Adaptive Optics Microperimetry and OCT Images Show Preserved Function and Recovery of Cone Visibility in Macular Telangiectasia Type 2 Retinal Lesions

Wang, Qinyun; Tuten, William S.; Lujan, Brandon J.; Holland, Jennifer L.; Bernstein, Paul S.; Schwartz, Steven D.; Duncan, Jacque L.; Roorda, Austin

doi:10.1167/iovs.14-15576

Cited by 89 publications

(82 citation statements)

References 33 publications

(34 reference statements)

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“…In clinical applications, the higher dynamic range of stimulus lights will enable dark adapted vision-as well as rod function testing. Rod function testing is of importance for clinically oriented visual testing [15,31,32], especially with regard to retinal diseases affecting mesopic and scotopic vision, where early signs of the disease is most likely found in reduced rod function [33,34].…”

Section: Discussionmentioning

confidence: 99%

Ultra-high contrast retinal display system for single photoreceptor psychophysics

Domdei¹,

Domdei²,

Reiniger³

et al. 2017

Biomed. Opt. Express

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Due to the enormous dynamic range of human photoreceptors in response to light, studying their visual function in the intact retina challenges the stimulation hardware, specifically with regard to the displayable luminance contrast. The adaptive optics scanning laser ophthalmoscope (AOSLO) is an optical platform that focuses light to extremely small retinal extents, approaching the size of single photoreceptor cells. However, the current light modulation techniques produce spurious visible backgrounds which fundamentally limit experimental options. To remove unwanted background light and to improve contrast for high dynamic range visual stimulation in an AOSLO, we cascaded two commercial fiber-coupled acousto-optic modulators (AOMs) and measured their combined optical contrast. By compensating for zero-point differences in the individual AOMs, we demonstrate a multiplicative extinction ratio in the cascade that was in accordance with the extinction ratios of both single AOMs. When latency differences in the AOM response functions were individually corrected, single switch events as short as 50 ns with radiant power contrasts up to 1:10 10 were achieved. This is the highest visual contrast reported for any display system so far. We show psychophysically that this contrast ratio is sufficient to stimulate single foveal photoreceptor cells with small and bright enough visible targets that do not contain a detectable background. Background-free stimulation will enable photoreceptor testing with custom adaptation lights. Furthermore, a larger dynamic range in displayable light levels can drive photoreceptor responses in cones as well as in rods.

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Section: Discussionmentioning

confidence: 99%

Ultra-high contrast retinal display system for single photoreceptor psychophysics

Domdei¹,

Domdei²,

Reiniger³

et al. 2017

Biomed. Opt. Express

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“…10). Nevertheless, a failure to visualize a cone does not immediately imply a missing cone or even a lack of cone function (see Sec 4.2 or see (Wang et al 2015)). The reflection from a cone might be weak and the dynamic range of the camera might not be high enough to detect it, but the dynamic range of human light sensitivity can be very high (Rodieck 1998).…”

Section: 0 Discussionmentioning

confidence: 99%

“…While standard approaches involving the recording of scattered light from the retina have proven useful for both fundus camera and SLO modalities, the reflected or scattered light does not provide specific information about a retinal cell's function or its health. Even the simple notion that a visible cone is a healthy cone or an invisible cone indicates visual dysfunction has been questioned (Wang et al 2015). However, this review will show that there is an expanding array of more innovative uses of AO technology within these modalities, and we've witnessed only the very beginnings of what can be done.…”

Section: 0 What Is Ao?mentioning

confidence: 99%

“…Macular telangiectasia type 2 (Yannuzzi et al 2006) is less prevalent than diabetes or AMD, but a recent paper using a combination of AOSLO imaging and AO microperimetry highlights two discoveries that might prove to be relevant to many retinal degenerative diseases (Wang et al 2015). Patients with macular telangiectasia can present, at the early stages, with small discrete lesions in the photoreceptor layer close to fixation.…”

Section: 0 How Is Aoslo Being Used Clinically?mentioning

confidence: 99%

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Adaptive Optics Ophthalmoscopy

Roorda

Duncan

2015

Annu. Rev. Vis. Sci.

143

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This review starts with a brief history and description of adaptive optics (AO) technology, followed by a showcase of the latest capabilities of AO systems for imaging the human retina and an extensive review of the literature on where AO is being used clinically. The review concludes with a discussion on future directions and guidance on usage and interpretation of images from AO systems for the eye.

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“…Online tracking achieved through the recording of eye motion from an AOSLO video alone [10] has been previously effective for anesthetized monkeys [7] and trained psychophysical observers with normal vision [5,6]. However, only one publication reports the use of online tracking for targeted visual function testing in patients with eye disease [11]. The particular patients in that study had normal visual acuity and fixation.…”

Section: Introductionmentioning

confidence: 99%

Active eye-tracking for an adaptive optics scanning laser ophthalmoscope

Sheehy

Tiruveedhula

Sabesan

et al. 2015

Biomed. Opt. Express

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Abstract:We demonstrate a system that combines a tracking scanning laser ophthalmoscope (TSLO) and an adaptive optics scanning laser ophthalmoscope (AOSLO) system resulting in both optical (hardware) and digital (software) eye-tracking capabilities. The hybrid system employs the TSLO for active eye-tracking at a rate up to 960 Hz for real-time stabilization of the AOSLO system. AOSLO videos with active eyetracking signals showed, at most, an amplitude of motion of 0.20 arcminutes for horizontal motion and 0.14 arcminutes for vertical motion. Subsequent real-time digital stabilization limited residual motion to an average of only 0.06 arcminutes (a 95% reduction). By correcting for high amplitude, low frequency drifts of the eye, the active TSLO eye-tracking system enabled the AOSLO system to capture high-resolution retinal images over a larger range of motion than previously possible with just the AOSLO imaging system alone.

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Adaptive Optics Microperimetry and OCT Images Show Preserved Function and Recovery of Cone Visibility in Macular Telangiectasia Type 2 Retinal Lesions

Abstract: Visual sensitivity and recovery of cone visibility in areas of apparent focal cone loss suggests that MacTel type 2 lesions with a preserved ELM may contain functioning cones with abnormal scattering and/or waveguiding characteristics. (ClinicalTrials.gov number, NCT00254605.).

Cited by 89 publications

References 33 publications

Ultra-high contrast retinal display system for single photoreceptor psychophysics

Ultra-high contrast retinal display system for single photoreceptor psychophysics

Adaptive Optics Ophthalmoscopy

Active eye-tracking for an adaptive optics scanning laser ophthalmoscope

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