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Claudine E Pang, Sarah Mrejen, David Sarraf, Naomi Goldberg, Roberto Gallego-Pinazo, James Klancnik, John A Sorenson, Lawrence A Yannuzzi, K Bailey Freund; Adaptive Optics Imaging of Cone Mosaic Abnormalities in Acute Macular Neuroretinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2613.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the cone photoreceptor mosaic in acute macular neuroretinopathy(AMN) using adaptive optics(AO) imaging.
Four consecutive patients with AMN were evaluated by dilated funduscopic examination, near-infrared reflectance(IR), confocal scanning laser ophthalmoscopy(SLO), eye-tracked spectral-domain optical coherence tomography(SDOCT) and a flood-illuminated retinal AO camera. Correlations were made between IRSLO, SDOCT and AO images at baseline and follow-up in 3 patients. Microperimetry was performed and correlated with SDOCT and AO images in 1 patient.
At presentation, the cone photoreceptor density was decreased at the level of the AMN lesions in AO images in all patients. The cone photoreceptor mosaic disruption was more widespread than the lesion detected by IRSLO and SDOCT. At complete resolution of the AMN lesion in IRSLO, there was incomplete recovery of cone photoreceptor mosaic in AO. In 2 cases, there was persistent cone damage in AO despite restoration of the ellipsoid zone integrity on SDOCT at last follow-up. The area of disruption in cone mosaic revealed characteristic appearance of RPE cells in AO and correlated well with both SDOCT and microperimetry findings.
Cone photoreceptor damage and reconstitution were documented in vivo at the cellular level in AMN using AO imaging. AO appeared more sensitive than combined IRSLO and SDOCT to detect and follow photoreceptor damage in AMN patients. There was some irreversible cone photoreceptor damage in the 4 patients evaluated.
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