A dual-modal retinal imaging system with adaptive optics

Meadway, Alexander; Girkin, Christopher A.; Zhang, Yuhua

doi:10.1364/oe.21.029792

Cited by 43 publications

(45 citation statements)

References 58 publications

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“…Compared to the instrument used by Mrejen et al, our AOSLO system has confocal imaging, more actuators on the deformable mirror, a high speed wavefront sensor, and a low coherent light source with broader spectrum (center wavelength 840 nm, bandwidth 60 nm) to further reduce interference artifacts. 35, 36, 39 With these technical advantages we observed that the packing density of granules in the centers of stage 3 subretinal drusenoid deposit was similar to or higher than that of presumably healthy photoreceptors outside the dark annulus (Fig. 4 and Fig.…”

Section: Discussionmentioning

confidence: 89%

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Photoreceptor Perturbation Around Subretinal Drusenoid Deposits as Revealed by Adaptive Optics Scanning Laser Ophthalmoscopy

Zhang¹,

Wang²,

Rivero³

et al. 2014

American Journal of Ophthalmology

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Purpose To describe the microscopic structure of photoreceptors impacted by subretinal drusenoid deposits, also called pseudodrusen, an extracellular lesion associated with age-related macular degeneration (AMD), using adaptive optics scanning laser ophthalmoscopy (AOSLO). Design Observational case series. Methods Fifty-three patients with AMD and 10 age-similar subjects in normal retinal health were recruited. All subjects underwent color fundus photography, infrared reflectance, red-free reflectance, autofluorescence, and spectral-domain optical coherence tomography (SD-OCT). Subretinal drusenoid deposits were classified with a 3-stage OCT-based grading system. Lesions and surrounding photoreceptors were examined with AOSLO. Results Subretinal drusenoid deposits were found in 26 eyes of 13 patients with AMD and imaged by AOSLO and SD-OCT in 18 eyes (n=342 lesions). SD-OCT showed subretinal drusenoid deposits as highly reflective material accumulated internal to the retinal pigment epithelium. AOSLO revealed that photoreceptor reflectivity was qualitatively reduced by stage 1 subretinal drusenoid deposits and greatly reduced by stage 2. AOSLO presented a distinct structure in stage 3, a hyporeflective annulus consisting of deflected, degenerated or absent photoreceptors. A central core with a reflectivity superficially resembling photoreceptors is formed by the lesion material itself. A hyporeflective gap in the photoreceptor ellipsoid zone on either side of this core shown in SD-OCT corresponded to the hyporeflective annulus seen by AOSLO. Conclusions AOSLO and multimodal imaging of subretinal drusenoid deposits indicate solid, space filling lesions in the subretinal space. Associated retinal reflectivity changes are related to lesion stages and are consistent with perturbations to photoreceptors, as suggested by histology.

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Section: Discussionmentioning

confidence: 89%

“…35, 36 This instrument was based upon an earlier prototype that used a micro-electric-mechanic-system based deformable mirror. 20 The new instrument addressed several major obstacles that impede imaging of older patients with AMD.…”

Section: Methodsmentioning

confidence: 99%

Photoreceptor Perturbation Around Subretinal Drusenoid Deposits as Revealed by Adaptive Optics Scanning Laser Ophthalmoscopy

Zhang¹,

Wang²,

Rivero³

et al. 2014

American Journal of Ophthalmology

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“…49,50 As mitochondria comprise up to 74% to 85% of cone ellipsoids, 51 whether the IS ellipsoids coincide with the SD-OCT EZ remains of key interest and debate. 52,53 Reflectivity of photoreceptors on SD-OCT has been postulated to originate from light scattering or waveguiding. 54,55 Mitochondria have been identified as an organelle potentially responsible for photoreceptor reflectivity, as they powerfully scatter light in vitro.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of the Ellipsoid Zone Intensity in Phenotypic Variations of Intermediate Age-Related Macular Degeneration

Gin

Chew

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Citation: Gin TJ, Wu Z, Chew SKH, Guymer RH, Luu CD. Quantitative analysis of the ellipsoid zone intensity in phenotypic variations of intermediate age-related macular degeneration. Invest Ophthalmol Vis Sci. 2017;58:207958: -208658: . DOI:10.1167 PURPOSE. Reduction of the ellipsoid zone (EZ) intensity has been reported in eyes with agerelated macular degeneration (AMD). This study determined whether overall EZ intensity, in retinal locations undisturbed by pathologic features, is associated with the presence of clinical features, which are known important phenotypic risk factors for disease progression, large drusen, reticular pseudodrusen (RPD), and pigmentary abnormalities. METHODS.A horizontal B-scan through the foveola on spectral-domain optical coherence tomography (SD-OCT) was performed in both eyes of 75 participants with bilateral intermediate AMD and 10 age-similar control participants. Eyes with AMD were classified as per the presence of large drusen, RPD, and hyperpigmentary changes. The relative EZ intensity profile, up to an eccentricity of 3400 lm, was averaged over seven 1000-lm retinal segments. The association between relative EZ intensity profile over seven retinal segments and AMD pathologic features was analyzed.RESULTS. The average relative EZ intensities were significantly reduced in eyes with intermediate AMD compared to normal eyes (P 0.025) and with increasing age (P 0.020). On multivariate analyses, only the presence of hyperpigmentary changes and increasing age were significantly associated with reduced overall relative intensities (P 0.024), but not the presence of large drusen or RPD (P ‡ 0.115).CONCLUSIONS. The presence of hyperpigmentary change in the macula in association with large drusen, not large drusen alone, nor large drusen with RPD, was significantly associated with a generalised reduction in EZ intensity. Quantitative assessment of the relative EZ intensity may serve as an effective biomarker of disease severity and progression.

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“…48 As visualized by adaptive optics-OCT, the perifoveal ISel band is ∼6.0 μm thick, too thick for a single reflective plane, and suggestive of the tapered outer half of the anatomical ISel. 49, 50 Comparing OCT scans with histology to test the relative contributions of wave guiding and scattering to band reflectivity has been hindered by the lack of human tissue specimens with perturbed photoreceptor layers, which we herein provide.…”

Section: Discussionmentioning

confidence: 99%

Outer Retinal Tubulation in Advanced Age-Related Macular Degeneration

Schaal

Freund

Litts

et al. 2015

Retina

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113

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Purpose To compare optical coherence tomography (OCT) and histology of outer retinal tubulation (ORT) secondary to advanced age-related macular degeneration (AMD) in patients and in post-mortem specimens, with particular attention to the basis of the hyper-reflective border of ORT. Method A private referral practice (imaging) and an academic research laboratory (histology) collaborated on two retrospective case series. High-resolution OCT raster scans of 43 eyes (34 patients) manifesting ORT secondary to advanced AMD were compared to high-resolution histological sections through the fovea and superior perifovea of donor eyes (13 atrophic AMD and 40 neovascular AMD) preserved ≤4 hours after death. Results ORT seen on OCT corresponded to histologic findings of tubular structures comprised largely of cones lacking outer segments (OS) and lacking inner segments (IS). Four phases of cone degeneration were histologically distinguishable in ORT lumenal walls, nascent, mature, degenerate, and end-stage (IS and OS; IS only; no IS; no photoreceptors and only Müller cells forming external limiting membrane, ELM, respectively). Mitochondria, which are normally long and bundled within IS ellipsoids, were small and scattered within shrunken IS and cell bodies of surviving cones. A lumenal border was delimited by an ELM. ORT observed in closed and open configurations were distinguishable from cysts and photoreceptor islands on both OCT and histology. Hyper-reflective lumenal material seen on OCT represents trapped retinal pigment epithelium (RPE) and non-RPE cells. Conclusions The defining OCT features of ORT are location in the outer nuclear layer (ONL), a hyper-reflective band differentiating it from cysts, and RPE that is either dysmorphic or absent. ORT histologic and OCT findings corresponded in regard to composition, location, shape, and stages of formation. The reflectivity of ORT lumenal walls on OCT apparently does not require an OS or an IS/OS junction, indicating an independent reflectivity source, possibly mitochondria, in the IS.

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A dual-modal retinal imaging system with adaptive optics

Cited by 43 publications

References 58 publications

Photoreceptor Perturbation Around Subretinal Drusenoid Deposits as Revealed by Adaptive Optics Scanning Laser Ophthalmoscopy

Photoreceptor Perturbation Around Subretinal Drusenoid Deposits as Revealed by Adaptive Optics Scanning Laser Ophthalmoscopy

Quantitative Analysis of the Ellipsoid Zone Intensity in Phenotypic Variations of Intermediate Age-Related Macular Degeneration

Outer Retinal Tubulation in Advanced Age-Related Macular Degeneration

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