Abstract
Purpose :
To evaluate the performance of Retromode confocal scanning laser ophthalmoscopy (cSLO) for detection of subretinal drusenoid deposits (SDD).
Methods :
In this IRB-approved prospective study, 30 eyes of 22 consecutive patients with non-exudative age-related macular degeneration (AMD) with evidence of SDD on optical coherence tomogrpahy (OCT) were imaged by the Mirante (Nidek, Japan) camera with retro mode illumination using multiple confocal apertures: deviated right (DR) and deviated left (DL). (Figure 1) Images were imported into Image J (Bethesda, Maryland, USA) and the total area occupied by SDD was manually outlined by two graders. Areas occupied by other retinal abnormalities such as geographic atrophy or other types of drusen (cuticular, soft drusen) were excluded. The measurements obtained by the two graders were averaged for comparison between the confocal aperture settings. Intergrader reliability was evaluated by intra-class correllation coefficients (ICCs), and a paired t-test was used to compare measurements obtained with retro mode illumination using the two different apertures modes.
Results :
The mean total SDD area measured by the two graders were 56.15 ± 23.25 mm2 and 56.52 ± 30.43 mm2 in DR and DL retro mode illumination, respectively. Agreement between graders was high with ICCs of 0.98 (95% CI .986 - .996, p < 0.05) and 0.99 (95% CI .991 – 1.000, p< 0.05) for the DR and DL aperture modes, respectively. The two aperture modes also showed a high agreement with a mean non-significant difference of 0.555 mm2 (p=0.379), confirmed by a Pearson’s correlation coefficient of -0.29 (p=0.664).
Conclusions :
SDD are well-visualized on retromode imaging regardless of which aperture setting is used. The borders of the regions involved by SDD are well seen on retromode imaging and be quantified with high-levels of reproducibility. Given the importance of SDD in AMD pathogenesis, retromode imaging may be a useful tool for quantitatively monitoring SDD in future studies.
This is a 2020 ARVO Annual Meeting abstract.