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S. A. Burns, D. X. Hammer, N. V. Iftimia, C. E. Bigelow, R. D. Ferguson, A. E. Elsner; High Resolution Imaging of the Retina: Combining Three Imaging Modalities. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2855.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the utility of combining high resolution information from multiple measurement modalities to understand light-tissue interaction in retinal pathology. In general these modalities each have different strengths, and to compare them we imaged subjects using all three modes.
We obtained information on the same eyes from three different high resolution imaging modalities: confocal SLO, OCT, and large aperture SLO, which includes multiply scattered light. Adaptive optics with a small field of view was used to provide information from all three modes at the cellular level. The imaging wavelengths were centered in the same NIR window (800-860 nm). Low magnification SLO images were also obtained for reference to standard clinical views.
As expected the three approaches, while clearly showing the same pathology, provided quite different views. The AOSLO provided high quality, high resolution, low noise images which could readily be used to construct a wider field view. The AOOCT provided precise axial information through retina layers, but provided less information on the enface continuity of the smallest structures due to speckle and eye motion. The large aperture SLO provided information concerning scattering, apparently from turbid fluid, that was not evident from either of the other modalities. As an example, in a patient with recurrent central serous retinopathy, wide field imaging revealed a region with two apparent reflective scars in the region of the pathology. The AOSLO showed that the lesions have regions with apparently normal cones - with reflectance similar to cones outside the affected area - but also have surrounding regions of low reflectivity, which may indicate the presence of areas of disrupted photoreceptors. AOOCT indicated that these regions were slightly elevated, but primarily had what appeared to be cystic spaces in the outer plexiform layer surrounding them. The large aperture SLO showed that the regions with intact photoreceptors scattered very strongly perhaps due to multiple scattering in the cystic region. The low-resolution wide field view is therefore apparently dominated by this scattered light.
Combining high resolution imaging modalities can provide a much more complete understanding of retinal pathology, and how light tissue interactions combine to form typical low resolution views of the retina.
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