On spectral-domain OCT of the macula, a 62-year-old diabetic shows loss of the ellipsoid zone (photoreceptor inner segment–outer segment junction) without any macular oedema. This OCT finding is most indicative of:
- A Chronic macular ischaemia / photoreceptor loss ✓
- B Vitreomacular traction syndrome
- C Central serous chorioretinopathy
- D Epiretinal membrane formation
Correct answer: A. Chronic macular ischaemia / photoreceptor loss
Explanation
The ellipsoid zone on SD-OCT corresponds to the IS/OS junction of photoreceptors; its focal or diffuse disruption signals photoreceptor death rather than oedema or mechanical distortion. In chronic diabetic macular ischaemia, capillary non-perfusion leads to photoreceptor loss reflected as ellipsoid zone loss. VMT causes foveal contour distortion with vitreous adhesion, CSCR shows subretinal fluid, and ERM produces inner retinal wrinkling.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.