Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry

Reumueller, Adrian; Wassermann, Lorenz; Salas, Matthias; Karantonis, Maria; Sacu, Stefan; Georgopoulos, Michael; Drexler, Wolfgang; Pircher, Michael; Pollreisz, Andreas; Schmidt‐Erfurth, Ursula

doi:10.1016/j.ajo.2019.12.015

Cited by 23 publications

(12 citation statements)

References 54 publications

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“…With the introduction of OCT imaging non-invasive visualization of intra- and subretinal fluid became possible, thereby greatly impacting the diagnosis of diabetic macular edema and other retinal disease 10 – 19 .…”

Section: Introductionmentioning

confidence: 99%

Intraprocedural OCT monitoring of the immediate treatment response during indocyanine green angiography-guided laser therapy of teleangiectatic capillaries in diabetic macular edema

Datlinger

Datlinger²,

Pollreisz

et al. 2022

Sci Rep

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In this retrospective study the morphological response of teleangiectatic capillaries (TCs) to focal laser treatment and the functional and morphological outcome after Indocyanine green angiography (ICGA)-guided laser therapy was evaluated. TCs in eyes with diabetic macular edema (DME) were treated with laser therapy. The immediate and subsequent reaction of the TCs lumina to direct photocoagulation was monitored with customized OCT single scans. Additionally, patients were treated with intravitreal anti-VEGF as needed. 12 eyes of 9 patients with treatment naive (6 eyes) and pretreated (6 eyes) DME were followed-up for a mean of 24 months (± 8.1SD). Best-corrected visual acuity improved from 0.25 logMar (± 0.2SD) to 0.12 (± 0.10SD; p = 0.06) at each patient’s last visit. During laser treatment a darkening of the TCs lumina was achieved in 91.3% of lesions. All these lesions fully resolved, whereas TCs, which showed no darkening of their lumen in OCT persisted and required re-treatment with laser. Additional anti-VEGF injections were indicated in only one eye (8.3%). The darkening of the TCs lumina visible in OCT might provide an image-biomarker that indicates successful coagulation of aneurysmatic lesions. Consequently, a significant functional and morphological improvement with need for anti-VEGF treatment in only one eye, was achieved.Information concerning the registration of the trial: date of registration: 11th of december, 2019. Trial registration number: 107/2019.

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Section: Introductionmentioning

confidence: 99%

Intraprocedural OCT monitoring of the immediate treatment response during indocyanine green angiography-guided laser therapy of teleangiectatic capillaries in diabetic macular edema

Datlinger

Datlinger²,

Pollreisz

et al. 2022

Sci Rep

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“…Because we used clinical examination to distinguish macula-off and -on RRD, it is possible that some macula-on RRD patients may have had subclinical subretinal fluid in the macula, limiting our ability to make distinctions between the relationships in macula-on as opposed to macula-off RRD. A recent smaller study after macula-off RRD repair found similar changes in photoreceptor morphology measured by adaptive optics OCT and retinal sensitivity [21]. Some retinal detachment studies have also shown an association between visual acuity and central ONL thickness [17,22], photoreceptor morphology and cone packing density [8,9,11,18].…”

Section: Discussionmentioning

confidence: 68%

Visual deterioration in patients with photoreceptor loss after retinal reattachment surgery

Rasool

Kaushik

Chaudhary

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose Assess the relationship between photoreceptor degeneration and visual function after retinal reattachment surgery (RRS) in a prospective cohort. Methods Patients with rhegmatogenous retinal detachment (RRD) were reviewed before and 6 months after vitreoretinal surgery. Optical coherence tomographical thickness of the outer nuclear layer (ONL), outer retinal segment (ORS), retinal pigmented epithelium to ellipsoid zone (RPE-EZ) and external limiting membrane to EZ (ELM-EZ) were recorded 6 months post-operatively. These were compared to best corrected visual acuity (BCVA) and retinal sensitivity (Humphrey visual field). Results Thirteen macula-off and 8 macula-on RRD patients were included. The mean ONL thickness was higher after macula-on RRD compared to macula-off RRD (97.70 ± 3.62 μm vs. 73.10 ± 4.98 μm). In all RRD eyes, every 1 μm decrease in ONL thickness correlated with a 0.052 dB decrease and in retinal sensitivity and every 1 μm decrease in ORS thickness was associated with a 0.062 dB reduction in retinal sensitivity. ORS, ELM-EZ and RPE-EZ thickness did not correlate with BCVA post-RRS. Conclusion There was greater ONL and ORS thinning following macula-off compared to macula-on RRD. Correlations between ONL and ORS thinning with decreased retinal sensitivity may be explained by RRD-induced photoreceptor death.

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“…AO-OCT imaging was performed with a system developed at the Center for Medical Physics and Biomedical Engineering at the Medical University of Vienna which had been clinically applied before. 23 , 25 , 27 – 29 In brief, the system combines an AO fundus camera and AO-OCT in a compact system by utilizing a deformable mirror (Mirao52-e RC; Imagine Eyes, Orsay, France) and a Shack Hartmann wavefront sensor (Haso First; Imagine Optics, Orsay, France) for AO enhancement. 30 , 31 The OCT system is operated at 840 nm with an A-scan rate of 200 kHz and an axial resolution in the retina of approximately 5 µm.…”

Section: Methodsmentioning

confidence: 99%

Assessment of Detailed Photoreceptor Structure and Retinal Sensitivity in Diabetic Macular Ischemia Using Adaptive Optics-OCT and Microperimetry

Datlinger

Wassermann

Reumueller

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to assess density and morphology of cone photoreceptors (PRs) and corresponding retinal sensitivity in ischemic compared to nonischemic retinal capillary areas of diabetic eyes using adaptive optics optical coherence tomography (AO-OCT) and microperimetry (MP). Methods In this cross-sectional, observational study five eyes of four patients (2 eyes with proliferative diabetic retinopathy (DR) and 3 eyes moderate nonproliferative DR) were included. PR morphology and density was manually assessed in AO-OCT en face images both at the axial position of the inner-segment outer segment (IS/OS) and cone outer segment tips (COSTs). Retinal sensitivity was determined by fundus-controlled microperimetry in corresponding areas (MP-3, Nidek). Results In AO-OCT, areas affected by capillary nonperfusion showed severe alterations of cone PR morphology at IS/OS and COST compared to areas with intact capillary perfusion (84% and 87% vs. 9% and 8% of area affected for IS/OS and COST, respectively). Mean reduction of PR signal density in affected areas compared to those with intact superficial capillary plexus (SCP) and deep capillary plexus (DCP) perfusion of similar eccentricity was –38% at the level of IS/OS ( P = 0.01) and –39% at the level of COST ( P = 0.01). Mean retinal sensitivity was 10.8 ± 5.4 in areas affected by DCP nonperfusion and 28.2 ± 1.5 outside these areas ( P < 0.001). Conclusions Cone PR morphology and signal density are severely altered in areas of capillary nonperfusion. These structural changes are accompanied by a severe reduction of retinal sensitivity, indicating the importance of preventing impaired capillary circulation in patients with DR.

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Morphologic and Functional Assessment of Photoreceptors After Macula-Off Retinal Detachment With Adaptive-Optics OCT and Microperimetry

Cited by 23 publications

References 54 publications

Intraprocedural OCT monitoring of the immediate treatment response during indocyanine green angiography-guided laser therapy of teleangiectatic capillaries in diabetic macular edema

Intraprocedural OCT monitoring of the immediate treatment response during indocyanine green angiography-guided laser therapy of teleangiectatic capillaries in diabetic macular edema

Visual deterioration in patients with photoreceptor loss after retinal reattachment surgery

Assessment of Detailed Photoreceptor Structure and Retinal Sensitivity in Diabetic Macular Ischemia Using Adaptive Optics-OCT and Microperimetry

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