High resolution adaptive optics imaging complements standard spectral domain optical coherent tomography in retinal diseases with micro-structural details: a case series

• Main Authors: Gibran Syed Khurshid, Sasha Strul, Adam Boretsky, Massoud Motamedi, Praveena Gupta
• Format: Article
• Language: English
• Published: Pan-American Association of Ophthalmology 2015-10-01
• Series: Vision Pan-America
• Subjects: Adaptive optics; confocal scanning laser ophthalmoscopy; AO-SLO; adaptive optics confocal scanning laser ophthalmoscopy; rod-cone dystrophy; acute retinal pigment epitheliitis; Krill's disease; occult macular dystrophy; photoreceptor mosiac
• Online Access: http://journals.sfu.ca/paao/index.php/journal/article/view/261
• ISSN: 2219-4665; 2219-4673

Purpose: To evaluate if high resolution adaptive optics confocal scanning laser ophthalmoscopy (AO-SLO) can be used as an adjunct complementary diagnostic tool to spectral domain optical coherent tomography (SD-OCT) in characterizing three macular diseases: rod-cone dystrophy, acute retinal pigment epitheliitis (Krill’s disease), and occult macular dystrophy. Methods: As part of a complete clinical examination, each patient was subjected to color fundus pictures, multimodal imaging scans with Heidelberg SpectralisTM and high resolution retinal images with a custom built adaptive optics scanning laser ophthalmolscope (AO-SLO). The registered AO-SLO images were averaged to improve the signal to noise ratio and used to generate larger photoreceptor mosaics. Results: AO-SLO mosaics for all three conditions showed distinct, characteristic disruptions of the photoreceptors in areas that corresponded to the abnormalities observed on fundus photography and SD-OCT scans. Conclusions: AO-SLO defined fine structural changes associated with retinal pathology at the photoreceptor level that could not be achieved using standard diagnostic methods. A combination of adaptive optics scanning laser ophthalmoscopy (AO-SLO) and SD-OCT provided views of the retina with enhanced lateral and axial resolution. High-resolution, ultra-structural details of the retina may provide additional insights into the disease etiology, progression and management of patients with vision threatening macular diseases.