June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Structural and Functional Correlation of Retinal Photoreceptors Overlying Lesions in White Dot Syndrome
Author Affiliations & Notes
  • Aniruddha Agarwal
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Mohamed Kamel Soliman
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
    Ophthalmology, Assiut University, Assiut, Egypt
  • Nithya Rajagopalan
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Mostafa Saad Hanout
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Mohammad Ali Sadiq
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Loren S Jack
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Salman Sarwar
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Diana V Do
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Quan Nguyen
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Yasir Jamal Sepah
    Ophthalmology, University of Nebraska Medical Center, Omaha, NE
  • Footnotes
    Commercial Relationships Aniruddha Agarwal, None; Mohamed Soliman, None; Nithya Rajagopalan, None; Mostafa Hanout, None; Mohammad Sadiq, None; Loren Jack, None; Salman Sarwar, None; Diana Do, None; Quan Nguyen, None; Yasir Sepah, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5889. doi:
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    • Get Citation

      Aniruddha Agarwal, Mohamed Kamel Soliman, Nithya Rajagopalan, Mostafa Saad Hanout, Mohammad Ali Sadiq, Loren S Jack, Salman Sarwar, Diana V Do, Quan Nguyen, Yasir Jamal Sepah; Structural and Functional Correlation of Retinal Photoreceptors Overlying Lesions in White Dot Syndrome. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5889.

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

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Abstract 
 
Purpose
 

Lesions in white dot syndromes (WDS) may be associated with photoreceptor (PR) loss. A prospective cohort study was performed to evaluate PR density and correlate it with retinal sensitivity overlying lesions in WDS.

 
Methods
 

Lesions of WDS (≤ 3 chosen/eye), within 5° foveal eccentricity, were imaged using adaptive optics (AO) (rxt1, Imagine Eyes, France), spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) (Heidelberg Spectralis®, Germany). In this study, lesions were defined as active if there were presence of hyper-autofluorescence within the lesions. Eyes with choroidal neovascularization, high myopia (> 6 diopters), media opacity and other concomitant diseases were excluded. PR density was calculated using manufacturer-provided AO Detect 1.0 software after adjustment for axial length using IOLMaster® (Zeiss Meditech, CA). Retinal sensitivity was assessed using microperimetry (MP) (Optos SLO, UK) and correlated with PR density using Spearman Rank Correlation test.

 
Results
 

Twenty-six lesions (9 patients: 7 females, mean age of 54.9 ± 16.6 years; 16 eyes) were analyzed. Diagnoses included serpiginous choroiditis (2 eyes), birdshot choroidopathy (3 eyes), presumed ocular histoplasmosis syndrome (2 eyes), punctate inner choroidopathy (6 eyes) and multifocal choroiditis (4 eyes). Mean PR density overlying 8 active lesions was 3076 ± 4654.89 cones/mm2 and 6943.5 ± 5739.51 cones/mm2 overlying 18 inactive lesions (p = 0.117). Mean PR density over 20 lesions with disrupted inner segment-outer segment (IS-OS) junction on SD-OCT was 5005.64 ± 5024.89 cones/mm2 and 6943.5 ± 5739.51 cones/mm2 over 6 lesions with intact IS-OS junction (p = 0.28). Mean retinal sensitivity (7.42 ± 4.70 dB) showed fair correlation with PR density (ρ = 0.43, p = 0.04). Mean retinal sensitivity over lesions with intact IS-OS junction was 13 ± 2.45 dB and 5.71 ± 4.16 dB over lesions with disrupted IS-OS junction (p = 0.007). Appearance of lesions on AO imaging is shown in figure.

 
Conclusions
 

AO imaging may allow high-resolution analysis of PR loss among lesions in WDS. Such microstructural changes may correlate with functional loss.  

 
Image shows an active lesion on FAF (A) associated with focal hypo-intensities on AO imaging (yellow asterisks) suggestive of PR loss (B). Healed lesions (C) show circumferential hypo-intense halo (white arrowheads) surrounding area of scarring (D).
 
Image shows an active lesion on FAF (A) associated with focal hypo-intensities on AO imaging (yellow asterisks) suggestive of PR loss (B). Healed lesions (C) show circumferential hypo-intense halo (white arrowheads) surrounding area of scarring (D).

 
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