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Toke Bek; New Features Of Diabetic Retinopathy Lesions Detected By Adaptive Optics Scanning.. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5656.
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© ARVO (1962-2015); The Authors (2016-present)
Diabetic retinopathy is characterized by morphological lesions in the retina secondary to disturbances in vascular function. The study of diabetic retinopathy requires imaging techniques that enable the resolution of small retinal elements, and has hitherto been limited by the optics of the eye. The purpose of the present study was to study whether the new imaging modality adaptive optics (AO) scanning can improve the detection of diabetic retinopathy lesions as compared with conventional imaging techniques.
Twenty-five patients with diabetes mellitus (fifteen T1D and ten T2D patients) with moderate diabetic retinopathy were subjected to fundus photography, Heidelberg OCT scanning and adaptive optics (AO) scanning (EyeOptics, Paris, France) of a 4 x 4 degrees area immediately temporal from the fovea containing haemorrhages, microaneurysms, hard exudates and focal edema. The three imaging modalities were superimposed and the presence and appearance of retinal lesions compared.
All retinopathy lesions observed on fundus photography and OCT scanning could be detected by AO scanning, although retinal edema worsened the AO imaging quality. Adaptive optics scanning could differentiate retinal hemorrhages to represent either aggregates of erythrocytes or hemolyzed blood. Hard exudates appeared to have irregular surfaces similar to crystaline structures, and the smallest hard exudates observed by AO scanning were invisible by fundus photography and OCT scanning
Adaptive optics scanning allows the resolution of features of diabetic retinal lesions that have not hitherto been detectable in vivo. This method may improve the diagnosis of diabetic retinopathy and contribute to a further understanding of the pathophysiology of the disease.
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