Purchase this article with an account.
Alex Onishi, Peter Nesper, Lee M Jampol, Amani A Fawzi; Adaptive Optics Scanning Laser Ophthalmoscopy Compared to Multimodal Retinal Imaging in White Spot Syndromes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5100.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Current imaging modalities may not have sufficient resolution to visualize photoreceptor disruption caused by the group of chorioretinopathies known as the white spot syndromes (WSS). This study used Adaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) and compared it to multimodal retinal imaging to characterize photoreceptor changes in the WSS. Our goal was to examine the ability of AOSLO to aid in the monitoring of photoreceptors in these diverse entities.
28 patients with WSS were enrolled in the study. Exclusion criteria were media opacity that precluded high-resolution AOSLO imaging. After application of criteria, 19 eyes of 14 patients were included for analysis. The macular region was imaged with AOSLO (Apaeros Retinal Imaging System, Boston Micromachines), and the photoreceptor images were manually overlaid onto infrared reflectance fundus photos (IR) using retinal vessels as landmarks and coordinates from the AOSLO imaging session. The IR images were registered with optical coherence tomography (OCT; HRA+OCT, Spectralis, Heidelberg Engineering), allowing point-by-point correlation between these imaging modalities and AOSLO.
AOSLO images generally correlated well with results seen on OCT. Areas with healthy photoreceptors as visualized through AOSLO showed intact retinal pigment epithelium (RPE), inner/outer segment (IS/OS) lines, and interdigitation zones on OCT, whereas areas with photoreceptor loss on OCT corresponded with regions of OS signature loss in AOSLO images. Importantly, the sizes of the lesions detected through AOSLO were often significantly greater than were indicated by OCT.
Although findings were broadly consistent between AOSLO images and OCT, AOSLO allowed for enhanced resolution of photoreceptors compared with OCT. As a result, it was sometimes possible to identify photoreceptor disruption through AOSLO imaging that was not apparent on OCT. AOSLO holds great potential as an additional tool for the diagnosis and monitoring of photoreceptors in WSS through the improved detection of photoreceptor loss.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Figure 1. AOSLO image overlaid onto IR fundus photo (left), and corresponding OCT (right, yellow line). Enlarged AOSLO image (bottom). Healthy OS are bright in AOSLO with intact photoreceptor lines on OCT (blue arrows). Areas of photoreceptor disruption are dark on AOSLO, with a loss of photoreceptor lines on OCT (yellow arrows).
This PDF is available to Subscribers Only