June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Microangiopathic Features of Central Retinal Vein Occlusion Imaged Using Fluorescence Adaptive Optics Scanning Light Ophthalmoscopy
Author Affiliations & Notes
  • Alexander Pinhas
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
    Mount Sinai School of Medicine, New York, NY
  • Nishit Shah
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • Michael Dubow
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
    Mount Sinai School of Medicine, New York, NY
  • Mitul Mehta
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • Patricia Garcia
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • Nicole Scripsema
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
    New York Medical College, Valhalla, NY
  • Joseph Carroll
    Ophthalmology, Medical College of Wisconsin, Milwaukee, WI
    Cell Biology, Neurology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
  • Yusufu Sulai
    The Institute of Optics, University of Rochester, Rochester, NY
  • Alfredo Dubra
    Ophthalmology, Medical College of Wisconsin, Milwaukee, WI
    Biophysics, Medical College of Wisconsin, Milwaukee, WI
  • Richard Rosen
    Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • Footnotes
    Commercial Relationships Alexander Pinhas, None; Nishit Shah, None; Michael Dubow, None; Mitul Mehta, None; Patricia Garcia, None; Nicole Scripsema, None; Joseph Carroll, Imagine Eyes, Inc. (S); Yusufu Sulai, None; Alfredo Dubra, US Patent No: 8,226,236 (P); Richard Rosen, Opko-OTI (C), Optos (C), Clarity (C), OD-OS (C), Topcon (R), Zeavision (F), Genetech (F), Optovue (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 6066. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Alexander Pinhas, Nishit Shah, Michael Dubow, Mitul Mehta, Patricia Garcia, Nicole Scripsema, Joseph Carroll, Yusufu Sulai, Alfredo Dubra, Richard Rosen; Microangiopathic Features of Central Retinal Vein Occlusion Imaged Using Fluorescence Adaptive Optics Scanning Light Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6066. doi: https://doi.org/.

      Download citation file:


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

      ×
  • Supplements
Abstract
 
Purpose
 

Central retinal vein occlusion (CRVO) remains a common cause of vision loss in retinal vascular disease, second only to diabetic retinopathy. Fluorescein angiography (FA) has remained the gold standard for confirming its diagnosis and assessing the degree of retinal nonperfusion, macroangiopathic change and macroscopic response to treatment. The high transverse resolution of adaptive optics scanning light ophthalmoscopy (AOSLO) has allowed for in vivo study of retinal micropathology, but has been limited in its capability to image retinal microvasculature. Here, we demonstrate the use of fluorescence AOSLO (FAOSLO) for imaging microscopic angiopathic features of CRVO.

 
Methods
 

Reflectance AOSLO (RAOSLO) images (790nm; 1° field of view) were collected in five adult CRVO patients to identify microvascular points of interest. Patients then ingested 1g fluorescein dye. Simultaneous RAOSLO and FAOSLO images were then collected between 15 and 60 minutes post-ingestion. The fluorescence channel used a 488nm light for excitation; and, an emission filter centered at 525nm with a 45nm bandwidth. For comparison with conventional imaging techniques, Topcon fundus imaging with and without IV fluorescein was performed.

 
Results
 

The combination of RAOSLO and FAOSLO enabled us to visualize CRVO microangiopathic features in vivo in the finest capillaries of the retinal inner nuclear layer. Among the features visualized were vessel wall thickening, microaneurysms, neovascularization and hemorrhage. FAOSLO showed the full extent and detail of microangiopathy, as opposed to RAOSLO and conventional fundus photography.

 
Conclusions
 

We believe that the clinical role of FAOSLO has significant potential. Comparison with motion contrast-based techniques remains to be evaluated. We believe that coupled with RAOSLO and a method to analyze microangiopathic features quantitatively, FAOSLO will lead to a better understanding of CRVO pathophysiology, disease progression and a more comprehensive method in monitoring tissue response to different treatment modalities.

 
 
Fig 1. Fine capillary microaneurysms were seen (C, D) that were not appreciated on either conventional imaging (A, B) or RAOSLO.
 
Fig 1. Fine capillary microaneurysms were seen (C, D) that were not appreciated on either conventional imaging (A, B) or RAOSLO.
 
 
Fig 2. RAOSLO was better at visualizing hemorrhage (B) and vessel wall thickening (D), whereas FAOSLO was better at outlining the intravascular space and visualizing capillaries of finest caliber (C, E).
 
Fig 2. RAOSLO was better at visualizing hemorrhage (B) and vessel wall thickening (D), whereas FAOSLO was better at outlining the intravascular space and visualizing capillaries of finest caliber (C, E).
 
Keywords: 688 retina • 749 vascular occlusion/vascular occlusive disease • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×