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Nick M. Muthiah, Joe Zhong, Carlos Gias, Gurmit Uppal, Peter J. Coffey, Lyndon da Cruz; Adaptive Optics Retinal Imaging Demonstrates Macula Photoreceptor Rescue, in 3 Patients with Good Visual Outcome, 6 to 8 years Post-Macular Translocation Surgery for Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):843.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the ability of an adaptive optics (AO) camera to image photoreceptor outer segments and show the structure-function correlates in patients who have undergone macular translocation surgery for neovascular age-related macular degeneration (AMD)
Three patients who had previously undergone macular translocation surgery, underwent en-face AO retinal imaging of their retinas, with an infrared flood-illumination AO retinal camera (rtx1, Imagine Eyes, Orsay, France). The AO imaging findings of their cone photoreceptor patterns were then registered and correlated anatomically and functionally with spectral-domain optical coherence tomography scans (SD-OCT) (Spectralis, Heidelberg, Germany) and microperimetry (MP) (Nidek MP-1, Padova, Italy).
AO images were taken at 6, 7 and 8 years post-surgery on the three patients respectively. Their AO imaging clearly showed areas of mosaic pattern of photoreceptor outer segments and these correspond to the new foveal site where the macula was translocated. Corresponding SD-OCT at these regions showed the presence of inner and outer segments of the photoreceptor cell layer, unlike the diseased areas. Microperimetry at the corresponding site showed good retinal sensitivity and this correlates with their excellent visual acuities of 0.04, 0.20 and 0.22 LogMAR.
AO retinal imaging enabled us to demonstrate the rescue and survival of photoreceptor outer segments by mid equatorial RPE following macular translocation surgery. In vivo AO images of our 3 patients’ photoreceptor outer segments demonstrated structural integrity, which correlates with their successful functional outcome. AO retinal imaging may be a useful technique for assessing structural and functional outcomes with cell based retinal therapy in the future.
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