Characterization of In Vivo Retinal Lesions of Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy

Purpose. To characterize hallmark diabetic retinopathy (DR) lesions utilizing adaptive optics scanning laser ophthalmoscopy (AOSLO) and to compare AOSLO findings with those on standard imaging techniques. Methods. Cross-sectional study including 35 eyes of 34 study participants. AOSLO confocal and multiply scattered light (MSL) imaging were performed in eyes with DR. Color fundus photographs (CF), infrared images of the macula (Spectralis, Heidelberg), and Spectralis spectral domain optical coherence tomography SDOCT B-scans of each lesion were obtained and registered to corresponding AOSLO images. Main Outcome Measures. Individual lesion characterization by AOSLO imaging. AOSLO appearance was compared with CF and SDOCT imaging. Results. Characterized lesions encompassed 52 microaneurysms (MA), 20 intraretinal microvascular abnormalities (IRMA), 7 neovascularization (NV), 11 hard exudates (HE), 5 dot/blot hemorrhages (HEM), 4 cotton wool spots (CWS), and 14 intraretinal cysts. AOSLO allowed assessment of perfusion in vascular lesions and enabled the identification of vascular lesions that could not be visualized on CF or SDOCT. Conclusions. AOSLO imaging provides detailed, noninvasive in vivo visualization of DR lesions enhancing the assessment of morphological characteristics. These unique AOSLO attributes may enable new insights into the pathological changes of DR in response to disease onset, development, regression, and response to therapy.

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Adaptive optics scanning laser ophthalmoscopy for in vivo imaging of lamina cribrosa

Journal of the Optical Society of America A ◽

10.1364/josaa.24.001417 ◽

2007 ◽

Vol 24 (5) ◽

pp. 1417 ◽

Cited By ~ 37

Author(s):

Abhiram S. Vilupuru ◽

Nalini V. Rangaswamy ◽

Laura J. Frishman ◽

Earl L. Smith III ◽

Ronald S. Harwerth ◽

...

Keyword(s):

Adaptive Optics ◽

In Vivo Imaging ◽

Lamina Cribrosa ◽

Scanning Laser ◽

Scanning Laser Ophthalmoscopy

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Versatile Multi-Detector Scheme for Adaptive Optics Scanning Laser Ophthalmoscopy

10.1101/408526 ◽

2018 ◽

Author(s):

Sanam Mozaffari ◽

Volker Jaedicke ◽

Francesco Larocca ◽

Pavan Tiruveedhula ◽

Austin Roorda

Keyword(s):

Adaptive Optics ◽

Signal To Noise Ratio ◽

Scattered Light ◽

Scanning Laser ◽

Retinal Vasculature ◽

Single Element ◽

Scanning Laser Ophthalmoscopy ◽

Signal To Noise ◽

Detection Scheme ◽

Multiple Detectors

AbstractAdaptive Optics Scanning Laser Ophthalmoscopy (AOSLO) is a powerful tool for imaging the retina at high spatial and temporal resolution. In this paper, we present a multi-detector scheme for AOSLO which has two main configurations: pixel reassignment and offset aperture imaging. In this detection scheme, the single element detector of the standard AOSLO is replaced by a fiber bundle which couples the detected light into multiple detectors. The pixel reassignment configuration allows for more light throughput while maintaining optimal confocal resolution. The increase in signal-to-noise ratio (SNR) from this configuration can improve the accuracy of motion registration techniques. The offset aperture imaging configuration enhances the detection of multiply scattered light, which improves the contrast of retinal vasculature and inner retinal layers similar to methods such as nonconfocal split-detector imaging and multi-offset aperture imaging.

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Adaptive optics with combined optical coherence tomography and scanning laser ophthalmoscopy for in vivo mouse retina imaging

Ophthalmic Technologies XXVIII ◽

10.1117/12.2288607 ◽

2018 ◽

Author(s):

Pengfei Zhang ◽

Daniel J. Wahl ◽

Jacopo Mocci ◽

Suman K. Manna ◽

Ratheesh K. Meleppat ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Adaptive Optics ◽

Scanning Laser ◽

Mouse Retina ◽

Scanning Laser Ophthalmoscopy ◽

Optical Coherence

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Retinal Blood Velocity and Flow in Early Diabetes and Diabetic Retinopathy Using Adaptive Optics Scanning Laser Ophthalmoscopy

Journal of Clinical Medicine ◽

10.3390/jcm8081165 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1165 ◽

Cited By ~ 10

Author(s):

Cherilyn Mae A. Palochak ◽

Hee Eun Lee ◽

Jessica Song ◽

Andrew Geng ◽

Robert A. Linsenmeier ◽

...

Keyword(s):

Blood Flow ◽

Diabetic Retinopathy ◽

Adaptive Optics ◽

Blood Velocity ◽

Vessel Density ◽

Retinal Blood Flow ◽

Low Flow ◽

Scanning Laser ◽

Diabetic Patients ◽

Scanning Laser Ophthalmoscopy

Using adaptive optics scanning laser ophthalmoscopy (AOSLO), we measured retinal blood velocity and flow in healthy control eyes and eyes of diabetic patients with or without retinopathy. This cross-sectional study included 39 eyes of 30 patients with diabetes (DM) with mild non-proliferative diabetic retinopathy (NPDR) or without retinopathy (DM no DR) and 21 eyes of 17 healthy age-matched controls. Participants were imaged with a commercial optical coherence tomography angiography (OCTA) device (RTVue-XR Avanti) and AOSLO device (Apaeros Retinal Imaging System, Boston Micromachines). We analyzed AOSLO-based retinal blood velocity and flow, and OCTA-based vessel density of the superficial (SCP), deep retinal capillary plexus (DCP), and full retina. Retinal blood velocity was significantly higher in eyes with DM no DR and lower in NPDR across all vessel diameters compared to controls. Retinal blood flow was significantly higher in DM no DR and lower in NPDR in vessel diameters up to 60 μm compared to controls. When comparing flow outliers (low-flow DM no DR eyes and high-flow NPDR eyes), we found they had a significantly different retinal vessel density compared to the remaining eyes in the respective groups. Retinal blood velocity and flow is increased in eyes with DM no DR, while these parameters are decreased in eyes with mild NPDR compared to healthy age-matched controls. The similarity of OCTA vessel density among outliers in the two diabetic groups suggests an initial increase followed by progressive decline in blood flow and OCTA vessel density with progression to clinical retinopathy, which warrants further investigation.

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