June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Adaptive Optics Imaging of Peripapillary Nerve Fiber Bundles: Implications for Glaucomatous Damage Seen on Circumpapillary OCT Scans.
Author Affiliations & Notes
  • Dongwon Lee
    Department of Psychology, Columbia University, New York, NY
  • Monica Chen
    UCLA David Geffen School of Medicine, Los Angeles, CA
  • Toco Yuen Ping Chui
    New York Eye & Ear Infirmary, New York, NY
  • Benjamin Epstein
    Department of Psychology, Columbia University, New York, NY
  • Robert Ritch
    New York Eye & Ear Infirmary, New York, NY
  • Richard B Rosen
    New York Eye & Ear Infirmary, New York, NY
  • Alfredo Dubra
    The Eye Institute, Medical College of Wisconsin, Milwaukee, WI
  • Donald Hood
    Department of Psychology, Columbia University, New York, NY
    Department of Ophthalmology, Columbia University, New York, NY
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4555. doi:
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      Dongwon Lee, Monica Chen, Toco Yuen Ping Chui, Benjamin Epstein, Robert Ritch, Richard B Rosen, Alfredo Dubra, Donald Hood; Adaptive Optics Imaging of Peripapillary Nerve Fiber Bundles: Implications for Glaucomatous Damage Seen on Circumpapillary OCT Scans.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4555.

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

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Abstract
 
Purpose
 

To better understand glaucomatous damage seen on circumpapillary disc scans obtained with optical coherence tomography (OCT), these scans were compared to images of the peripapillary retinal nerve fiber (RNF) bundles obtained with an adaptive optics/scanning light ophthalmoscope (AO-SLO).

 
Methods
 

Six eyes of 6 glaucoma patients with arcuate defects within the macular region on 10-2 visual fields were tested using a prototype AO-SLO system[1] and frequency-domain OCT circular (1.7 mm radius) disc scans (3D-OCT2000, Topcon). With OCT, circumpapillary images were obtained and RNF layer (RNFL) thickness compared to machine controls. With the AO-SLO, images of RNF bundles were obtained near the edge of the optic disc. These images were montaged, and co-registered with a fundus photograph. The OCT and AO-SLO images were compared after aligning the images via corresponding blood vessels.

 
Results
 

All 6 eyes had an abnormally thin RNFL on OCT scans and abnormal regions of RNF bundles on AO-SLO images in corresponding regions of the disc. However, regions of abnormal, but equal, RNFL thickness on OCT scans varied in appearance on AO-SLO images. These regions could be largely devoid of RNF bundles (5 eyes, Fig. 1A, red arrows), have abnormal appearing bundles of lower contrast (6 eyes, Fig. 1B, orange arrow), or have isolated areas with a few relatively normal appearing bundles (2 eyes, Fig. 1A, yellow arrow). There were local variations in reflectivity, as well as thickness, of the OCT RNFL that corresponded to the variations in RNF bundle appearance.

 
Conclusions
 

Relatively similar 10-2 visual field defects with similar OCT RNFL thickness profiles can have very different degrees of RNF bundle damage as seen on AO-SLO. While the results point to limitations of OCT RNFL thickness as typically analyzed, they also illustrate the potential for improving OCT by attending to variations in local intensity. 1. Dubra, Sulai (2011) Biomed Opt Exp.  

 
Fig. 1. Peripapillary AO-SLO images of the temporal region of the disc of a left eye (A) and right eye (B) showing missing (red arrows in A), abnormal appearing (orange arrow in B), and relatively preserved (yellow arrow in A), RNF bundles in regions of approximately the same OCT RNFL thickness.
 
Fig. 1. Peripapillary AO-SLO images of the temporal region of the disc of a left eye (A) and right eye (B) showing missing (red arrows in A), abnormal appearing (orange arrow in B), and relatively preserved (yellow arrow in A), RNF bundles in regions of approximately the same OCT RNFL thickness.

 
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