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K. Nakashima, V. Sarda, B. Lamory, S. Mohand-Said, J. A. Sahel, M. Paques, I. Audo; Photoreceptor Images in Occult Maculopathy With Adaptive Optics. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2325.
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© ARVO (1962-2015); The Authors (2016-present)
To correlate high resolution optical coherence tomography (OCT) to Adaptive-Optics (AO) retinal camera imaging in patients with occult maculopathy.
Three patients with a diagnosis of occult maculopathy underwent en face retinal imaging by AO. AO imaging was done using a retinal camera based on a 52-actuator electromagnetic deformable mirror and a 1024-lenslet Shack-Hartmann sensor (both Imagine Eyes, France). A super luminescent diode operating at 750 nm was focused at the retina to probe optical aberrations. A 4x4 deg area was flood-illuminated by a pulsed infrared LED and imaged onto a low-noise CCD camera. AO images were taken at the eccentricities from 0 deg to 6 deg. AO images were confronted to images from high resolution spectral domain OCT (Spectralis OCT, Heidelberg, Germany).
There were 2 males and 1 female with an age range of 16 to 47 years. Visual acuities ranged from 20/160 to 20/25. Fundus was normal or showed minimal foveal abnormalities. Multifocal electroretinography showed reduced central responses amplitude. By OCT, all eyes showed minimal yet definite alteration of outer segment reflectivity; both eyes of one patient had marked foveal thinning. By AO imaging, all eyes showed disseminated hyper and hyporeflectance dots in the foveal area that were 3-5 microns in size, i.e. with a size similar to extrafoveal cones.
AO retinal camera is a new useful tool for retinal imaging that facilitates detection and mapping of damage to the cone outer segment mosaic. Patients with occult maculopathy may show abnormal reflectance of foveal cones outer segments. We suggest that this aspect is due to a patchy loss of cones. AO may be useful to investigate patients with unexplained central visual loss.
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