

PubMed Disclaimer

References

    1. Historical review. Acta Ophthalmologica 1935;13:13–28.
    1. Polyak SL. The Retina: The Anatomy and the Histology of the Retina in Man, Ape, and Monkey, Including the Consideration of Visual Functions, the History of Physiological Optics, and the Histological Laboratory Technique. Chicago, IL: Universiity of Chicago Press; 1941.
    1. Spaide RF, Curcio CA. Anatomical correlates to the bands seen in the outer retina by optical coherence tomography: literature review and model. Retina 2011;31:1609–1619.
    1. Hoang QV, Linsenmeier RA, Chung CK, Curcio CA. Photoreceptor inner segments in monkey and human retina: mitochondrial density, optics, and regional variation. Vis Neurosci 2002;19:395–407.
    1. Litts KM, Zhang Y, Freund KB, Curcio CA. Optical coherence tomography and histology of age-related macular degeneration support mitochondria as reflectivity sources. Retina 2018;38:445–461.

Publication types

MeSH terms