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Shintaro Nakao, Ryoichi Arita, Muneo Yamaguchi, Tatsuro Ishibashi; Characterization of Microaneurysm in Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2604.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to evaluate microaneurysm (Ma) in patients with diabetic retinopathy (DR) using Adaptive Optics Scanning Laser Ophthalmoscopy (AO-SLO).
Patients with diabetes (no observable diabetic retinopathy [NDR]; 4 eyes from 4 patients, nonproliferative diabetic [NPDR]; 6 eyes from 5 patients) and 3 healthy subjects were evaluated in this study. All patients underwent a full ophthalmologic examination and imaging with prototype AO-SLO systems (Canon Inc). For each eye, images focused on the photoreceptor layer as well as the nerve fiber layer were recorded in four areas (820µmX820µm) 1mm away from the fovea, and blood vessel map was created from AO-SLO images. Ma was characterized in the area with the created blood vessel map and the original movie, and the characterization was evaluated by comparing with fundus camera and fluorescein angiography. The number of Ma was also counted in the area with the created blood vessel map and the original movie.
AO-SLO showed significant increased number of Ma in patients of NPDR (14.3±7.9/area) compared with NDR patients (2.75±5.5/area) (p=0.03). Interestingly, AO-SLO imaging could detect Ma in a patient with NDR. Turbulence of blood flow in some Ma could be observed clearly by focusing on the nerve fiber layer. Furthermore, AO-SLO images could reveal that some NPDR patients include ultra-microaneurysm (UMa) which could not be detected with color fundus photography.
AO-SLO images could detect ophthalmoscopically undetectable Ma in DR patients. AO-SLO could be a valuable tool for early diagnosis of DR in diabetes patients.
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