Visual Psychophysics / Physiological Optics - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological OpticsNishit Shah 1 , Michael Dubow 1, 2 , Alexander Pinhas 1, 2 , Nicole K.Scripsema 1 , Alfredo Dubra 3, 4 , Yusufu N. Sulai 6, 3 , Drew H. Scoles 5, 3 ,Richard B. Rosen 1 . 1 Ophthalmology, New York Eye and EarInfirmary, New York, NY; 2 Mount Sinai Hospital, Mount SinaiSchool of Medicine, New York, NY; 3 Ophthalmology, MedicalCollege of Wisconsin, Milwaukee, WI; 4 Biophysics, Medical Collegeof Wisconsin, Milwaukee, WI; 5 Biomedical Engineering, Universityof Rochester, Rochester, NY; 6 The Institute of Optics, University ofRochester, Rochester, NY.Purpose: To report high resolution images of retinal vasculatureusing Fluorescein Angiography (FA) with the Adaptive OpticsScanning Light Ophthalmoscope (AOSLO).Methods: 5 subjects with no retinal pathology or evidence of eyedisease were identified prior to imaging. Reflectance imaging with a790nm super luminescent diode was used to identify the vascularstructures of interest. One gram of fluorescein mixed with 4oz oforange juice was administered orally. Single-photon fluorescenceimages were then collected at the previously identified areas using a488nm solid state laser for excitation and an emission filter centeredat 525nm with a 45nm bandwidth over a 1° field of view. Imagingwas repeated at 15 minute intervals until signal extinction. 3 subjectswere also imaged after IV fluorescein administration.Results: Averaging 120 fluorescence images revealed the retinalmicrovasculature. Measurable fluorescence signal was observed asearly as 8 minutes and as late as 2 hours after administeringfluorescein orally. Although absolute fluorescence signal variedacross patients, the best images were obtained between 15 and 45minutes after administration. On the AOSLO, oral fluoresceinprovided comparable image quality to that of IV fluorescein. Time tosignal extinction with IV fluorescein was shorter, probably due toquicker redistribution of the dye. No side effects from either oral orIV administration of fluorescein were observed.Conclusions: Fluorescein angiography is an invaluable tool in themanagement of ocular disease. Coupled with AOSLO, it permits adetailed examination of the capillary bed of the inner nuclear layerwhen compared to conventional IV FA. Furthermore, FAOSLO withoral fluorescein is a safer alternative to IV angiography and providesa longer imaging time window. High resolution imaging of the retinalmicrovasculature with FAOSLO will not only help to furtherunderstand vascular micropathology but will also guide earlyintervention in management of vascular diseases.Fig 1. Retinal vasculature as seen on: A.fundus photography B.withIV Fluorescein C.magnified view of a vessel (top arrow in B)D.FAOSLO image with IV fluorescein corresponding to frame CE.magnified view of a vessel (bottom arrow in B) F.FAOSLO imagewith oral fluorescein corresponding to frame EFig 2. Comparison of mean intensity over time on averagedfluorescence imagesCommercial Relationships: Nishit Shah, None; Michael Dubow,None; Alexander Pinhas, None; Nicole K. Scripsema, None;Alfredo Dubra, US Patent No: 8,226,236 (P); Yusufu N. Sulai,None; Drew H. Scoles, None; 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, The BurroughsWellcome Fund and the Glaucoma Research FoundationProgram Number: 6065 Poster Board Number: B0076Presentation Time: 10:30 AM - 12:15 PMHistopathologic Features of Diabetic Microangiopathy ImagedUsing an Adaptive Optics Scanning Laser FluoresceinAngiographyRichard B. Rosen 1, 2 , Alfredo Dubra 3 , Rishard Weitz 1 , JosephCarroll 3 , Michael Dubow 1, 4 , Alexander Pinhas 1, 4 , Nishit Shah 1 ,Yusufu N. Sulai 3, 5 , Nicole K. Scripsema 1, 2 , Joseph B. Walsh 1, 2 .1 Ophthalmology, New York Eye & Ear Infirmary, New York, NY;2 Ophthalmology, New York Medical College, Valhalla, NY;3 Ophthalmology, Medical College of Wisconsin, Milwaukee, WI;4 Ophthalmology, Mount Sinai School of Medicine, New York, NY;5 Ophthalmology, University of Rochester, Rochester, NY.Purpose: To describe the fluorescein angiographic features ofdiabetic microangiopathy lesions imaged with an adaptive opticsscanning light ophthalmoscope (AOSLO) compared to theirappearance on conventional fundus photography and spectral domainoptical coherence tomography (SDOCT).Methods: AOSLO images (790nm; 1° degree field of view) withoutfluorescein dye were collected in 15 adult diabetic retinopathypatients to identify microvascular points of interest. Patients theningested 1gm fluorescein dye mixed in 4oz of orange juice.Simultaneous reflectance (790 nm) and fluorescence (488 nmexcitation, 503-548 nm emission) AOSLO images (1° field of view)were collected between 15 and 60 minutes post-ingestion. Forcomparison with conventional imaging techniques, fundus imagingwith and without intravenous fluorescein were performed.Results: In the fluorescence AOSLO channel we were able to©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.