June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
High resolution structural phenotyping of intermediate and advanced non-neovascular age-related macular degeneration
Author Affiliations & Notes
  • Chiara M Eandi
    Vision Institute and Quinze-Vingts National Ophthalmology Hospital, PARIS group, Paris, France
    Department of Surgical Science, University Torino, Torino, Italy
  • Valerie Snyder
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Kate Grieve
    Vision Institute and Quinze-Vingts National Ophthalmology Hospital, PARIS group, Paris, France
  • Kunal K Dansingani
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Jay Chhablani
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Grace Eddy
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Andrew W Eller
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Joseph Martel
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Thomas R Friberg
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
    Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pennsylvania, United States
  • Wei Chen
    Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
    Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Yvette Perry Conley
    Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
    University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, United States
  • Jose Alain Sahel
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
    Vision Institute and Quinze-Vingts National Ophthalmology Hospital, PARIS group, Paris, France
  • Michel Paques
    Vision Institute and Quinze-Vingts National Ophthalmology Hospital, PARIS group, Paris, France
  • Ethan A Rossi
    Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
    Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Chiara Eandi, None; Valerie Snyder, None; Kate Grieve, None; Kunal Dansingani, None; Jay Chhablani, None; Grace Eddy, None; Andrew Eller, None; Joseph Martel, None; Thomas Friberg, None; Wei Chen, None; Yvette Perry Conley, None; Jose Sahel, None; Michel Paques, None; Ethan Rossi, None
  • Footnotes
    Support  This work was supported by a grant from the Edward N. & Della L. Thome Memorial Foundation, the HELMHOLTZ, ERC Grant Agreement #610110, and by the NIH CORE Grant P30 EY08098 to the University of Pittsburgh Department of Ophthalmology
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 210. doi:
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      Chiara M Eandi, Valerie Snyder, Kate Grieve, Kunal K Dansingani, Jay Chhablani, Grace Eddy, Andrew W Eller, Joseph Martel, Thomas R Friberg, Wei Chen, Yvette Perry Conley, Jose Alain Sahel, Michel Paques, Ethan A Rossi; High resolution structural phenotyping of intermediate and advanced non-neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2020;61(7):210.

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

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Abstract

Purpose : Non-neovascular age-related macular degeneration (AMD), accounting for ~90% of prevalence, is currently untreatable. Adaptive optics ophthalmoscopy (AOO) offers promise to define and monitor microscopic and progressive changes in AMD, yet limited data on high resolution AMD structural phenotypes and their relationship to conventional imaging metrics limits the power of this approach. We hypothesize that AOO can characterize different phenotypes in AMD that may correlate with short and long-term progression patterns. As a first step, we define the cellular level structural phenotypes associated with intermediate and advanced AMD and their relationship to clinical imaging biomarkers in a large cohort.

Methods : We recruited 118 patients with intermediate and advanced AMD from the Quinze-Vingts National Ophthalmology Hospital and the University of Pittsburgh Department of Ophthalmology. All participants underwent color fundus photography, spectral-domain optical coherence tomography (SD-OCT), confocal scanning laser ophthalmoscopy (near-infrared (NIR) reflectance; blue fundus autofluorescence (FAF) and NIR FAF), and flood-illumination adaptive optics (FIAO) ophthalmoscopy (rtx1, Imagine Eyes, France). Select patients were imaged with adaptive optics scanning light ophthalmoscopy (AOSLO). Multi-modal en face images were registered and structural phenotypes were evaluated and compared across multi-scale images.

Results : Several distinct cellular level structural phenotypes were identified. Though some structures, such as drusen, were visible in clinical images and in AOO, their appearance and spatial extent differed markedly between modalities. Geographic atrophy (GA) lesions, visible in 21 patients, presented in AOO with several discrete forms, including either distinct or indistinct borders, marginal hyper- or hypo-reflectance and heterogenous distribution of pigmented cellular aggregates along the GA border.

Conclusions : Multi-modal and multi-scale imaging provides unprecedented insight into the in vivo tissue and cellular-level morphological alterations associated with intermediate and advanced AMD. Longitudinal follow-up imaging will provide insight into potential differences in progression rate amongst phenotypes. Ongoing work will evaluate the relationship between cellular phenotypes, disease progression rate, genotype and clinical characteristics.

This is a 2020 ARVO Annual Meeting abstract.

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