June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
A comparison of morphological changes seen on en-face wide-field OCT imaging to short-wavelength fundus autofluorescence imaging in Stargardt disease
Author Affiliations & Notes
  • Vivienne C Greenstein
    Ophthalmology, Columbia University Med Center, New York, New York, United States
  • Jason Nunez
    Psychology, Columbia University, New York, New York, United States
  • Kasper Schurch
    Ophthalmology, Columbia University Med Center, New York, New York, United States
  • Winston Lee
    Ophthalmology, Columbia University Med Center, New York, New York, United States
  • Juan Reynaud
    Devers Eye Institute, Portland, Oregon, United States
  • Brad Fortune
    Devers Eye Institute, Portland, Oregon, United States
  • Rando Allikmets
    Ophthalmology, Columbia University Med Center, New York, New York, United States
    Pathology & Cell Biology, Columbia University, New York, New York, United States
  • Donald Hood
    Psychology, Columbia University, New York, New York, United States
    Ophthalmology, Columbia University Med Center, New York, New York, United States
  • Footnotes
    Commercial Relationships   Vivienne Greenstein, None; Jason Nunez, None; Kasper Schurch, None; Winston Lee, None; Juan Reynaud, None; Brad Fortune, None; Rando Allikmets, None; Donald Hood, Heidelberg Engineering (F), Heidelberg Engineering (R), Topcon, Inc (F), Topcon, Inc (R)
  • Footnotes
    Support  R01 EY009076
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1856. doi:
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    • Get Citation

      Vivienne C Greenstein, Jason Nunez, Kasper Schurch, Winston Lee, Juan Reynaud, Brad Fortune, Rando Allikmets, Donald Hood; A comparison of morphological changes seen on en-face wide-field OCT imaging to short-wavelength fundus autofluorescence imaging in Stargardt disease. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1856.

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

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Abstract

Purpose : To compare morphological changes on en-face images derived from wide-field swept-source optical coherence tomography (ssOCT) scans to hypo- and hyper-autofluorescent (hypoAF, hyperAF) areas detected with short-wavelength autofluorescence (SW-AF) images in patients with recessive Stargardt disease (STGD1).

Methods : Wide-field, ssOCT cube scans (9X12 mm, 256 B-scans, 512 A-scans, DRI-OCT, Topcon, Inc) were obtained from 16 patients (16 eyes) aged 11 to 70 yrs with genetically confirmed STGD1. OCT averaged B-scans and SW-AF images, were also obtained using Spectralis HRA+OCT (Heidelberg Eng). Following manual correction of the automated Topcon segmentation of the inner/outer segment (IS/OS) junction, the OS/retinal pigment epithelium (OS/RPE), and RPE/Bruch's membrane boundaries, the average reflective intensity of en-face slabs of varying thickness were generated with these boundaries as references using special purpose software (ATL 3D-Suite).[1] For each eye, the area of the central macular lesion/atrophy on a sub-RPE slab positioned below the RPE, and on an IS/OS band slab were compared to the central hypo- and hyperAF areas on the SW-AF image using ImageJ. The number and location of flecks observed on an OS/RPE slab positioned just above the RPE were compared to those on the SW-AF image.

Results : For all eyes, the sub-RPE slab showed a hyper-reflective area in the central macula (Fig. 1A), consistent with recent findings.[2,3] With the IS/OS slab (Fig. 1B), the corresponding area was hypo-reflective, and was significantly larger. For 14 eyes, there was a significant correlation between the abnormal hyper-reflective area on the sub-RPE en-face image and the hypoAF area (Fig. 1C) (r= 0.96), and between the abnormal area on the IS/OS slab (Fig. 1B) and the combined hypo- and hyperAF areas on the SW-AF image (Fig. 1C) (r=0.73). Two eyes were excluded based on absence of a distinct area of abnormal AF in one eye, and on diffuse AF abnormalities in the other. We also found good agreement between SW-AF and en-face OS/RPE slab images regarding fleck number and location (Fig. 2).

Conclusions : En-face imaging is of use in detecting morphological changes in STGD1, and indicates that in these cases IS/OS junction loss precedes RPE atrophy. 1. Fortune et al. IOVS 2014 2. Sodi et al. Graefe's Arch. 2016 3. Melillo et al. IOVS 2016

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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