Repeatability and Reproducibility of Photoreceptor Density Measurement in the Macula Using the Spectralis High Magnification Module

Mendonça, Luísa S.M.; Braun, Phillip X.; Martin, Sarah M.; Huther, Alexander; Mehta, Nihaal; Zhao, Yi; Abu-Qamar, Omar; Konstantinou, Eleni K.; Regatieri, Caio V.; Witkin, André J.; Baumal, Caroline R.; Duker, Jay S.; Waheed, Nadia K.

doi:10.1016/j.oret.2020.04.021

Cited by 10 publications

(15 citation statements)

References 31 publications

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“…The patients’ pupil size was mostly smaller than 2.0–2.5 mm in our study. This might be a reason that we did not acquired clear HMM images in some eyes as larger pupil would bring more aberration [ 9 – 11 ]. Taken together, it seemed that HMM require higher for refractive status, pupil size, fixation, or other condition than traditional OCT.…”

Section: Discussionmentioning

confidence: 99%

“…The resolution power of HMM reaches 1.5 μm. It allows to resolve retinal microstructures, especially the photoreceptor mosaic in vivo without pupil dilation which is not available in a traditional clinical setting [ 9 – 11 ].…”

Section: Methodsmentioning

confidence: 99%

“…All patients are presented normal size (smaller than 2.5 mm in diameter). As the pupil size was suggested 1.5 mm [ 9 – 11 ], we kept the examination room bright to further minimal the pupil size smaller than 2.0 mm. Then these steps were followed: disable the auto-brightness option before starting the acquisition to ensure optimal illumination can be achieved; acquire a 30-degree IR image to assess the overall quality (illumination, signal, etc.…”

Section: Methodsmentioning

confidence: 99%

“…It is called High Magnification Module (HMM). So far, there is few relevant literature report on clinical application of this product [ 9 – 11 ]. Here’s a preliminary application of HMM in healthy subjects and post-operation MH patients.…”

Section: Introductionmentioning

confidence: 99%

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Ultrastructural study of closed macular hole- preliminary application of a novel high magnification module combining with OCT

Qiu¹,

Shi²,

Zhao³

et al. 2021

BMC Ophthalmol

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Background As a novel high magnification module (HMM) combining with OCT (OCT-HMM) is able to detect the microstructure of retina, we apply it to explore the ultrastructure of the macula after closure of the idiopathic macular hole (IMH) by surgery. Methods This is an observational case series study in which patients with full-thickness IMHs who had undergone successful macular closure by vitrectomy and internal limiting membrane peeling and healthy subjects were recruited. After comprehensive ophthalmic examinations, the images of macular area were obtained and collected by professional operators using OCT-HMM. Then images were independently analyzed by 4 masked vitreoretinal specialists. Results A total of 24 IMH eyes and 42 healthy eyes were examined. HMM images were obtained in 10 IMH eyes. Among them, 4 eyes whose macula closed completely with recovery of photoreceptor layer presented a dark arc nasal to the fovea, oriented to the optic, and the notch of arc faced temporally. Six eyes in which the macula closed incompletely with photoreceptor cells loss revealed a dark ring with uneven bright spots inside. The other 14 eyes failed to obtain clear images by OCT-HMM. The contra lateral eyes of the patients and the healthy subjects’ eyes succeeded to obtain the HMM images which displayed evenly grey background thickly covered with tiny bright dots that was in similar size and evenly and widely distributed and there no dark arc or ring. OCT B-scan and IR images could be acquired in all of the IMH and healthy eyes. Conclusion The preliminary application of HMM has supplied us a brand-new insight into the microstructure of closed IMH. A dark arc sign could be detected with OCT-HMM in the macula which was functionally closed after surgery that was probably the healing mark on a microstructure photoreceptors level. Its existence and shape indicated that the functional closure followed by a retinal displacement mainly horizontally from temporal side to nasal side but not symmetric centripetally.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrastructural study of closed macular hole- preliminary application of a novel high magnification module combining with OCT

Qiu¹,

Shi²,

Zhao³

et al. 2021

BMC Ophthalmol

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show abstract

“…Images acquired by HMM™ cover a fundus area of 8 × 8°, allowing for a digital lateral resolution of 1.5 μm/px if the high-resolution mode of the device is chosen for imaging [7]. While HMM™ was capable to visualize outer retinal structures on a cellular level, it remained doubtful if HMM™ images could provide reliable and repeatable quantitative parameters of retinal photoreceptors [8][9][10].…”

Section: Key Messagesmentioning

confidence: 99%

Computer-assisted photoreceptor assessment on Heidelberg Engineering Spectralis™ High Magnification Module™ images

Mulders

Klevering

Hoyng

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose To evaluate reliability and repeatability of computer-assisted measurements of cone photoreceptor metrics on Heidelberg Engineering Spectralis™ High Magnification Module (HMM™) Automatic Real-time Tracking (ART™) images. Methods We analyzed HMM™ images in three separate study arms. Computer-assisted cone identification software was validated using an open-access adaptive optics (AO) dataset. We compared results of the first arm to data from AO and histology. We evaluated intersession repeatability of our computer-assisted cone analysis in the second arm. We assessed the capability of HMM™ to visualize cones in the presence of pathology in the third arm. Results We included 10 healthy subjects in the first arm of our study, 5 additional healthy participants in the second arm and 5 patients in the third arm. In total, we analyzed 225 regions of interest on HMM™ images. We were able to automatically identify cone photoreceptors and assess corresponding metrics at all eccentricities between 2 and 9° from the fovea. Cone density significantly declined with increasing eccentricity (p = 4.890E-26, Friedman test). With increasing eccentricity, we found a significant increase in intercell distance (p = 2.196E-25, Friedman test) and nearest neighbor distance (p = 1.997E-25, Friedman test). Cone hexagonality ranged between 71 and 85%. We found excellent automated intersession repeatability of cone density counts and spacing measurements. In pathology, we were also able to repeatedly visualize photoreceptors. Conclusion Computer-assisted cone photoreceptor analysis on Spectralis™ HMM™ images is feasible, and most cone metrics show excellent repeatability. HMM™ imaging may be useful for photoreceptor analysis as progression marker in outer retinal disease.

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In vivo cone-photoreceptor density comparison between eyes with subretinal drusenoid deposits and healthy eyes using high magnification imaging

El Ghazi,

Miere,

Crincoli

et al. 2024

Int Ophthalmol

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Repeatability and Reproducibility of Photoreceptor Density Measurement in the Macula Using the Spectralis High Magnification Module

Cited by 10 publications

References 31 publications

Ultrastructural study of closed macular hole- preliminary application of a novel high magnification module combining with OCT

Ultrastructural study of closed macular hole- preliminary application of a novel high magnification module combining with OCT

Computer-assisted photoreceptor assessment on Heidelberg Engineering Spectralis™ High Magnification Module™ images

In vivo cone-photoreceptor density comparison between eyes with subretinal drusenoid deposits and healthy eyes using high magnification imaging

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