Noninvasive Evaluation of Age-Related Maculopathy by Indirect Viewing Using a New Scanning Laser Ophthalmoscope

Abstract

Purpose: : To determine the usefulness of noninvasive evaluation of age-related maculopathy (ARM) by indirect viewing using a new scanning laser ophthalmoscope (SLO).

Methods: : Fundus examination, fluorescein angiography, and optical coherence tomography were performed in 24 eyes of 12 patients (mean age ±SD, 70.4±10.8 yrs) with ARM. SLO findings were observed noninvasively with a diode laser (790 nm), by direct viewing with a confocal aperture that has a central small aperture, and by the two kinds of indirect viewing (the dark-field mode with a ring aperture that has a central stop and the retro mode with a new confocal aperture that is off-center from the optical axis).

Results: : Drusen were clearly detected and in greater numbers on topographic imaging using the SLO by indirect viewing especially in retro-mode compared with photography. An area of high reflectivity observed using the dark-field mode corresponded to choroidal neovascularization (CNV) detected by angiography, but the area was larger than that observed on angiography. Retinal cystic changes on the CNV were observed clearly using retro-mode. In some cases, these findings, which are barely visible using a fundus camera, were observed even in patients with a cataract.

Conclusions: : SLO indirect viewing, especially in retro-mode, precisely demonstrated drusen noninvasively and not only the vascular abnormalities but also the surrounding structural changes in ARM. This new device is valuable for evaluating structural changes and helpful for studying the relationship with functional changes in ARM.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • age-related macular degeneration • retina