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Jia Qin, Nicholas Rinella, Daniel M Schwartz, Michael Deiner, Kyle C. McDermott, Shane Griffin, Panagiota Loumou, John S Werner, Austin Roorda, Jacque L Duncan; Cone Photoreceptor Imaging and OCT Angiography in AMD Geographic Atrophy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4947.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to visualize and quantify cone photoreceptor and choriocapillaris changes at the edge of geographic atrophy (GA) in patients with age-related macular degeneration (AMD).
Cone photoreceptors and choriocapillaris were imaged using confocal adaptive optics scanning laser ophthalmoscopy (AOSLO) and optical coherence tomography-angiography (OCT-A). Cone photoreceptor and choriocapillaris images from 3 normal subjects were compared with 2 patients with AMD and non-foveal GA. The AOSLO cone mosaic was superimposed upon OCT-A microvasculature images using blood vessels as landmarks. Regions of interest (ROIs) extending 200 µm x 200 µm, were selected in the superimposed cone mosaic and microvasculature images acquired from the same eye. Regions of interest were selected at the edge of well-defined areas of GA and in areas without GA in 2 AMD patients, and at comparable eccentricities in 3 normal subjects. Cone spacing was calculated and choriocapillaris perfusion was assessed in each of the ROIs.
Confocal AOSLO images showed irregular cone packing and areas where cones were not visible at the edge of GA in the AMD patients. Cone spacing increased mildly at the edge of GA in the AMD patients compared with normal eyes. Choriocapillaris perfusion in the ROIs at the edge of GA was reduced, but not completely absent, compared with ROIs at similar eccentricities in regions without GA and in normal eyes.
Cone photoreceptor spacing measures were abnormal at the edge of GA. Vascular perfusion of the choricapillaris at the edge of the GA appeared reduced compared with areas without GA, and normal eyes. The abilities of AOSLO and OCT-A to noninvasively visualize alterations in photoreceptor and choriocapillaris structure make them promising tools for assessing AMD with GA. Cone photoreceptor spacing and choriocapillaris perfusion changes can be distinguished and assessed in AMD patients with GA and normal eyes. The combination of AOSLO and OCT-A imaging and evaluation may be useful for elucidating disease development and progression.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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