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Tara L Favazza, Emily A Swanson, Lucia Ambrosio, Garima Soni, Ronald M Hansen, James D Akula, Anne B Fulton; AO-SLO imaging of diseased retina using offset and confocal apertures. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1662.
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© 2017 Association for Research in Vision and Ophthalmology.
Complex intraretinal structures, such as the pathological schitic cavities characterizing juvenile x-linked retinoschisis (XLRS), scatter photons. These structures may be nearly invisible using standard confocal adaptive optics (AO) scanning light ophthalmoscopy (SLO), but can be revealed using offset aperture imaging techniques. The purpose of this experiment was to contrast the appearance of intraretinal structures observed using confocal AO-SLO and offset-aperture AO-SLO.
Subjects with secure genetic diagnoses of XLRS and Stargardt disease (SG) were recruited, as well as age-similar controls with healthy eyes. Subject’s eyes were dilated with phenylephrine 2.5% and tropicamide 1%. AO-SLO images were obtained, using both offset and confocal apertures, covering approximately 3°×3° of central retina and 2°-10° nasal and temporal retina on the horizontal meridan. Images were registered, aligned, and montaged using custom software, ImageJ, and Photoshop CS3.
In confocal images, schitic cavities were black patches. Offset-aperture imaging, however, displayed a remarkable “hill and valley” topography that evoked an impression of canal-like cavities spreading throughout the spoke-wheel pattern characteristic of XLRS. These patterns were never seen in control subjects. In subjects with SG, photoreceptor inner segments, intralaminar disruptions,and putative lipofuscin accumulations were visible in the offset-aperture SLO images, but poorly visualized in confocal aperture images. A leading SG disease front was also often better visualized in offset than confocal images.
Capture of multiply scattered photons by use of offset aperture AO-SLOs can reveal disease structures that are invisible to conventional confocal imaging. Using both methods can provide a more thorough means of imaging diseased retina.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
SLO images of the same region of central retina in an XLRS subject taken with confocal and offset apertures.
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