July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Non-correspondence of photoreceptor (PR) morphology and sensitivity in acute zonal occult outer retinopathy (AZOOR)-like retinal lesions as assessed by adaptive-optics optical coherence tomography (AO-OCT) and microperimetry (MP)
Author Affiliations & Notes
  • Lorenz Clement Wassermann
    Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
    Vienna Clinical Trial Center, Medical University of Vienna, Vienna, Austria, Austria
  • Matthias Salas
    Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria, Austria
  • Adrian Reumueller
    Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
  • Stefan Sacu
    Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
    Vienna Clinical Trial Center, Medical University of Vienna, Vienna, Austria, Austria
  • Wolfgang Drexler
    Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria, Austria
  • Michael Pircher
    Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria, Austria
  • Marion Funk
    Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
  • Ursula Schmidt-Erfurth
    Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
  • Andreas Pollreisz
    Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
    Vienna Clinical Trial Center, Medical University of Vienna, Vienna, Austria, Austria
  • Footnotes
    Commercial Relationships   Lorenz Wassermann, None; Matthias Salas, None; Adrian Reumueller, None; Stefan Sacu, None; Wolfgang Drexler, None; Michael Pircher, None; Marion Funk, None; Ursula Schmidt-Erfurth, None; Andreas Pollreisz, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4603. doi:
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      Lorenz Clement Wassermann, Matthias Salas, Adrian Reumueller, Stefan Sacu, Wolfgang Drexler, Michael Pircher, Marion Funk, Ursula Schmidt-Erfurth, Andreas Pollreisz; Non-correspondence of photoreceptor (PR) morphology and sensitivity in acute zonal occult outer retinopathy (AZOOR)-like retinal lesions as assessed by adaptive-optics optical coherence tomography (AO-OCT) and microperimetry (MP). Invest. Ophthalmol. Vis. Sci. 2019;60(9):4603.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate and compare retinal morphology (integrity of PR) and function (retinal sensitivity) in eyes with presumed AZOOR.

Methods : In this descriptive study, three eyes of three patients with AZOOR-like retinal lesions were included. Images were obtained with a prototype AO-OCT system allowing 3D cellular retinal imaging and Spectralis HRA+OCT (Heidelberg Engineering). Retinal sensitivity was evaluated by MP (MP-3, Nidek). OCT, blue autofluorescence (BAF) imaging and MP testing were performed at the center and border of AZOOR-like lesions as well as adjacent areas.

Results : Retinal sensitivity levels in the center of AZOOR-like lesions were within normal limits in the 62 year-old male patient (mean:27.20dB) and reduced in the other two subjects (24 year-old female, mean:15.49dB and 52 year-old male, mean:15.53dB). In the corresponding area AO and conventional OCT imaging revealed a disturbed or complete loss of PR signals with BAF imaging showing hyperautofluorescence. AZOOR-like border and adjacent areas with regular BAF signal showed preserved sensitivity levels in all 3 subjects (mean±standard deviation: 28.7±1.45dB). The border area presented with a higher hyperautofluorescent signal than the center in the 24 year-old female and AO-OCT B-scans revealed a weak and disrupted signal from IS/OS and ETPR layers with the RPE appearing as an irregular and inhomogenous hyperreflective band (all 3 subjects). In this area en-face AO-OCT images showed an inhomogenous PR pattern at both IS/OS and ETPR levels. Directly adjacent retinal areas displayed similar morphological findings with impaired PR morphology at both IS/OS and ETPR levels as visualized by AO-OCT technology.

Conclusions : Our study showed disturbed PR morphology at the level of IS/OS and ETPR in the border and immediate adjacent retinal regions of AZOOR-like lesions with still preserved retinal function. AO-OCT imaging provides detailed in vivo insights into photoreceptor morphology superior to conventional OCT imaging techniques.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

24 yo female patient with AZOOR-like lesion (right eye) and healthy controll (left eye)

24 yo female patient with AZOOR-like lesion (right eye) and healthy controll (left eye)

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