Hyaloid adhesion to the macula is associated with AMD, and frequently causes VMT in eyes with CNV. Tractional forces may antagonize the effect of anti-VEGF treatment, and cause pharmacological resistance in a subpopulation of patients. Future studies are needed to define the role of vitreoretinal surgery in such cases. Spectral OCT/SLO allows careful diagnosis and follow-up.

The nonlinear response and strong coupling of control channels in micromachined membrane deformable mirror (MMDM) devices make it difficult for one to control the MMDM to obtain the desired mirror surface shapes. A closed-loop adaptive control algorithm is developed for a continuous-surface MMDM used for aberration compensation. The algorithm iteratively adjusts the control voltages of all electrodes to reduce the variance of the optical wave front measured with a Hartmann-Shack wave-front sensor. Zernike polynomials are used to represent the mirror surface shape as well as the optical wave front. An adaptive experimental system to compensate for the wave-front aberrations of a model eye has been built in which the developed adaptive mirror-control algorithm is used to control a deformable mirror with 19 active channels. The experimental results show that the algorithm can adaptively update control voltages to generate an optimum continuous mirror surface profile, compensating for the aberrations within the operating range of the deformable mirror.

Scanning laser ophthalmoscope microperimetry is able to detect changes in retinal sensitivity in AMD patients overlying drusen and at the margin of GA. It is a useful device to grade focal retinal sensitivity in patients with dry age-related macular degeneration.

Drusen volume as determined by spectral domain-OCT correlates with AREDS-determined drusen area and AREDS grade in nonexudative AMD. The correlation is not perfect, however, because drusen area and volume average 40% and 82% of the variation, respectively. Drusen volume can provide additional information in grading the severity of eyes with dry AMD.

PURPOSE-To assess retinal nerve fiber layer (RNFL) thickness in patients with human immunodeficiency virus (HIV) disease without cytomegalovirus retinitis (CMV). DESIGN-A case-control study.METHODS-The study included 113 eyes of 65 patients in one center. Thickness of RNFL along a 3.4-mm-diameter circle centered on the optic nerve head was evaluated using third-generation optical coherence tomography. Patients in group A (39 eyes of 22 patients) were human immunodeficiency virus-negative control subjects. Group B (36 eyes of 18 patients) was composed of HIV patients with no history of CMV retinitis and CD4 counts consistently above 100. Group C (38 eyes of 25 patients) comprised HIV patients with no history of CMV retinitis but a history of CD4 count less than 100 at some point lasting for at least 6 months. RESULTS-The average RNFL thicknesses in groups A, B, and C were 103.33 ± 8.50 μm, 103.30 ± 9.28 μm, and 90.10 ± 12.50 μm, respectively. Group C had significantly thinner overall RNFL than either of the groups A and B (Tukey-Kramer). This difference was most prominent in temporal, superior, and inferior retinal areas. No difference was in nasal retinal area, nor between groups A and B in any of the areas.

Purpose We studied the appearance of margins of Geographic atrophy in high- resolution optical coherence tomography (OCT) images and correlate those changes with fundus autofluorescence imaging. Design Retrospective observational case study. Methods Patients with geographic atrophy secondary to dry age related macular degeneration (ARMD) were assessed by means of Spectral Domain OCT (Spectralis HRA/OCT; Heidelberg Engineering, Heidelberg, Germany or OTI, Inc, Toronto, Canada) as well as Autofluoresence Imaging (HRA or Spectralis Heidelberg Engineering, Heidelberg, Germany): The outer retinal layer alterations were analyzed in the junctional zone between normal retina and atrophic retina, and correlated with corresponding fundus autofluorescence. Results 23 eyes of 16 patients aged between 62 years to 96 years were examined. There was a significant association between OCT findings and the fundus autofluorescence findings(r=0.67, p<0.0001). Severe alterations of the outer retinal layers at margins on Spectral OCT correspond significantly to increased autofluorescence; Smooth margins on OCT correspond significantly to normal fundus autofluorescence. (Kappa-0.7348, p<0.0001). Conclusion Spectral OCT provides in vivo insight into the pathogenesis of geographic atrophy and its progression. Visualization of reactive changes in the retinal pigment epithelial cells at the junctional zone and correlation with increased fundus autofluorescence; secondary to increased lipofuscin may together serve as determinants of progression of geographic atrophy.

Multicolor scanning laser imaging provides superior ERM detection and delineation of surface folds than conventional FP, primarily due to the green channel present in the combination-pseudocolor image in MCI.

Purpose Human Immunodeficiency Virus (HIV) patients develop non-infectious retinopathy characterized by retinal cotton wool spots (CWS) and micro vascular abnormalities. Ophthalmoscopically CWS fade with time. We hypothesized that structural changes should be permanent and possibly visible well after ophthalmoscopic resolution. We used simultaneous spectral domain optical coherence tomography/ scanning laser ophthalmoscope (SD-OCT/SLO) to allow co-localization of the lesions and determine the extent and location of residual damage after ophthalmoscopic resolution of the lesions. Design Retrospective, non-interventional case series. Participants Eight eyes of seven human immunodeficiency virus (HIV) patients with nineteen resolved retinal cotton wool spots. Methods Nineteen retinal cotton wool spots were imaged between 2 and 16 (median 7.84) years after the acute lesions using simultaneous SD-OCT and scanning laser ophthalmoscope (SLO) examinations. The areas of the previous CWS were scanned by overlaying the color retinal image over the SLO image and scanning at high resolution in the horizontal plane thru the resolved lesion. Each CWS lesion had a control area taken from the same eye within 2 disc diameters of the lesion. The thickness of each of the retinal layers was compared between lesions and control areas using a paired t-test using multi-test correction. Main Outcome Measures Thickness of the retinal nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL) and outer nuclear (ONL) layers. Results The largest loss of thickness was seen in the retinal GCL with a 43% reduction in thickness. There was a statistically significant thinning of the retinal NFL, GCL, IPL, INL and OPL. The median thickness differences ranged from 5 to 7 microns. This difference was highly statistically significant. Another striking finding was the displacement of the ONL towards the retinal surface resulting in an apparent increase in thickness of the ONL by over 15 % (median difference of 12 microns). Conclusions Our data using ultrahigh resolution and high speed OCT/SLO shows and quantifies the presence of permanent retinal destruction associated with retinal cotton wool spots in HIV disease.