Current Understanding of the Pathophysiology of Disorganization of the Retinal Inner Layers and Relationship to Visual Acuity

Abstract

In clinical practice, visual acuity (VA) outcomes after treatment may be associated with multiple optical coherence tomography (OCT) variables including central subfield thickness (CST), ellipsoid zone (EZ) disruption , epiretinal membrane, vitreoretinal interface abnormalities, and disorganization of retinal inner layers (DRIL). Since CST has shown only a modest correlation with VA, additional OCT-based prognostic factors can be useful. DRIL is an OCT derived variable that may be a prognostic factor. Ischemia and inflammation may explain the pathogenesis of DRIL but are not well understood. Visual transmission pathways may be interrupted and affect VA. This review highlights the various studies on DRIL and VA, specifically within diabetic macular edema (DME), diabetic retinopathy, retinal vein occlusion, and Uvetic macular edema (ME). Based on the current literature review, DRIL’s prognostic value in predicting VA is not well elucidated but shows potential to be utilized in clinical practice.