June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
High Resolution Imaging of Parafoveal Cones in Different Stages of Diabetic Retinopathy using Adaptive Optics Fundus Camera
Author Affiliations & Notes
  • Mohamed Kamel Soliman
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
    Ophthalmology, Assiut University, Assiut, Egypt
  • Mohammad Ali Sadiq
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
  • Aniruddha Agarwal
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
  • Salman Sarwar
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
  • Mostafa Saad Hanout
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
  • Frank E Graf
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
  • Robin High
    College of Public Health, University of Nebraska Medical Center, Omaha, NE
  • Diana V Do
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
  • Quan Dong Nguyen
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
  • Yasir Jamal Sepah
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE
  • Footnotes
    Commercial Relationships Mohamed Soliman, None; Mohammad Sadiq, None; Aniruddha Agarwal, None; Salman Sarwar, None; Mostafa Hanout, None; Frank Graf, None; Robin High, None; Diana Do, None; Quan Dong Nguyen, None; Yasir Sepah, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4922. doi:
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      Mohamed Kamel Soliman, Mohammad Ali Sadiq, Aniruddha Agarwal, Salman Sarwar, Mostafa Saad Hanout, Frank E Graf, Robin High, Diana V Do, Quan Dong Nguyen, Yasir Jamal Sepah; High Resolution Imaging of Parafoveal Cones in Different Stages of Diabetic Retinopathy using Adaptive Optics Fundus Camera. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4922.

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

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Abstract
 
Purpose
 

Neurodegeneration has been proposed as one of the possible pathophysiological mechanisms underlying diabetic retinopathy (DR). In this prospective cohort study, we investigated parafoveal cone density in different stages of DR using adaptive optics (AO) retinal imaging.

 
Methods
 

An AO retinal camera (rtx1; Imagine Eyes, Orsay, France) was used to acquire images of parafoveal cones from patients with diagnosis of diabetes mellitus with or without retinopathy and from healthy controls with no known systemic or ocular disease. Eyes with myopia (> 10 diopters), media opacity, current macular edema, or any coexistent retinal diseases other than DR were excluded. The final image produced by the AO camera is equivalent to ≈ 1.2 × 1.2 mm (4° × 4°) based on axial length (AL) of the eye. The density of the parafoveal cones was calculated in 100 × 100 µm square located at 300 and 500 µm from the foveal center (a minimum of 250 µm from the foveal center is recommended for feasible cone assessment) along nasal, temporal, superior and inferior quadrants. The measurements (cones/mm2) were done using automated AOdetect Ver. 0.1. Software provided by the manufacturer. AL were measured using non-contact biometry (IOL Master®; Carl Zeiss Meditech, Germany). Correlation between diabetes control (Hb1Ac) and severity of DR with cone density was analyzed using Spearman correlation test.

 
Results
 

Ten subjects (10 eyes) with no known ocular or systemic diseases and 14 (17 eyes) with diabetes were included (Table). Among those with diabetes, 4 patients (5 eyes) did not have retinopathy, 3 (4 eyes) had mild NPDR, 5 (6 eyes) had moderate NPDR and 2 (2 eyes) had severe NPDR. The mean Hb1Ac among patients with diabetes was 8.5 ±2. A significant difference (P< 0.001) in cone density was found between healthy controls and moderate/severe NPDR group (figure); however, no statistical significance was found between controls and no retinopathy or mild NPDR groups.<br /> An inverse relationship between cone density and Hb1Ac was observed in all parafoveal regions; however, no relationship could be correlated for the duration of diabetes.

 
Conclusions
 

Patients with diabetes may have loss of photoreceptors with increasing severity of DR. AO provides assessment of photoreceptors, which may allow better understanding of the disease pathology.  

 
 
Figure - Cone density in different stages of diabetic retinopathy
 
Figure - Cone density in different stages of diabetic retinopathy

 
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