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B. J. Lujan, P. F. Stetson, J. L. Duncan, A. Kaines, S. Sundquist, A. Soloyevev, M. Sato, S. D. Schwartz, A. Roorda; Correlation Between Adaptive Optics Scanning Laser Ophthalmoscopy and Spectral Domain Optical Coherence Tomography in Macular Telangiectasia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1657.
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The adaptive optics scanning laser ophthalmoscope (AOSLO) can acquire high-fidelity en face scans of the retina with two micron lateral resolution. While it is confocal, its axial resolution is between 60-100 microns. By comparison, spectral domain optical coherence tomography (SDOCT) is limited in its lateral resolution by ocular aberrations, but commercial systems are capable of acquiring a dense macular volume with five micron axial resolution. We investigate the use of these complementary systems to visualize photoreceptor anatomy in patients diagnosed with macular telangiectasia.
Best-corrected visual acuity, fundus examination, fluorescein angiography, fundus autofluorescence, SDOCT (Cirrus HD-OCT, Carl Zeiss Meditec, Inc) and AOSLO were performed in 9 eyes of 6 patients with macular telangiectasia. Image processing and registration of the resulting images were used to analyze macular photoreceptors.
In SDOCT images the photoreceptor inner-segment/outer-segment junction (IS/OS) is highly reflective and can be used as a proxy for photoreceptor (PR) integrity. Topographical analysis of the IS/OS layer by manual segmentation of each B-scan, using software on the SDOCT system and a proprietary automated algorithm, demonstrated patchy areas of PR loss. In areas where the IS/OS junction was absent on SDOCT, no unambiguous photoreceptors were visualized in registered AOSLO images. Regions where intact IS/OS were present correlated with areas where cones were unambiguously visualized using AOSLO. Furthermore, distinct transition zones between intact and absent IS/OS correlated with AOSLO images.
SDOCT analysis of patients with macular telangiectasia demonstrated regions of apparent photoreceptor disruption which were highly correlated with regions where cones were not visualized using AOSLO. This pilot study demonstrates the synergistic nature of these high-resolution retinal imaging systems.
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