ADAPTIVE OPTICS AND MULTIMODAL IMAGING FOR INFLAMMATORY VITREORETINAL INTERFACE ABNORMALITIES

Abstract

Purpose : To investigate the changes of the vitreoretinal interface as seen on multimodal adaptive optics imaging of eyes with uveitis.

Methods : Four eyes (4 patients) affected by fovea-attached (subtype 1A) or fovea sparing epiretinal membranes (ERM) on spectral domain optical coherence tomography (SD-OCT) or visible internal limiting membrane (ILM) on Infrared fundus imaging were recruited in this pilot study.
The microstructure of the vitreoretinal interface was imaged using flood-illumination adaptive optics (FIAO) and images were compared to the cross-sectional SD-OCT data.
Two eyes from 2 additional patients with Gunn’s dots identified by FIAO had their FIAO images compared with the microstructures seen associated with ILM.

Results : Adaptive optics images revealed multiple abnormalities of the vitreoretinal interface, such as deep linear striae in ERM, and hyperreflective microstructures at the location of ERMs (picture 1) and ILMs.
The Gunn’s dots were morphologically different from the hyperreflective microstructures or spots associated with the ILM and ERM.

Conclusions : FIAO imaging can identify specific patterns associated with ERMs and ILMs.
FIAO imaging of the vitreomacular interface and its correlation to FIOA imaging of outer retinal structures to discerne structural alterations can be valuable to understand the cause of significant macular dysfunction associated to ERM.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Figure. SD-OCT, IR and FIAO pictures from patient RLAB0329 left eye (Birdshot chorioretinopathy). FIAO shows hyperreflective microstructures around the fovea (right); an ERM with vitreomacular traction on SD-OCT (left). FIAO at the macula shows the cones mosaic with alterations of the mosaic were the ERM is located (bottom)