Visual Psychophysics / Physiological Optics - ARVO

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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological OpticsAdaptive Optics Measurements of Retinal Arterial WallThickness in both Normotensive and Hypertensive SubjectsJake Hillard 1 , Toco Y. Chui 1 , Dan A. Sapir 2 , Thomas Gast 1 , StephenA. Burns 1 . 1 School of Optometry, Indiana University, Bloomington,IN; 2 Medical School, Indiana University, Bloomington, IN.Purpose: To make precise measurements of vascular wall thicknessin the retinas of both systemically normotensive and hypertensiveindividuals using an adaptive optics scanning laser ophthalmoscope(AOSLO).Methods: We used the Indiana AOSLO, operated with a relativelylarge (10x the Airy disc) confocal aperture, displaced by more thanthe Airy disc radius. This imaging approach provides excellentimaging of the retinal vasculature, and gives a better visualization ofthe walls (Chui et al 2012). Images of retinal blood vessels rangingfrom capillaries to the largest retinal vessels were obtained in a groupof 6 normal subjects and 16 subjects with a history of hypertension.Vessels ranging in size from an inner diameter of 9 to 171 micronswere measured. Measurements were made using an image editingprogram and were repeated on each vessel 5 times. The lumens of thevessels were differentiated from the vessel walls by the motion oferythrocytes, within the lumens, readily seen on aligned videosequences.Results: Arterial walls and lumens were able to be measured in allsubjects and in almost all of the vessels chosen for analysis. Venouswalls were occasionally measurable in hypertensive but not in normalsubjects. Some arteries could not be measured due to shadowing orfocusing in a different plane although all tested individuals had atleast some measurable arteries. For both small arteries and arterioles(lumen diameters < 50 microns) and larger ones, the hypertensivesubjects had higher wall to lumen ratios (p< 0.02 , p
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological Optics(C); Sotaro Ooto, None; Nagahisa Yoshimura, Canon (C), Canon(F), Nidek (C), Topcon (F), PCT/JP2011/073160 (P)Program Number: 6063 Poster Board Number: B0074Presentation Time: 10:30 AM - 12:15 PMIn vivo imaging of Hypertensive Retinopathy using FluorescenceAdaptive Optics Scanning Light OphthalmoscopyMichael Dubow 1, 2 , Alexander Pinhas 1, 2 , Nishit Shah 1 , Yusufu N.Sulai 3 , Patricia Garcia 1 , Nicole K. Scripsema 4 , Joseph Carroll 5 ,Alfredo Dubra 5 , Richard B. Rosen 1 . 1 New York Eye and EarInfirmary, New York City, NY; 2 Mount Sinai School of Medicine,Mount Sinai Hospital, New York City, NY; 3 University of Rochester,Rochester, NY; 4 New York Medical College, Valhalla, NY; 5 MedicalCollege of Wisconsin, Milwaukee, WI.Purpose: While hypertension affects 1 in 3 adults and 2 in 3 adultsover age 60, hypertensive retinopathy is often overlooked as animportant indicator of systemic disease. Previous studies haveexplored the relationship between hypertensive retinopathy anddiabetes, nephropathy, heart disease and cerebrovascular events.Reflectance adaptive optics scanning light ophthalmoscopy(RAOSLO) is a powerful tool in our exploration of the retina,providing access to retinal microstructure previously unavailable invivo. However, the technology has not yet been optimized to studythe microvasculature. Our group has combined AOSLO withfluorescein angiography (FAOSLO) to image patients withhypertensive retinopathy.Methods: 12 adult patients with vascular disease were recruited.Baseline RAOSLO images were collected using a 790 nm lightsource and 1° FOV. Patients then ingested 1g of fluorescein sodiummixed with juice. Starting at 15 minutes post ingestion, reflectanceand fluorescence (488nm excitation emission; emission filtercentered at 525nm; 45nm bandwidth) 1° FOV image sequences wererecorded simultaneously. Conventional fundus photography with andwithout intravenous fluorescein was performed.Results: FAOSLO revealed fine changes in the retinalmicrovasculature not seen with traditional imaging modalities andRAOSLO in all patients. We successfully imaged features ofhypertensive retinopathy present in larger vessels on the microscopicscale, including microaneurysms, hemorrhages, intravascular lesions,focal arteriolar narrowing, and vessel tortuosity.Conclusions: FAOSLO represents a promising new technology toimage features of hypertensive retinopathy with resolution previouslyattainable only through biopsy. New quantitative classificationschemas will need to be developed to describe and categorize theseabnormalities. Following patients over time will capture the evolutionof the disease, giving invaluable insight into the onset andprogression of hypertensive changes, both in the eye and throughoutthe body.Figure 1: A tortuous tertiary artery imaged on both fundus photo (A)and IV fluorescein (B). While the artery was visible on RAOSLO(C), FAOSLO revealed a focal filling defect (D, E), suggesting localconstriction or intravascular lesion.Figure 2: Variable vessel tortuosity was seen in all levels inhypertensive retinopathy.Commercial Relationships: Michael Dubow, None; AlexanderPinhas, None; Nishit Shah, None; Yusufu N. Sulai, None; PatriciaGarcia, None; Nicole K. Scripsema, None; Joseph Carroll,Imagine Eyes, Inc. (S); Alfredo Dubra, US Patent No: 8,226,236(P); Richard B. Rosen, Opko-OTI (C), Optos (C), Clarity (C), OD-OS (C), Topcon (R), Zeavision (F), Genetech (F), Optovue (C)Support: Marrus Family Foundation, Bendheim-Lowenstein FamilyFoundation, Wise Family Foundation, Chairman's Research Fund ofthe NYEEI, Research to Prevent Blindness, Burroughs WellcomeFund, Glaucoma Research FoundationProgram Number: 6064 Poster Board Number: B0075Presentation Time: 10:30 AM - 12:15 PMNormal retinal vasculature imaged using fluorescence adaptiveoptics scanning light ophthalmoscopy (FAOSLO)©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
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