June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Perturbation of photoreceptor optical property by cuticular drusen revealed by adaptive optics scanning laser ophthalmoscopy
Author Affiliations & Notes
  • Xiaolin Wang
    Doheny Eye Institute, Los Angeles, California, United States
  • Sujin Hoshi
    Ophthalmology, University of California Los Angeles, Los Angeles, California, United States
    Tsukuba Daigaku, Tsukuba, Ibaraki, Japan
  • Shin Kadomoto
    Ophthalmology, University of California Los Angeles, Los Angeles, California, United States
    Kyoto Daigaku Daigakuin Igaku Kenkyuka Igakubu, Kyoto, Kyoto, Japan
  • Ruixue Liu
    Doheny Eye Institute, Los Angeles, California, United States
  • Yuhua Zhang
    Doheny Eye Institute, Los Angeles, California, United States
    Ophthalmology, University of California Los Angeles, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Xiaolin Wang None; Sujin Hoshi None; Shin Kadomoto None; Ruixue Liu None; Yuhua Zhang None
  • Footnotes
    Support  NIH R01EY024378, NIH R01EY034218, W. M. Keck Foundation, Carl Marshall Reeves & Mildred Almen Reeves Foundation, and Research to Prevent Blindness/Dr. H. James and Carole Free Catalyst Award for Innovative Research Approaches for AMD.
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2154. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Xiaolin Wang, Sujin Hoshi, Shin Kadomoto, Ruixue Liu, Yuhua Zhang; Perturbation of photoreceptor optical property by cuticular drusen revealed by adaptive optics scanning laser ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2154.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : To characterize the microscopic structure of photoreceptors surrounding cuticular drusen in patients with age-related macular degeneration (AMD) using multimodal imaging, including adaptive optics scanning laser ophthalmoscopy (AOSLO).

Methods : Study patients (n = 8, aged 70.1 ± 6.6 years) with early to intermediate AMD (grade 2-8 on the AREDS 9-step severity scale) and predominantly cuticular drusen in both eyes underwent color fundus photography, blue and infrared reflectance, autofluorescence (AF), and optical coherence tomography (OCT). AOSLO was performed to image macular cone photoreceptors. Cuticular drusen were characterized into 3 phenotypes: type 1 had shallow retinal pigment epithelium (RPE) elevations, type 2 appeared as saw-tooth mounds, and type 3 formed broad mounds causing significant elevations of the RPE band. Type 1 lesions had indiscernible druse internal contents, whereas type 2&3 manifested hyporeflective internals. Cone photoreceptor structure was evaluated by cone reflectivity on AOSLO.

Results : AOSLO revealed distinctive cone reflectivity alterations over different phenotypes of cuticular drusen (Figure). While most cones maintained normal orientation on type 1 lesions, the area impacted by the cuticular druse became hyporeflective. Cones lost reflectivity on type 2 lesions. Most cones became invisible on type 3 lesions. We measured 1501 cuticular drusen affected areas showing quasicircular hyporeflectivity in 16 eyes. The diameter was 49.12 ± 16.42 μm, ranging from 15.81 to 99.22 μm.

Conclusions : The characterized photoreceptor reflectivity perturbation associated with cuticular drusen indicates that the optical properties of the photoreceptors have been impacted at the beginning of the lesion development, suggesting displacement or dysfunction of the supporting RPE cells, as evidenced by characteristic hypertransmission underneath in the choroid.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Cuticular drusen perturbation of photoreceptors revealed by AOSLO (left panels) and OCT (right panels). Color arrows indicate corresponding cuticular drusen in AOSLO and OCT. Cones are represented by evenly spaced hyperreflective spots. Cuticular drusen affected regions show reduced reflectivity. Type 1 cuticular drusen caused minimal disturbance in the ellipsoid zone (EZ) and interdigitation zone-RPE-Bruch’s Membrane complex, whereas types 2&3 lesions significantly changed the EZ and RPE shape.

Cuticular drusen perturbation of photoreceptors revealed by AOSLO (left panels) and OCT (right panels). Color arrows indicate corresponding cuticular drusen in AOSLO and OCT. Cones are represented by evenly spaced hyperreflective spots. Cuticular drusen affected regions show reduced reflectivity. Type 1 cuticular drusen caused minimal disturbance in the ellipsoid zone (EZ) and interdigitation zone-RPE-Bruch’s Membrane complex, whereas types 2&3 lesions significantly changed the EZ and RPE shape.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×