Ultrahigh Resolution Optical Coherence Tomography in Stargardt's Disease

Abstract

Abstract: : Purpose: To examine and compare structural changes in macular dystrophies with ultrahigh resolution optical coherence tomography (UHR-OCT), which is capable of identifying all retinal layers including the inner and outer segments of the photoreceptor layer and the external limiting membrane, as well as fluorescein angiography, ERG and microperimetry. Methods: 16 patients with different stages of Stargardt's disease (SD) (6 female, 10 male, mean age 34,3) were examined clinically and with a compact, new generation ultrahigh resolution ophthalmic optical coherence tomography (OCT) system, UHR-OCT, and results compared with fluorescein angiography, ERG and SLO microperimetry. Results. UHR-OCT scans of patients with SD showed a diffuse retinal atrophy with a reduction in the thickness of all retinal layers, sub-pigmentepithelial deposits corresponding with the spots found in eyes with fundus flavimaculatus and a focal loss of IS/OS photoreceptors. These results, in particular the photoreceptor loss, were also reflected in the fluorescein angiographic and microperimetric results. Conclusion. Ultrahigh resolution ophthalmic OCT has the potential and clinical efficacy to enhance sensitivity and specificity in the judgment of structural changes in SD and to correlate these with functional results. Thus, it might contribute to a better under standing of ocular pathogenesis.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, S • retinal degenerations: hereditary • photoreceptors