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