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Yuhua Zhang, Xiaolin Wang, Ernesto Blanco, Mark Clark, Clark Witherspoon, Christopher Girkin, Cynthia Owsley, Christine Curcio; Photoreceptor deflection around subretinal drusenoid deposits (SDD) revealed by adaptive optics scanning laser ophthalmoscopy (AOSLO). Invest. Ophthalmol. Vis. Sci. 2013;54(15):1514.
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To use a novel imaging technique to reveal microscopic structure of photoreceptors around SDD, a lesion recently recognized in eyes with age-related macular degeneration (AMD).
Patients with various stages of AMD (n=33) and age-similar participants in normal macular health (n=7) underwent best-corrected visual acuity as measured by the EVA and digital color fundus photography. En-face infrared, red-free, and autofluorescence (AF) images were acquired with confocal SLO. Retinal cross-sections were imaged with SD-OCT. AOSLO was performed to image the maculae of the participants. SDD were determined by a reticular pattern discernible in color fundus photo, IR reflectance, AF, and red-free images. A subset of solitary lesions with complete rings of hypo-reflectance in IR was further examined in detail. Photoreceptor structure around these specific SDD formations was examined en-face by AOSLO and by SD-OCT scans that crossed them.
AOSLO produced high-magnification, high-resolution, and high-contrast images in 13 eyes of 8 patients with bilateral SDD, revealing a distinct en-face structure (Fig.1 A): a hyporeflective ring surrounding an area with indistinct photoreceptors. SD-OCT revealed that SDD was an accumulation of highly reflective material in the subretinal space internal to the retinal pigment epithelium (RPE) and Bruch’s membrane complex (Fig.1 B, C).
AOSLO may be an effective method for imaging SDDs. The findings indicate that solitary SDD can deflect surrounding photoreceptors, thus supporting histological studies describing SDD as solid, space filling lesions in the subretinal space; accordingly, photoreceptor function is expected to be negatively impacted by this perturbation.
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