Visual Psychophysics / Physiological Optics - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological Opticssubsided and the visual acuity had improved. At the 14-month followup visit, the density of cone photoreceptors, as measured by AO-SLOexamination, had only decreased slightly, but the cellular hexagonrate declined remarkably in both eyes on average. Compared to theinitial inferior local edema of 0.5 mm in the left eye, the cellularhexagon rate decreased from 36.4% to 22.8% at the 14-month followupexam.Conclusions: The analyses by AO-SLO imaging revealed only aslightly lower density of cone cells, but the cellular hexagon ratedecreased in both eyes as compared to the examination 14 monthsprior. The cellular hexagon rate of previous edema area of left eyeshowed marked decline. The macular edema from long-term diabeticmacular edema had subsided, based on the OCT image which showedflatter retina. The visual acuity had also improved, but the detaildensity and morphology still remained and even worsened. Longtermedema, diabetic retinopathy, or aging might be the risk factors.However, AO-SLO is more sensitive to the level of a single cone cell,and the ability to visualize the cone cells in vivo should be used in alarger diabetic retinopathy survey and may also be useful for studyingother retinal diseases as well.Commercial Relationships: Ching-Lung Chen, None; Sung PyoPark, None; Takeshi Kitamura, Canon U.S.A., Inc. (E); StanleyChang, Alcon Laboratories (C), Alimera Sciences (C)Support: None in the Support fieldProgram Number: 3451 Poster Board Number: C0172Presentation Time: 11:00 AM - 12:45 PMPhotoreceptor Structure in Presumed Non-NeoplasticAutoimmune RetinopathyDavid B. Kay 1 , Robert F. Cooper 2 , Drew H. Scoles 3 , Fouad R.Zakka 1 , Vesper Williams 1 , Alfredo Dubra 1, 4 , Joseph Carroll 1, 4 ,Kimberly E. Stepien 1 . 1 Department of Ophthalmology, MedicalCollege of Wisconsin, Milwaukee, WI; 2 Department of BiomedicalEngineering, Marquette University, Milwaukee, WI; 3 Department ofBiomedical Engineering, University of Rochester, Rochester, NY;4 Department of Biophysics, Medical College of Wisconsin,Milwaukee, WI.Purpose: Autoimmune retinopathies (AIR) are rare diseases,sometimes associated with systemic neoplasms, in which anti-retinalantibodies lead to cone and rod dysfunction. Patients present withprogressive, bilateral, painless vision loss despite normal clinicalfundus appearance, making diagnosis difficult. SD-OCT has shownouter retinal abnormalities and decreased macular thickness in AIRpatients. Adaptive optics scanning light ophthalmoscopy (AOSLO)enables high-resolution imaging of the photoreceptor mosaic. Thisstudy incorporates AOSLO into the comprehensive investigation ofindividuals with AIR to evaluate its utility in improving thecharacterization and management of AIR.Methods: Three individuals with presumed non-neoplastic AIR whopresented with vision loss, normal fundus appearance and knownanti-retinal antibodies underwent a comprehensive ophthalmicevaluation and multiple retinal imaging sessions over a 5 - 14 monthinterval. Retinal appearance and lamination were assessed usingfundus photography and SD-OCT. The photoreceptor mosaic wasassessed using AOSLO.Results: All three individuals had different anti-retinal antibodycombinations in serum, and presenting vision ranged from 20/40 to20/100. Clinical and fundus photography evaluation confirmednormal appearing fundus. SD-OCT revealed decreased centralmacular thickness in two of the three patients, and focal disruption ofouter retinal lamination was seen at the fovea in all patients. Thisdisruption was also visible in the AOSLO images as a largehyporeflective area at the fovea. In addition, AOSLO imagesrevealed significant reduction in parafoveal cone density in all threesubjects, with variable numbers of non-waveguiding conesinterspersed throughout the mosaic. This disruption was notvisualized on SD-OCT.Conclusions: Both SD-OCT and AOSLO show outer retinalstructure changes associated with AIR not apparent on clinicalexamination. However, AOSLO allows for assessment ofphotoreceptor structure at a resolution not resolvable on SD-OCT.AOSLO may prove to be a useful, noninvasive, highly accurate toolto aid in diagnosis of AIR as well as monitoring progression andtreatment responses. Further study is needed to determine whetherAOSLO can be used to accurately track progression of photoreceptordisruption in AIR over time.Commercial Relationships: David B. Kay, None; Robert F.Cooper, None; Drew H. Scoles, None; Fouad R. Zakka,VitreoRetinal Surgery Foundation (F); Vesper Williams, None;Alfredo Dubra, US Patent No: 8,226,236 (P); Joseph Carroll,Imagine Eyes, Inc. (S); Kimberly E. Stepien, NoneSupport: VitreoRetinal Surgery Foundation, Research to PreventBlindness, NIH (UL1RR031973, EY017607, EY001931), AlconResearch Institute, Burroughs Wellcome FundProgram Number: 3452 Poster Board Number: C0173Presentation Time: 11:00 AM - 12:45 PMCone photoreceptors at the fovea after serous retinal detachmentobserved with adaptive optics fundus camera (rtx1)Atsushi Hayashi, Tomoko Nakamura, Naoki Tojo, Tomoko Ueda,Toshihiko Oiwake, Akio Miyakoshi, Hironori Ozaki. Ophthalmology,University of Toyama, Toyama, Japan.Purpose: Purpose: To examine recovery of cone photoreceptors inthe fovea after serous retinal detachment (SRD) in patients withcentral serous chorioretinopathy (CSC) and Vogt-Koyanagi-Haradadisease (VKH) with an adaptive optics (AO) fundus camera and toexamine correlations between cone analyses and visual acuity.Methods: Methods: Ten eyes of CSC and 4 eyes of VKH wereexamined. After the SRD at the fovea was resolved withphotodynamic therapy or steroid therapy, photographs of conephotoreceptors including the fovea were taken with an AO funduscamera (rtx1, Imagine eyes, France). The area of 200µm X 200µm atthe fovea was chosen in the photograph of each eye and analyzedwith the manufacturer’s software. Analyses of cone density, conespacing, and voronoi domains were obtained and correlationsbetween visual acuity and cone analyses were examined. OCT wasobtained at the same time and length of the IS/OS line in the OCTimage was measured in the area of 200µm at the fovea.Results: Results: Cone analyses showed that average cone density atthe fovea was 15363±4239, average cone spacing was 8.96±1.21μm,and average voronoi domains was 36.9±4.1%. Average visual acuity(logMAR) was 0.155±0.391. Average length of the IS/OS line in thearea of 200µm was 77.7±31.5%. Visual acuity and cone analysesshowed significant correlations. Cone density; rs= -0.698(Spearman’s rank Correlation Coefficient), cone spacing; rs=0.663,and voronoi domains; rs=-0.749. The length of IS/OS line and conedensity showed a significant correlation; rs=0.770.Conclusions: Conclusions: Analyses of cone photoreceptors at thefovea after SRD was resolved were significantly correlated withvisual acuity.Commercial Relationships: Atsushi Hayashi, None; TomokoNakamura, None; Naoki Tojo, None; Tomoko Ueda, None;Toshihiko Oiwake, None; Akio Miyakoshi, None; Hironori Ozaki,NoneProgram Number: 3453 Poster Board Number: C0174©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.