June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Photoreceptor deflection around subretinal drusenoid deposits (SDD) revealed by adaptive optics scanning laser ophthalmoscopy (AOSLO)
Author Affiliations & Notes
  • Yuhua Zhang
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL
  • Xiaolin Wang
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL
  • Ernesto Blanco
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL
    BioMedical Engineering, University of Alabama at Birmingham, Birmingham, AL
  • Mark Clark
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL
  • Clark Witherspoon
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL
  • Christopher Girkin
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL
  • Cynthia Owsley
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL
  • Christine Curcio
    Ophthalmology, Univ of Alabama at Birmingham, Birmingham, AL
  • Footnotes
    Commercial Relationships Yuhua Zhang, None; Xiaolin Wang, None; Ernesto Blanco, None; Mark Clark, None; Clark Witherspoon, None; Christopher Girkin, SOLX (F), Heidelberg Engineering (F); Cynthia Owsley, Genentech (F), Patent Licensed to: MacuLogix (P), Allergan (R); Christine Curcio, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1514. doi:
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    • Get Citation

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

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Abstract
 
Purpose
 

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).

 
Methods
 

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.

 
Results
 

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).

 
Conclusions
 

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.

 
 
Fig.1 SDD perturbation of photoreceptors, revealed by AOSLO and SD-OCT. 73 year old man with non-neovascular AMD OS (AREDS grade 6, VA 20/25). A. AOSLO image. Cone photoreceptors are represented by evenly spaced spots of hyper-reflectivity (bright). SDD is indicated by a wide hypo-reflective ring with indistinct borders. B-C. SD-OCT scans through SDD center (B) and off-center (C) reveal a gap in the photoreceptor ellipsoid zone (EZ) on either side of the SDD. The gap corresponds to the hypo-reflective ring in the AOSLO image, strengthening the association between the reflectivity sources in these 2 imaging modalities.
 
Fig.1 SDD perturbation of photoreceptors, revealed by AOSLO and SD-OCT. 73 year old man with non-neovascular AMD OS (AREDS grade 6, VA 20/25). A. AOSLO image. Cone photoreceptors are represented by evenly spaced spots of hyper-reflectivity (bright). SDD is indicated by a wide hypo-reflective ring with indistinct borders. B-C. SD-OCT scans through SDD center (B) and off-center (C) reveal a gap in the photoreceptor ellipsoid zone (EZ) on either side of the SDD. The gap corresponds to the hypo-reflective ring in the AOSLO image, strengthening the association between the reflectivity sources in these 2 imaging modalities.
 
Keywords: 504 drusen • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 648 photoreceptors  
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