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S. D. Schwartz, A. Kaines, J. Duncan, B. Lujan, S. Sundquist, S. A, M. Sato, A. Roorda; Human Cone Anatomy in Macular Disease: Adaptive Optics Scanning Laser Ophthalmoscopic Imaging of Cones in Idiopathic Macular Telangectasia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1656.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the photoreceptor (cone) array in different stages of idiopathic macular telangectasia (IMT) with the adaptive optics scanning laser ophthalmoscope (AOSLO). This device can acquire high-fidelity en face scans of the retina with two-micron lateral resolution.
In this observational case series, high-resolution retinal images of 15 eyes from 8 patients were obtained with AOSLO. Conventional clinical measures included spectral domain OCT (SDOCT), color fundus photos, autofluorescence and fluorescein angiograms. Observational measures of AOSLO images included the presence or absence and the reflectivity of the cone array. Images were quantified by measuring cone spacing relative to the foveal center and making statistical comparisons with data from over 20 normal healthy eyes.
AOSLO imaging allowed visualization of cone arrays in IMT. Characteristic patterns of the 8 patients included focal areas of cone loss (which were confirmed with SDOCT) surrounded by regions of contiguous cone arrays with spacing and appearance that was no different from healthy eyes. Abnormal cone mosaics were observed only in regions proximal to the paracentral regions of cone loss and were often associated with hyper-reflective cones.
This study suggests cone anatomy can be studied in various stages of human macular disease (IMT). Statistical analyses of visible cone densities may correlate with disease severity. Serial imaging of cone spacing, cone reflectivity and regions of cone dropout by AOSLO may provide a meaningful endpoint able to quantitate disease progression or response to intervention.
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