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Jia Qin, Nicholas Rinella, Michael Deiner, Kyle McDermott, John S Werner, Austin Roorda, Travis C Porco, Daniel M. Schwartz, Jacque L. Duncan; OCT Angiography and Cone Photoreceptor Imaging in Geographic Atrophy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):368.
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© ARVO (1962-2015); The Authors (2016-present)
To assess cone photoreceptors and choriocapillaris in zones adjacent to geographic atrophy (GA) and in normal-appearing areas in patients with age-related macular degeneration (AMD) in comparison to age-similar normal eyes.
Cone photoreceptors and choriocapillaris were imaged using adaptive optics scanning laser ophthalmoscopy (AOSLO) and optical coherence tomography-angiography (OCT-A). Cone photoreceptor and choriocapillaris images at regions adjacent to GA were compared with normal-appearing regions in each patient and to age-matched normal subjects. AOSLO images were superimposed upon OCT-A microvasculature images acquired from the same eye, using retinal blood vessels as landmarks. Choriocapillaris perfusion was qualitatively assessed in 3mm×3mm OCT-A en face images segmented to visualize the choriocapillaris. Regions with relative hypoperfusion and normal perfusion were identified and delineated in the choriocapillaris images, which were used to select regions of interest (ROIs) in AOSLO images of cone photoreceptors extending 50µm×50µm within the delineated hypoperfusion regions at the border of well-defined areas of GA, the normal appearing perfusion areas in images of four dry AMD eyes with GA, and at comparable eccentricities in three normal eyes. AOSLO cone spacing was measured in each of the ROIs for comparison. Linear mixed effects regression was used to compare cone spacing between ROIs.
When regions within the same eye were compared, cone spacing was not significantly related to choriocapillaris perfusion (n=4 eyes, T value: 0.25). However, cone spacing in regions of choriocapillaris hypoperfusion adjacent to GA was significantly greater than in ROIs at similar eccentricities in age-similar normal eyes (n=3 eyes, T value: 3.28).
Cone spacing in eyes with AMD was not significantly different in ROIs overlying choriocapillaris hypoperfusion in areas surrounding GA compared with ROIs in regions with normal-appearing perfusion. However, in regions adjacent to GA, choriocapillaris perfusion defects were associated with increased cone spacing compared to age-similar normal eyes. OCT-A and AOSLO can noninvasively visualize alterations in choriocapillaris structure and cellular photoreceptor, making them promising tools for assessing AMD with GA. The combination of AOSLO and OCT-A imaging is useful for elucidating disease development and progression, eventually directing therapeutics.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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