April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Monitoring Retinal Vasculopathic Changes Over Time Using In Vivo Offset Pinhole Adaptive Optics Scanning Light Ophthalmoscopy
Author Affiliations & Notes
  • Richard B Rosen
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
    Ophthalmology, New York Medical College, Valhalla, NY
  • Alexander Gan
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
  • Moataz M Razeen
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
  • Alexander Pinhas
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
    Icahn School of Medicine at Mount Sinai, New York, NY
  • Eric Cheang
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
    Stuyvesant High School,, New York, NY
  • Chun Lin Liu
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
    Bronx Science High School, New York, NY
  • Lenny Rostomian
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
    Hunter College, The City University of New York, New York, NY
  • Rishard Weitz
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
  • Alfredo Dubra
    Ophthalmology, Medical College of Wisconsin, Milwaukee, WI
    Biophysics, Medical College of Wisconsin, Milwaukee, WI
  • Toco Yuen Ping Chui
    Ophthalmology, New York Eye & Ear Infirmary, Mount Sinai Health System, New York, NY
    Ophthalmology, New York Medical College, Valhalla, NY
  • Footnotes
    Commercial Relationships Richard Rosen, Clarity (C), OD-OS (C), Optovue (C); Alexander Gan, None; Moataz Razeen, None; Alexander Pinhas, None; Eric Cheang, None; Chun Lin Liu, None; Lenny Rostomian, None; Rishard Weitz, None; Alfredo Dubra, Canon USA Inc (C), US Patent No: 8,226,236: (P); Toco Chui, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1657. doi:
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      Richard B Rosen, Alexander Gan, Moataz M Razeen, Alexander Pinhas, Eric Cheang, Chun Lin Liu, Lenny Rostomian, Rishard Weitz, Alfredo Dubra, Toco Yuen Ping Chui; Monitoring Retinal Vasculopathic Changes Over Time Using In Vivo Offset Pinhole Adaptive Optics Scanning Light Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1657.

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

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Abstract
 
Purpose
 

Offset pinhole adaptive optics scanning light ophthalmoscopy (OP AOSLO) of the retinal microvasculature allows non-invasive imaging of the retinal microvascular wall, lumen, and blood flow, without the use of an exogenous contrast agent. In this study, we used OP AOSLO to detect and monitor subclinical microvascular change over time in various retinal vasculopathies.

 
Methods
 

: Longitudinal OP AOSLO imaging was performed on 6 patients: 2 with diabetic retinopathy (DR), 2 with central retinal vein occlusion (CRVO), 1 with branch retinal vein occlusion (BRVO) and 1 with hypertensive retinopathy (HR). OP AOSLO was implemented using a 790 nm light by displacing the confocal detection aperture laterally, according to the orientation of the retinal blood vessels. An additional 850nm light source was used as a wavefront-sensing beacon. Image sequences were acquired using a 1° or 1.5° field-of-view at a frame rate of 15 Hz. After sinusoidal distortion and eye motion were removed, registered averaged images were stitched together to create larger DF microvascular maps. Serial maps from the same eyes, taken 1 week to 5 months, were qualitatively assessed for vasculopathic change over time.

 
Results
 

All patients showed vasculopathic features including microaneurysms, lumen clots, vessel looping and sprouting, non-perfused vessels (endothelial sleeves), tortuous vessels, and irregular lumen diameters. In one patient, we were able to detect microvascular changes as early as 1 month after the first imaging session. Two of the patients imaged showed no changes in microvascular structure (1 CRVO and 1 BRVO; Fig. 1A and B). In 4 patients, microvascular remodeling was observed, including microaneurysm regression (1 HR) and progression (1 HR and 1 CRVO), angiogenesis and capillary regression over time (2 DR) (F ig. 1C and D).

 
Conclusions
 

OP AOSLO reveals subclinical microvascular changes cross-sectionally and longitudinally, offering a great opportunity for studying the natural progression of vasculopathy and the response to treatment.

 
 
A and B) Non-perfused capillary (black arrows) in a CRVO patient, taken 4 months apart. C and D) A new capillary (black arrows) and an engorged capillary (white arrows) in a DR patient, taken one month apart.
 
A and B) Non-perfused capillary (black arrows) in a CRVO patient, taken 4 months apart. C and D) A new capillary (black arrows) and an engorged capillary (white arrows) in a DR patient, taken one month apart.
 
Keywords: 688 retina • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 749 vascular occlusion/vascular occlusive disease  
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