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Drew Scoles, Robert Cooper, Adam Dubis, Brian Higgins, Joseph Carroll, Alfredo Dubra; In vivo microscopic inner retinal phenotypes of retinal and neurologic disease. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1434.
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© ARVO (1962-2015); The Authors (2016-present)
Reflectance/backscattering adaptive optics scanning light ophthalmoscopy (AOSLO) has been used extensively to study the healthy and diseased photoreceptor mosaic. With the exception of recent work on vascular imaging, the inner retina remains largely unexplored with this imaging modality. In this study, we investigate the potential of AOSLO for non-invasive study of the inner retina.
Inner-retinal AOSLO images from 60 patients representing over 24 different retinal diseases (see Table for full list), acquired over the period of three years were identified. All images were collected using 790 nm (13-15 nm FHWM bandwidth) light sources, on three similar AOSLO instruments. Subjects thought to be free of eye disease were also imaged for comparison.
Inner retinal phenotypes were classified into 8 groups based on appearance, with most diseases demonstrating three or more distinct features. The two most common findings, punctate reflectivity and Gunn’s Dots were found in 88% and 54% of diseases respectively, as well as normal volunteers. Spectral domain optical coherence tomography, obtained on the day of AOSLO imaging in nearly all patients, did not identify all AOSLO findings.
Reflectance AOSLO imaging revealed a diverse set of inner-retinal phenotypes across these varied diseases. Interestingly, seemingly disparate diseases (e.g., post-operative macular hole and optic atrophy as well as commotio retinae and Best’s disease respectively) showed similar inner retinal findings. Common microscopic inner retinal phenotypes of retinal pathologies might point towards common pathways of disease or repair/defense mechanisms, and even suggest common treatment modalities.
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