April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
In vivo microscopy using adaptive optics scanning light ophthalmoscope fluorescein angiography and analysis of the foveal microvasculature in sickle cell retinopathy and comparison with SD-OCT
Author Affiliations & Notes
  • Alexander Gan
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
  • Nishit Shah
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
  • Moataz M Razeen
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
  • Alexander Pinhas
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
    Icahn School of Medicine at Mount Sinai, New York, NY
  • Eric Cheang
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
    Stuyvesant High School, New York, NY
  • Rishard Weitz
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
  • Ronald Gentile
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
    Department of Ophthalmology, Winthrop University Hospital, Mineola, NY
  • Alfredo Dubra
    Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI
    Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI
  • Toco Yuen Ping Chui
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
  • Richard B Rosen
    Departments of Ophthalmology, New York Eye and Ear Infirmary, Mount Sinai Health System and New York Medical College, New York, NY
  • Footnotes
    Commercial Relationships Alexander Gan, None; Nishit Shah, None; Moataz Razeen, None; Alexander Pinhas, None; Eric Cheang, None; Rishard Weitz, None; Ronald Gentile, None; Alfredo Dubra, Canon USA Inc (C), US Patent No: 8,226,236 (P); Toco Chui, None; Richard Rosen, Clarity (C), OD-OS (C), Optovue (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3871. doi:
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      Alexander Gan, Nishit Shah, Moataz M Razeen, Alexander Pinhas, Eric Cheang, Rishard Weitz, Ronald Gentile, Alfredo Dubra, Toco Yuen Ping Chui, Richard B Rosen; In vivo microscopy using adaptive optics scanning light ophthalmoscope fluorescein angiography and analysis of the foveal microvasculature in sickle cell retinopathy and comparison with SD-OCT. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3871.

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

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Abstract
 
Purpose
 

To compare the foveal microvascular density in sickle cell retinopathy (SCR) with healthy controls using adaptive optics scanning light ophthalmoscope fluorescein angiography (AOSLO FA), and to compare with SD-OCT retinal thickness profiles.

 
Methods
 

AOSLO FAs of 3 SCR subjects (average age: 36 years; range: 32-42) using oral fluorescein (20 mg/kg) were acquired and compared to previously obtained healthy control data. Simultaneous reflectance (790nm) and fluorescence (488nm) image sequences covering a 6° square area centered at the fovea were acquired using a 1.75° field of view. Images were stitched together to create larger microvascular perfusion maps (Fig. 1A). The maps were skeletonized (Fig.1B) and Foveal Vessel Density (FVD) (mm-1) was calculated for a concentric annulus centered at the fovea (A=200-800µm). Inner Foveal Vessel Density (iFVD, 200-400µm radius) and Outer Foveal Vessel Density (oFVD, 400-800µm radius) were also calculated. To compare VD with retinal thickness, 12 SD-OCT radial scans centered at the fovea were acquired for each eye and segmented to measure inner retinal thickness (IRT), outer retinal thickness (ORT) and total retinal thickness (TT) at 50-750µm from the foveal center with a 100 µm interval. OCT thickness profiles were averaged. Statistical significance was assessed using an unpaired t-test.

 
Results
 

Mean FVD was less in the SCR eyes compared to controls (34.8 ± 3.0 versus 41.8 ± 1.39 (mm-1), p=0.022). When comparing the inner and outer annuli, there was a significant decrease in the ORT thickness on SD-OCT in the outer annuli in SCR eyes versus controls (p=0.043). Although mean iFVD and oFVD in SCR were less than controls, the differences were not significant. (Fig.2).

 
Conclusions
 

The reduction in SCR VD compared to controls is indicative of microvascular abnormalities occurring in the foveal region. Our results indicate that VD analysis of AOSLO FAs may be a sensitive tool to detect subclinical changes to the foveal microvasculature, showing promise to gain more knowledge about SCR. Further studies with a larger sample size are needed to correlate VD with OCT thickness profiles.

 
 
Fig. 1. AOSLO FA foveal microvascular perfusion map of SCR (A) and its skeleton after binarization and thresholding (B).
 
Fig. 1. AOSLO FA foveal microvascular perfusion map of SCR (A) and its skeleton after binarization and thresholding (B).
   
Keywords: 688 retina • 550 imaging/image analysis: clinical • 749 vascular occlusion/vascular occlusive disease  
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