A Lensing Effect of Inner Retinal Cysts on Images of the Photoreceptor Mosaic

Langlo, Christopher S; Flatter, John; Dubra, Alfredo; Wirostko, William J.; Carroll, Joseph

doi:10.1097/iae.0b013e3182a2f50c

Cited by 13 publications

(7 citation statements)

References 4 publications

(5 reference statements)

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“…In addition, presence of intraretinal cysts and extracellular fluid accumulation in the inner retinal layers might affect the reliability of assessments of cone arrangement due to blurring or distortion of the images. 30,42,43 Finally, impairment of the photoreceptor layer might be related to abnormalities in the retinal pigment epithelium (RPE) in eyes with DME, since it is known that in DME the RPE's capacity for transepithelial transport is impaired and in part responsible for accumulation of fluid in the retinal parenchyma. 44 …”

Section: Discussionmentioning

confidence: 99%

Cone Photoreceptor Irregularity on Adaptive Optics Scanning Laser Ophthalmoscopy Correlates With Severity of Diabetic Retinopathy and Macular Edema

Lammer

Prager

Cheney

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PurposeTo determine whether cone density, spacing, or regularity in eyes with and without diabetes (DM) as assessed by high-resolution adaptive optics scanning laser ophthalmoscopy (AOSLO) correlates with presence of diabetes, diabetic retinopathy (DR) severity, or presence of diabetic macular edema (DME).MethodsParticipants with type 1 or 2 DM and healthy controls underwent AOSLO imaging of four macular regions. Cone assessment was performed by independent graders for cone density, packing factor (PF), nearest neighbor distance (NND), and Voronoi tile area (VTA). Regularity indices (mean/SD) of NND (RI-NND) and VTA (RI-VTA) were calculated.ResultsFifty-three eyes (53 subjects) were assessed. Mean ± SD age was 44 ± 12 years; 81% had DM (duration: 22 ± 13 years; glycated hemoglobin [HbA1c]: 8.0 ± 1.7%; DM type 1: 72%). No significant relationship was found between DM, HbA1c, or DR severity and cone density or spacing parameters. However, decreased regularity of cone arrangement in the macular quadrants was correlated with presence of DM (RI-NND: P = 0.04; RI-VTA: P = 0.04), increasing DR severity (RI-NND: P = 0.04), and presence of DME (RI-VTA: P = 0.04). Eyes with DME were associated with decreased density (P = 0.04), PF (P = 0.03), and RI-VTA (0.04).ConclusionsAlthough absolute cone density and spacing don't appear to change substantially in DM, decreased regularity of the cone arrangement is consistently associated with the presence of DM, increasing DR severity, and DME. Future AOSLO evaluation of cone regularity is warranted to determine whether these changes are correlated with, or predict, anatomic or functional deficits in patients with DM.

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Section: Discussionmentioning

confidence: 99%

Cone Photoreceptor Irregularity on Adaptive Optics Scanning Laser Ophthalmoscopy Correlates With Severity of Diabetic Retinopathy and Macular Edema

Lammer

Prager

Cheney

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…Typically, microcysts are associated with degenerative retinal diseases. However, a recent report found a microcyst viewed with an adaptive optics SLO (AOSLO) system following trauma from a motor vehicle accident, where the patient was diagnosed with commotio retinae and central vision loss [8]. This microcyst was also seen on an OCT B scan and was located in the inner nuclear layer, similar to the OCT-based findings in diseases.…”

Section: Introductionmentioning

confidence: 63%

“…Given the widespread occurrence of microcysts across numerous optic neuropathies, and the finding that microcysts are most prevalent in patients with mitochondrial hereditary optic neuropathies, it has been proposed that they arise from mitochondrial dysfunction, possibly in Müller cells [19]. The other AOSLO report of a microcyst structure implies that the trauma suffered by the patient could have led to the formation of the structure [8]. We noted that the patient in this study did have a mild head injury about 1 month prior to the discovery of the microcyst, although he reported no visual or cognitive symptoms associated with the incident.…”

Section: Discussionmentioning

confidence: 99%

Life Cycle and Lensing of a Macular Microcyst

et al. 2020

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Introduction: Microscopic details about retinal conditions can provide insight into pathological mechanisms, but these are ordinarily difficult to obtain in situ. We demonstrate how high-resolution imaging and optical modeling can be combined to reveal morphological features of a macular microcyst, offering insight into microcyst formation. Objective: To use adaptive optics scanning laser ophthalmoscopic (AOSLO) images to track a transient retinal microcyst and derive its 3-dimensional shape. Methods: A series of AOSLO images were gathered before, during, and after a transient retinal microcyst developed in an otherwise normal healthy 26-year-old male subject. Optical coherence tomography (OCT) independently confirmed the location of the microcyst. Optical modeling was conducted to quantify the lensing effect of the optically uniform microcyst and to determine its 3-dimensional shape. Increment threshold sensitivity, targeted within and around the microcyst, was tested to see if cone photoreceptor function was affected. Results: A transient microcyst appeared as a 50 µm diameter circle in AOSLO images, localized to the inner nuclear layer. Based on image distortion of the photoreceptor mosaic, optical modeling suggests that the microcyst had the shape of an aspherical lens, distinguishable from a spherical, cylindrical, or elliptical shape, indicative of an edematous expansion of laminar tissue. The microcyst spontaneously resolved about 30 days after first discovery. No changes to the photoreceptor mosaic ensued from the presence of the microcyst, and functional testing of the photoreceptors below the microcyst indicated no loss of light sensitivity. Conclusions: Microcysts have been associated with numerous subtypes of optic nerve degeneration, including multiple sclerosis and various inherited neuropathies. This microcyst appeared in a healthy individual and resolved without intervention. Lensing effects can be used to determine microcyst shape, which cannot be resolved by OCT imaging, and to help infer etiology.

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“… 14 On the other hand, PFCL could work like a spherical lens with a resultant magnification of underlying structure. 14 42 It causes retinal distortion, especially outer retina below the bubble of PFCL based on its distance and radii from the noted structure. 14 Although this has been identified with PFCL, it may also occur by other tamponade, as the mechanism of artifact is different refractive index.…”

Section: R Esultsmentioning

confidence: 99%