Abstract
Purpose :
Wavefront aberrations are measured using reflected light off the retina. We analyzed the effect of retinal pathology on wavefront aberration measurements.
Methods :
We performed wavefront measurements (OCULUS AXL Wave) and retinal imaging with OCT, and OCTA (Heidelberg Spectralis) in 47 subjects aged (54.3 +/- 18.4 yr). All subjects were consented and tested in a manner approved by the Indiana University Institutional Review Board, which adhered to the Declaration of Helsinki. For the wavefront analysis, root mean squared error for higher order aberrations (RMSHO) included Zernike terms greater than 3rd order. Central macular thickness (CMT) was computed using the on-board software, and the macular center was selected using OCTA. An ophthalmologist assessed the OCT and OCTA for posterior segment changes which included macular pucker, epiretinal membrane, drusen, and cystoid macular edema. Anterior segment conditions included dry eye, posterior capsular opacification, and cataract.
Results :
The mean CMT of the normal subjects is 273.67 +/- 21.58, C.I: 231.36-315.97 microns. In normal subjects there was no significant association between the central macular thickness and the RMSHO (RMSHO= 0.00039*CMT – 0.0398, r2: 0.0934 P= 0.62). However, 3 subjects had CMTs outside the confidence limits, all of whom had no known anterior segment abnormalities but had high RMSHO values (0.26, 0.12, 0.14). A significant association was found between the RMSHO and age for the normal subjects (RMSHO =0.0011*age + 0.016, r2 : 0.432, P: 0.017), when including older phakic subjects. For example, this predicts a value of 0.0894 microns for a 65 yr old. RMSHO were significantly higher in 17 subjects, 10 of whom had abnormal posterior segment but no known anterior segment findings. The other 7 had both.
Conclusions :
Wavefront aberration measurements may be affected by retinal pathology and do not solely reflect the optics of the anterior segment. This is clinically important in the context of refractive and cataract surgeries, wavefront measurements for refraction, and correction for adaptive optics imaging.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.