June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Microaneurysm (MA) Wall Characteristics on Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) are Related to MA Perfusion Status and Local Neural Retina Changes over Time
Author Affiliations & Notes
  • Omar Abu-Qamar
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Master of Medical Sciences In Clinical Investigation, Harvard Medical School, Boston, Massachusetts, United States
  • Yang Lu
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Scott R Peterson
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Konstantina Sampani
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Gary L. Yau
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Charles Cai
    Biomedical Engineering, Columbia University, New York, New York, United States
  • Ward Fickweiler
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
  • Paolo Silva
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Philippine Eye Research Institute, University of the Philippines, Manila, Manila, Philippines
  • Lloyd P Aiello
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Jennifer K Sun
    Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, United States
    Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Omar Abu-Qamar, None; Yang Lu, None; Scott Peterson, None; Konstantina Sampani, None; Gary Yau, None; Charles Cai, None; Ward Fickweiler, None; Paolo Silva, None; Lloyd Aiello, None; Jennifer Sun, Boston Micromachines (F), Optovue (F)
  • Footnotes
    Support  NEI R01 EY024702; JDRF 3-SRA-2014-264-M-R; Beatson Childcare Ambassador Program Foundation; Massachusetts Lions Eye Research Fund, Inc., Dubai Harvard Foundation for Medical Research
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5031. doi:
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    • Get Citation

      Omar Abu-Qamar, Yang Lu, Scott R Peterson, Konstantina Sampani, Gary L. Yau, Charles Cai, Ward Fickweiler, Paolo Silva, Lloyd P Aiello, Jennifer K Sun; Microaneurysm (MA) Wall Characteristics on Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) are Related to MA Perfusion Status and Local Neural Retina Changes over Time. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5031.

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

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Abstract

Purpose : To assess whether MA wall deformability (WD) and hyperreflectivity (WH) on AOSLO are associated with changes in MA perfusion and disorganization of the retinal inner layers (DRIL).

Methods : AOSLO imaging, 200° color fundus photography, and spectral domain optical coherence tomography (SD OCT) were performed in diabetic subjects. Fluorescein angiography (FA) was obtained in a subset and leakage assessed. MA AOSLO images were acquired, registered to SDOCT images and graded for WD and WH. OCT images were graded for DRIL within 500μm of MAs. Analyses adjusted for correlations between MAs from the same eye and repeated observations from the same MA.

Results : A total of 437 MAs (97 eyes, 57 subjects) were imaged. Mean±SD age was 44±12 yrs, DM duration 23±10 yrs, 39% female. DR severity was nonproliferative DR (70%) and PDR (30%). DME severity was none (71%), non-central involved (14%) and center-involved (14%). Follow-up imaging (1-4 and >5 times) was obtained for 147 and 19 MAs, respectively. Baseline analyses adjusting for prior anti-VEGF therapy showed WD was associated with smaller MAs (p=0.0003) and more perfusion (p=<.0001), but not with leakage or DRIL. WH was associated with larger MAs (p=<.0001), less perfusion (p=<.0001), leakage (p=0.01) and greater local DRIL extent (p=0.004). Longitudinal analyses identified a relationship between DRIL change and WD change (p=0.01). DRIL was less likely to improve near MAs when WD was present at baseline and subsequently resolved (19% vs 60%). Changes in DRIL were also correlated with changes in hyperreflective foci (p= 0.02) and leakage (p=0.02). Changes in WH were associated with changes in perfusion status (p= 0.02). Perfusion decreased most when MAs developed WH during follow-up. No association was found between changes in WH and changes in DRIL.

Conclusions : Based on these findings, WD may be a feature of earlier-stage MAs, and its loss may be associated with increasing local neural disorganization. In contrast, WH is present in more mature, larger MA’s that leak and have surrounding neural pathology. Development of WH may be concurrent with decreasing perfusion. Prospective AOSLO studies will elucidate whether these AOSLO features can be used as predictors of perfusion status and development of local neural retinal pathology.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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