Visual Psychophysics / Physiological Optics - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological OpticsNew York, NY; 3 University of Rochester, Rochester, NY; 4 MedicalCollege of Wisconsin, Madison, WI.Purpose: Patients with macula-off rhegmatogenous retinaldetachments can have poor visual recovery or metamorphopsiadespite successful retinal reattachment. Subtle changes in the fovealstructure, causing such visual disturbances, can be difficult to identifywith standard examination and imaging tools. Adaptive Optics (AO)allows in vivo imaging of individual photoreceptors. Using an AOscanning laser ophthalmoscope, we evaluated the fovealphotoreceptor appearance following repair of macula-off retinaldetachments. AO images were compared with infrared and OCTimaging. Visual acuity and microperimetry were obtained forfunctional correlation.Methods: Three patients who had previously undergoneanatomically successful repair of rhegmatogenous macula-off retinaldetachments were evaluated with AO following reattachmentsurgery. AO videos were recorded using a 790 nm light source and 1degree field of view. Motion contrast images from several videoswere used to create montages yielding a 2.5 degree field of viewcentered around the foveal depression. Montages from the affectedeye were compared with corresponding montages from the unaffectedeye. Spectralis infrared imaging (870 nm), Spectralis OCT, visualacuity and OCT/SLO microperimetry (Opko/OTI) were alsoobtained.Results: In reattached retina, the appearance of mottling of themacula with infrared imaging (Fig 1A) and hyporeflectivity of thefoveal IS/OS junction using OCT (Fig 1B) corresponded to patchydisruption of the foveal photoreceptor mosaic with AO imaging (Fig1C). These findings were associated with reduced visual acuities andthreshold sensitivities on microperimetry (Fig 2).Conclusions: AO imaging of repaired macula-off retinaldetachments demonstrated disruptions of the photoreceptor mosaic inregions of abnormal fundus infrared signal, irregular IS/OS junctionand reduced visual function. Further AO studies will help us betterunderstand microstructural and pathophysiological changes followingretinal detachment repair.Figure 1: A) Infrared imaging of a 43-year-old woman 6 weeksfollowing macula-off retinal detachment repair shows mottling of themacula. B) OCT of the fovea with hyporeflective regions in theIS/OS junction (Red). C) AO of foveal photoreceptors showing darkpatches interrupting the photoreceptor mosaic.Figure 2: Microperimetry corresponding to Figure 1 showingdepressed sensitivity within the macula.Commercial Relationships: Meenakashi Gupta, None; MichaelDubow, None; Alexander Pinhas, None; Nishit Shah, None;Patricia Garcia, None; Gennady Landa, None; Yusufu N. Sulai,None; 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 New York Eye and Ear InfirmaryProgram Number: 1746Presentation Time: 12:30 PM - 12:45 PMChanges in Cone Reflectivity and Regularity Assessed byAdaptive Optics Scanning Laser Ophthalmoscopy (AOSLO)Correlate with Presence of Diabetic RetinopathyJan Lammer 1, 2 , Amel Ahmed 5 , Sonja G. Prager 1, 2 , Michael C.Cheney 1 , Stephen A. Burns 4 , Paolo S. Silva 1, 3 , Lloyd P. Aiello 1, 3 ,Jennifer K. Sun 1, 3 . 1 Beetham Eye Institute, Joslin Diabetes Center,Boston, MA; 2 Department of Opthalmology and Optometry, MedicalUniversity of Vienna, Vienna, Austria; 3 Department ofOphthalmology, Harvard Medical School, Boston, MA; 4 School ofOptometry, Indiana University, Bloomington, IN; 5 Department ofHistology and Cell Biology, Faculty of Medicine, Assiut University,Assiut, Egypt.Purpose: To utilize high resolution AOSLO to evaluate differencesin cone density, reflectivity and regularity in eyes with and withoutdiabetes (DM) and across a range of diabetic retinopathy (DR)severity.Methods: Cone mosaics at the fovea and 4 macular quadrants(1x1.2° area, mean+SD eccentricity = 4.2±0.4°) were imaged usingAOSLO (2.5µm resolution). Contrast of aligned and averaged imageswas automatically standardized based on the 8-bit histogram. Conecounting was performed semi-automatically using ImageJ andmanual correction by 2 independent graders masked to clinical data.Count differences >20% were adjudicated. Parameters includingdensity, nearest neighbor (NN) and Voronoi tile measurements werecalculated as well as mean reflectivity of each Voronoi tile.Results: Forty eyes of 40 subjects were assessed. For subjects,mean±SD age was 44±12yrs, 57% (N=12) were male, 78% (31) hadDM, DM duration was 22±14yrs and 32% (10) had no DR, 19% (6)mild nonproliferative DR (NPDR), 29% (9) moderate NPDR, 10%©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.