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Nikhil Menon, Nadim Choudhury, Toco Yuen Ping Chui, Alexander Pinhas, Yusufu N B Sulai, Alfredo Dubra, Richard B Rosen; In vivo retinal vascular wall imaging in patients with diabetic retinopathy using non-confocal Split Detection Adaptive Optics Scanning Light Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5300.
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© ARVO (1962-2015); The Authors (2016-present)
To measure lumen diameter and wall thickness of perfused retinal vasculature, and to quantify changes in diabetic retinopathy (DR) relative to healthy control eyes.
The retinal vasculature of 5 subjects with DR [2 background DR (BDR), 1 nonproliferative DR (NPDR), 2 proliferative DR (PDR)] secondary to type II diabetes mellitus (mean age 54, range 41-62; mean HbA1c 8.2) and 5 healthy control subjects (mean age 31, range 25-55, mean HbA1c 5.2) was imaged with non-confocal split detection adaptive optics scanning light ophthalmoscopy (SD AOSLO; Scoles et al., 2014) using 790 nm light. Images of arterioles and venules along the retinal vascular arcades starting at the optic disc margin, as well as of the capillaries adjacent to the foveal avascular zone were acquired. After sinusoidal distortion and eye motion were removed, lumen diameter, vessel wall thickness, and wall to lumen ratio (WLR) were estimated in averaged images semiautomatically using custom Matlab software (MathWorks, Natick, MA) (Hillard et al, IOVS 2013. E-Abstract 6061).
Lumen (diameter) of arterioles and venules ranged between 8 and 135 μm. Mean ±SD of arteriolar wall thickness in DR subjects was 14±2 μm (range 5-27) as compared to 12±2μm (range 5-23) in controls (p<0.07). Mean±SD venular wall thickness was 9±1 μm (range 5-18) in DR as compared to 8±1 μm (range 4-17) in controls (p=0.50). DR subject eyes had significantly higher arteriolar WLR than control eyes (mean±SD: 0.35±0.06 vs. 0.26±0.03, unpaired t test, p<0.03). The same was also true of venular WLR in DR subject eyes as compared to controls (mean±SD: 0.19±0.03 vs. 0.15±0.02, unpaired t test, p<0.02).
Microscopic non-invasive imaging of the fine retinal vasculature using SD AOSLO allows quantification of lumen and wall thickness. This technique has potential both for early detection of DR, as well as accurate monitoring of progression and personalizing treatment.
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