Combined Confocal Scanning Laser Ophthalmoscopy and Spectral-Domain Optical Coherence Tomography Imaging of Reticular Drusen Associated with Age-Related Macular Degeneration

Schmitz-Valckenberg, Steffen; Steinberg, Julia S.; Fleckenstein, Monika; Visvalingam, Sivatharisini; Brinkmann, Christian; Holz, Frank G.

doi:10.1016/j.ophtha.2009.10.044

Cited by 145 publications

(104 citation statements)

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“…To avoid potential confounding, patients exhibiting ''diffusetrickling geographic atrophy'' were not included, as choroidal insufficiency has been previously implicated in the pathogenesis. [33][34][35][36][37] Genetic testing was conducted at the Institute of Human Genetics, University of Regensburg (n ¼ 7), and at the Center for Human Genetics Bioscientia, Ingelheim (n ¼ 6). Analysis of all coding exons of the ABCA4 and PRPH2 genes was done by either direct chain-terminating dideoxynucleotide Sanger sequencing, a custom-designed GeneChip CustomSeq Resequencing Array (RetChip; Affymetrix, Santa Clara, CA, USA), or next-generation sequencing (Regensburg, n ¼ 5; Bioscientia, n ¼ 6).…”

Section: Patient Characterizationmentioning

confidence: 99%

Choroidal Flow Signal in Late-Onset Stargardt Disease and Age-Related Macular Degeneration: An OCT-Angiography Study

Müller

Pfau

Möller

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the choroidal blood flow in areas within and adjacent to retinal pigment epithelium (RPE) atrophy secondary to late-onset Stargardt disease (STGD1) and agerelated macular degeneration (AMD). METHODS.A total of 43 eyes (23 STGD1 and 20 AMD) of patients with RPE atrophy and 25 eyes of healthy controls without ocular pathology underwent multimodal imaging including optical coherence tomography angiography (OCT-A; PLEX Elite 9000 Swept-Source OCT). Using an exploratory approach, choriocapillaris and deeper choroid OCT-A slabs were evaluated in order to detect differences between STGD1 and AMD. The magnitude of absenceof-flow signal (AFS) was investigated in terms of area-fraction and size-frequency distribution. RESULTS.Qualitative and quantitative analysis of areas of RPE atrophy revealed more pronounced rarefaction of the choriocapillaris flow signal in STGD1 as compared to AMD (AFS area fraction: 33.15% 6 6.86% vs. 31.68% 6 8.39%; P ¼ 0.517), while outside RPE atrophy rarefaction was less pronounced in STGD1 (AFS area fraction: 17.41% 6 5.67% vs. 21.59% 6 6.90%; P < 0.001), to the level of nonsignificance compared to controls (13.27% 6 2.99%, P ¼ 0.368). Given this discrepancy, the ratio of the AFS area fraction within/outside of RPE atrophy could be used to differentiate between STGD1 and AMD with 65.0% sensitivity and 92.3% specificity. CONCLUSIONS.Using OCT-A, comparison of choroidal flow signal within and outside the area of RPE atrophy revealed distinct differences between STGD1 and AMD, potentially implicating a differential role of the choroid in the pathogenesis of RPE atrophy in these two diseases.

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Section: Patient Characterizationmentioning

confidence: 99%

Choroidal Flow Signal in Late-Onset Stargardt Disease and Age-Related Macular Degeneration: An OCT-Angiography Study

Müller

Pfau

Möller

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…High-resolution imaging was performed using a combined instrument (Spectralis HRAþOCT; Heidelberg Engineering, Heidelberg, Germany) that allows for simultaneous recording of confocal laser scanning ophthalmoscopy (cSLO) and SD-OCT images as previously described. 29,30 In all patients included in this substudy, a minimum standardized imaging protocol was performed, which included acquisition of 488-nm fundus autofluorescence (FAF) and near-infrared reflectance (k ¼ 830 nm; field of view, 308 3 308; image resolution, 768 3 768 pixels) and simultaneous SD-OCT scanning using a second, independent pair of scanning mirrors (k ¼ 870 nm; acquisition speed, 40,000 A-scans per seconds; scan depth, 1.8 mm; digital depth resolution,~3.5 lm per pixel). 16 This allows for realtime registration and compensation of eye movements.…”

Section: Image Acquisitionmentioning

confidence: 99%

Local Progression Kinetics of Geographic Atrophy in Age-Related Macular Degeneration Are Associated With Atrophy Border Morphology

Lindner

Kosanetzky

Pfau

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To assess the impact of distinct atrophy border characteristics based on spectraldomain optical coherence tomography (SD-OCT) imaging on local atrophy progression. METHODS.Patients with geographic atrophy (GA) secondary to AMD were recruited in the context of the Longitudinal Fundus Autofluorescence in Age-related Macular Degeneration and Directional Spread in Geographic Atrophy studies (NCT00393692, NCT02051998). Horizontal and vertical SD-OCT scans were acquired at sequential visits using a device allowing for anatomically accurate registration of follow-up to baseline scans. For quantification of local atrophy progression, the lateral spread of GA (LSGA) was measured. Further, border types were independently graded. Comparison of LSGA between the different border types was performed using linear mixed-effects models. RESULTS. Seventy-two eyes of 49 patients (27 female) aged 74.0 years (Inter quartile range[IQR], 68.1-79.0) were included into this analysis. A total of 258 border sections were analyzed longitudinally over a median period of 1.2 years (IQR, 0.9-1.6). At baseline, 17.1% borders were classified as 'regular', 47.7% as 'irregular', and 35.3% as 'splitting'. Sixty-two percent of the eyes exhibited more than one border type. LSGA was slowest in 'regular' borders (62.85 6 25.29 lm/y), followed by 'irregular' borders (91.15 6 15.05 lm/y) and fastest in 'splitting' borders (183.15 6 18.17 lm/y). Differences between the 'splitting' and each other border type were statistically significant (P < 0.001). CONCLUSIONS.The results indicate that SD-OCT-based assessment of local GA border morphology can serve as a predictor for local atrophy progression. These observations help to better understand the natural history and potential pathogenetic factors of GA development and progression.

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“…Over time in these reattached retinas, they suggested that the cone outer segments reoriented themselves, although of course, their experiments could not determine whether their result was due to simple foveal cone outer segment reorientation, or actual replacement. Further use of newer methodologies like high resolution OCT, adaptive optics, 18 and confocal scanning laser ophthalmoscopy 19 viewing of the photoreceptor layer and other retinal structures will help us to resolve some of these questions non-invasively in living eyes over time that, therefore, could only be observed in histologic sections of enucleated globes, where correlation with visual function was not possible.…”

Section: Anatomic Disturbancesmentioning

confidence: 99%

The Optic UK Lecture: bench-to-bedside adventures of a diabetes researcher: results past, results present

Frank

2011

Eye

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Combined Confocal Scanning Laser Ophthalmoscopy and Spectral-Domain Optical Coherence Tomography Imaging of Reticular Drusen Associated with Age-Related Macular Degeneration

Cited by 145 publications

References 30 publications

Choroidal Flow Signal in Late-Onset Stargardt Disease and Age-Related Macular Degeneration: An OCT-Angiography Study

Choroidal Flow Signal in Late-Onset Stargardt Disease and Age-Related Macular Degeneration: An OCT-Angiography Study

Local Progression Kinetics of Geographic Atrophy in Age-Related Macular Degeneration Are Associated With Atrophy Border Morphology

The Optic UK Lecture: bench-to-bedside adventures of a diabetes researcher: results past, results present

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