June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Changes in Cone Reflectivity and Regularity Assessed by Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) Correlate with Presence of Diabetic Retinopathy
Author Affiliations & Notes
  • Jan Lammer
    Beetham Eye Institute, Joslin Diabetes Center, Boston, MA
    Department of Opthalmology and Optometry, Medical University of Vienna, Vienna, Austria
  • Amel Ahmed
    Department of Histology and Cell Biology, Faculty of Medicine, Assiut University, Assiut, Egypt
  • Sonja Prager
    Beetham Eye Institute, Joslin Diabetes Center, Boston, MA
    Department of Opthalmology and Optometry, Medical University of Vienna, Vienna, Austria
  • Michael Cheney
    Beetham Eye Institute, Joslin Diabetes Center, Boston, MA
  • Stephen Burns
    School of Optometry, Indiana University, Bloomington, IN
  • Paolo Silva
    Beetham Eye Institute, Joslin Diabetes Center, Boston, MA
    Department of Ophthalmology, Harvard Medical School, Boston, MA
  • Lloyd Aiello
    Beetham Eye Institute, Joslin Diabetes Center, Boston, MA
    Department of Ophthalmology, Harvard Medical School, Boston, MA
  • Jennifer Sun
    Beetham Eye Institute, Joslin Diabetes Center, Boston, MA
    Department of Ophthalmology, Harvard Medical School, Boston, MA
  • Footnotes
    Commercial Relationships Jan Lammer, None; Amel Ahmed, None; Sonja Prager, None; Michael Cheney, None; Stephen Burns, None; Paolo Silva, Optos plc (F); Lloyd Aiello, Genentech (C), Genzyme (C), Thrombogenetics (C), Ophthotech (C), Kalvista (C), Pfizer (C), Proteostasis (C), Abbott (C), Vantia (C), Optos, plc (F); Jennifer Sun, Boston Micromachines (F), Abbott Laboratories (C), Novartis (C), Genentech (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1746. doi:
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    • Get Citation

      Jan Lammer, Amel Ahmed, Sonja Prager, Michael Cheney, Stephen Burns, Paolo Silva, Lloyd Aiello, Jennifer Sun; Changes in Cone Reflectivity and Regularity Assessed by Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) Correlate with Presence of Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1746.

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

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Abstract

Purpose: To utilize high resolution AOSLO to evaluate differences in cone density, reflectivity and regularity in eyes with and without diabetes (DM) and across a range of diabetic retinopathy (DR) severity.

Methods: Cone mosaics at the fovea and 4 macular quadrants (1x1.2° area, mean+SD eccentricity = 4.2±0.4°) were imaged using AOSLO (2.5µm resolution). Contrast of aligned and averaged images was automatically standardized based on the 8-bit histogram. Cone counting was performed semi-automatically using ImageJ and manual correction by 2 independent graders masked to clinical data. Count differences >20% were adjudicated. Parameters including density, nearest neighbor (NN) and Voronoi tile measurements were calculated as well as mean reflectivity of each Voronoi tile.

Results: Forty eyes of 40 subjects were assessed. For subjects, mean±SD age was 44±12yrs, 57% (N=12) were male, 78% (31) had DM, DM duration was 22±14yrs and 32% (10) had no DR, 19% (6) mild nonproliferative DR (NPDR), 29% (9) moderate NPDR, 10% (3) severe NPDR and 10% (3) PDR. No consistent relationship for DM or DR was seen with absolute cone density, NN measurements, or reflectivity. However, the reflectivity regularity index (RI) (Voronoi tile reflectivity mean/SD) decreased in all 5 macular regions with increasing DR severity and this decrease was statistically significant in the inferior regions of the macula (No DR: 4.6±0.9, mild NPDR: 4.5±0.8, moderate NPDR: 4.5±0.7, severe NPDR: 4.2±0.9, PDR: 3.8±0.9, p<0.05). A significantly lower NN RI (NN mean/SD) was seen in macular quadrants in eyes with DM as compared with no DM (4.7±1.0 vs. 5.4±1.5, p<0.04). Increasing age correlated with a decrease in mean cone density (<35y: 11,567±2,848, 35-50y: 10,933±2,403, 50+y: 10,023±2,219 cones/mm2, p<0.05) as well as an increase in reflectivity RI (4.1±0.9, 4.3±0.8, 4.8±0.8, respectively, p=0.002) in all regions.

Conclusions: Although absolute cone density does not appear to change substantially in diabetes, decreases in regularity of cone spacing and reflectivity regularity are associated with presence of DM and increasing DR severity, respectively. If future studies demonstrate that these properties correlate with functional or metabolic alterations of the retinal photoreceptors, these assessments may provide novel predictors of visual or anatomic outcomes in the diabetic eye.

Keywords: 499 diabetic retinopathy • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 689 retina: distal (photoreceptors, horizontal cells, bipolar cells)  
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