Purchase this article with an account.
Kaitlyn Anne Sapoznik, Todd David Peabody, Patricia A Henderson, Lucie Sawides, Thomas Gast, Stephen A Burns; Multimodal imaging of Cellular Changes in Choroidal Nevi following Laser Treatment. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5859.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate in vivo cellular change over time in subjects with subretinal fluid (SRF) associated with choroidal nevi who have undergone treatment with focal laser. Adaptive optics (AO) imaging enables in vivo retinal imaging at the cellular level. By combining optical coherence tomography (OCT) and AO imaging, it is possible to measure detailed cellular changes associated with choroidal nevus and its sequelae.
With the Indiana AOSLO, confocal and multiply-scattered light imaging was performed on two subjects with foveal SRF associated with choroidal nevi. SD-OCT scans were acquired at each visit and used to guide AOSLO imaging. The first subject (S1), a 31 yo WF, was imaged 16 times over 12 months and the second subject (S2), a 52 yo WF, was imaged 6 times over 15 months. Each subject underwent focal laser photocoagulation for SRF between the first and second imaging sessions. Each session focused on regions of interest (ROIs) including laser burns, photoreceptor (PR) changes, and areas of cellular changes. AOSLO images were averaged with custom Matlab software, montaged, and imported into Photoshop CS6. Retinal areas of interest were identified, measured, and compared over time and to SD-OCT images.
In both subjects, hyper-reflective cellular structures ranging in diameter from 11-29 µm were located in regions of PR disruption. These contained multiple hyper-reflective particles within them. Retinal appearance varied markedly over time and in S1 the RPE mosaic was directly imaged in areas with shallow SRF. Also in S1, the location of a focal laser burn was identified via AOSLO imaging and appeared to be rapidly infiltrated with new cellular structures following the laser. At 20 and 34 days post-laser, the diameter of these structures ranged between 9-32 µm (see figure) and by 62 days post laser most were not apparent. Cones could not be identified at the burn site.
The in vivo imaging allows measurement of the dynamic changes as the retina responds to disease and treatment. These changes are likely secondary to microglial and RPE changes, PR loss and disruption, and macrophage infiltration associated with these tumors and corresponding treatment. The AOSLO provides a complementary view of many features that are utilized in the clinical differentiation of choroidal nevus and melanoma.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only