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Kiyoko Nakashima, Martine Ullern, Mustapha Benchaboune, Jose-Alain Sahel, Michel Paques; Adaptive Optics Imaging of Geographic Atrophy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2052.
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© ARVO (1962-2015); The Authors (2016-present)
To report the findings of en face adaptive optics (AO) fundus flood imaging in eyes with geographic atrophy(GA).
Eight eyes of eight patients with GA underwent 850nm AO imaging (rtx1, Imagine Eyes, France) of the macula. Results were compared to reflectance and autofluorescence scanning laser ophthalmoscope imaging and to optical coherence tomography. Disease progression was documented over successive examinations.
Compared to the other imaging modalities, AO allowed a better delineation of GA limits and showed more details about melanin redistribution within and around GA areas. Disseminated melanin clumps gave a diffuse salt and pepper appearance to all GA areas, independently of their size; such clumps were also detected outside of GA areas. On the retina bordering atrophic areas, focal or diffuse melanin accumulation at the level of the RPE colocalized with 488nm hyperautofluorescence. During follow-up (n=2 eyes), extension of GA areas was associated to melanin redistribution within and outside GA areas.
AO imaging allows a fine characterization of lesional extension and progression, in particular because of the precise mapping of the redistribution of melanin-like pigments. The latter is a dynamic process that may either reflect the disease activity or indicate a post-degenerative process. Therefore AO imaging may provide novel biomarkers for detecting the earliest stages, documenting the retinal pathology and monitoring progression of GA.
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