June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Cone structure imaged with Adaptive Optics Scanning Laser Ophthalmoscopy in eyes with Non-Neovascular Age-related Macular Degeneration
Author Affiliations & Notes
  • Shiri Zayit-Soudry
    Ophthalmology/Retina Division, University of California, San Francisco, San Francisco, CA
  • Reema Syed
    Ophthalmology/Retina Division, University of California, San Francisco, San Francisco, CA
  • Kavitha Ratnam
    Ophthalmology/Retina Division, University of California, San Francisco, San Francisco, CA
  • Moreno Menghini
    Ophthalmology/Retina Division, University of California, San Francisco, San Francisco, CA
  • Austin Roorda
    School of Optometry, University of California, Berkeley, Berkeley, CA
  • Jacque Duncan
    Ophthalmology/Retina Division, University of California, San Francisco, San Francisco, CA
  • Footnotes
    Commercial Relationships Shiri Zayit-Soudry, None; Reema Syed, None; Kavitha Ratnam, None; Moreno Menghini, None; Austin Roorda, US Patent #6890076 (P), US Patent #7118216 (P), UC Berkeley (P); Jacque Duncan, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1744. doi:
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      Shiri Zayit-Soudry, Reema Syed, Kavitha Ratnam, Moreno Menghini, Austin Roorda, Jacque Duncan; Cone structure imaged with Adaptive Optics Scanning Laser Ophthalmoscopy in eyes with Non-Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1744.

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

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Abstract
 
Purpose
 

To evaluate cone structure using Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) in eyes with non-neovascular age related macular degeneration (AMD), and to correlate progression of AOSLO-derived cone measures with standard measures of macular structure. High resolution imaging of cone photoreceptor morphology and quantitative measures of cone structure may enhance understanding of the pathophysiology of vision loss in AMD and provide a sensitive biomarker for disease progression.

 
Methods
 

AOSLO macular images were obtained over 12 to 21 months from 7 patients with non-neovascular AMD including 4 eyes with geographic atrophy (GA) and 6 eyes with drusen. AOSLO images were precisely superimposed onto color, infrared and autofluorescence fundus photographs and spectral domain optical coherence tomography (SD-OCT) images to allow direct correlation of cone parameters with macular structure. Cone spacing was measured for each visit in selected regions including areas over drusen (n=29), at the margin of GA (n=14), and regions without evidence of drusen or GA on fundus photos or SD-OCT (n=13) and compared to normal, age-related values.

 
Results
 

AOSLO imaging revealed intact cones up to the GA edge and overlying drusen, although subtle mosaic irregularity and reduced reflectivity often resulted in a dark signal surrounding GA margins and drusen. At baseline, cone spacing measures were normal at all study locations but 2 GA margin locations and 4 drusen locations. Although progression of GA was observed in most study eyes with standard clinical measures, AOSLO longitudinal tracking showed mild increases in cone spacing in 3 drusen locations, but stable cone spacing measures in all other drusen and GA margin locations.

 
Conclusions
 

AOSLO provides adequate resolution for quantitative measurement of cone structure at the margin of GA and over drusen in eyes with non-neovascular AMD, providing insight into the pathophysiology of GA progression. Despite reflectivity changes noted over drusen and at GA margins, cone spacing was often preserved at these locations and remained stable over time, suggesting changes in cone spacing may not represent a primary structural change in AMD progression.

 
Keywords: 412 age-related macular degeneration • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 688 retina  
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