June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Adaptive optics and 'en face' OCT imaging of the outer retina in Type 2 Macular Telangiectasia
Author Affiliations & Notes
  • Ferenc Sallo
    Research and Development, Moorfields Eye Hospital, London, United Kingdom
    Visual Neuroscience, UCL Institute of Ophthalmology, London, United Kingdom
  • Valerie Krivosic
    Service d'Ophtalmologie, Hopital Lariboisière Université Paris Diderot, Paris, France
  • Kiyoko Gocho
    Department of Ophthalmology, Nippon Medical University, Chiba Hokusoh Hospital, Chiba, Japan
  • Michel Paques
    CHNO des Quinze-Vingts & Institut de la Vision, Paris, France
  • Tunde Peto
    NIHR Biomedical Research Centre for Ophthalmology, at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
  • Alan Bird
    Inherited Eye Disease, Moorfields Eye Hospital, London, United Kingdom
  • Alain Gaudric
    Service d'Ophtalmologie, Hopital Lariboisière Université Paris Diderot, Paris, France
  • Footnotes
    Commercial Relationships Ferenc Sallo, None; Valerie Krivosic, None; Kiyoko Gocho, None; Michel Paques, MerckSerono (C), Roche (C), Sanofi (C); Tunde Peto, None; Alan Bird, None; Alain Gaudric, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1510. doi:
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      Ferenc Sallo, Valerie Krivosic, Kiyoko Gocho, Michel Paques, Tunde Peto, Alan Bird, Alain Gaudric, MacTel Study Group; Adaptive optics and 'en face' OCT imaging of the outer retina in Type 2 Macular Telangiectasia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1510.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Type 2 macular telangiectasia (type 2 MacTel) is associated with outer retinal abnormalities at and near the foveal centre. 'En face'Spectral Domain Optical Coherence Tomographic (SD-OCT) imaging of the inner segment/outer segment (IS/OS) junction layer is a validated method for following disease severity in MacTel. The resolution of commercially available SD-OCT systems is however limited. Devices equipped with adaptive optics (AO) offer superior clarity and resolution. Our aim was to examine outer retinal morphology using the two imaging modalities.

 
Methods
 

Patients were selected from the international prospective MacTel Study. SD-OCT volumesof at least 97 B-scans at 30µ intervals were acquired using a Heidelberg Spectralis OCT unit. Segmentation and 'en face' imaging of the 'IS/OS line' were performed manually, using dedicated 3D image analysis software. High resolution images of the fundus focusing on the photoreceptors were captured using an AO fundus camera (Imagine Eyes rtx1). 'En face' OCT and AO images were superimposed over images of the fundus and adjusted to attain exact correspondence. Lesions characteristic of the disease were analyzed in each imaging modality and results were compared.

 
Results
 

Twelve eyes of 7 MacTel patients (ranging in age 55-69 years, mean age 62.7, SD=5.7 years) were examined. In 4 eyes no IS/OS break was seen on OCT and the photoreceptor mosaic was imaged clearly and appeared normal in AO images. Eight eyes demonstrated a clear defect in the IS/OS layer. In AO images, areas corresponding to a break appeared featureless. Within some larger breaks however, clustered structures similar to photoreceptors were observed. On review of the B-scans, a highly reflective material near the RPE but discontiguous with the IS/OS line was apparent in these areas. In 5 eyes a vertical restructuring of the retinal layers was seen on OCT, in these regions, photoreceptor visibility was limited in AO images.

 
Conclusions
 

AO imaging demonstrates abnormalities in the photoreceptor mosaic corresponding to the breaks in the IS/OS layer seen in en face OCT images in MacTel. The segmentation used for producing en face images may need to be adjusted to capture surviving photoreceptors. A quantification of photoreceptor parameters in AO images including size, reflectivity, density and/or spacing may offer further tools for detecting early signs of outer retinal changes in type 2 MacTel.

 
Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 549 image processing • 689 retina: distal (photoreceptors, horizontal cells, bipolar cells)  
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