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.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.Individual lesion characterization by AOSLO imaging. AOSLO appearance was compared with CF and SDOCT imaging.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.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.
Purpose.: To quantify and compare phase retardation amplitude and regularity associated with the Henle fiber layer (HFL) between nonexudative AMD patients and age-matched controls using scanning laser polarimetry (SLP) imaging. Methods.: A scanning laser polarimeter was used to collect 15 × 15° macular-centered images in 25 patients with nonexudative AMD and 25 age-matched controls. Raw image data were used to compute macular phase retardation maps associated with the HFL. Consecutive, annular regions of interest from 0.5 to 3.0° eccentricity, centered on the fovea, were used to generate intensity profiles from phase retardation data and analyzed with two complementary techniques: a normalized second harmonic frequency (2f) of the fast Fourier Transform (FFT) analysis and a curve fitting analysis using a 2f sine function. Paired t-tests were used to compare the normalized 2f FFT magnitude at each eccentricity between the two groups, the eccentricity that yielded the maximum normalized 2f FFT between paired individuals across the two groups, and curve fitting RMS error at each eccentricity between the two groups. Results.: Normalized 2f FFT components were lower in the AMD group at each eccentricity, with no difference between the two groups in the maximum normalized 2f FFT component eccentricity. The root-mean-square (RMS) error from curve fitting was significantly higher in the AMD group. Conclusions.: Phase retardation changes in the central macula indicate loss and/or structural alterations to central cone photoreceptors in nonexudative AMD patients. Scanning laser polarimetry imaging is a noninvasive method for quantifying cone photoreceptor changes associated with central macular disease.
A custom imaging Mueller matrix retinal polarimeter (the GDx-MM) is built. Mueller matrix images of normal human fovea were acquired with the GDx-MM over a 9° field at 780nm and have been analyzed for depolarization index and the variation of degree of polarization with incident polarization state. The degree of polarization (DoP) was often above 50% and varied in complex ways as a function of the incident polarization states. The depolarization properties around the macula loosely correlated with the retardance image. High spatial frequency depolarizing structures were evident throughout the fovea.
We use two noninvasive, psychophysical techniques to study the foveal cones of patients with retinitis pigmentosa. The techniques, steady-state color matching and dynamic color matching, are based on the fact that a color match depends on the optical density of the photopigment contained in the cones 1 - 4 . Reduction of the number of cones or neural deficits will not affect the color match so long as the observer can do the task. These techniques provide estimates of 1) the optical density of the cones at a given retinal illuminance, 2) the illuminance that reduces optical density by half (the half-bleach illuminance or I O ), and 3) the rate of change in optical density 3 - 4 . To examine patients with minimal cone damage, we recruit patients in the early phases of disease with good visual acuity, 20/20-20/50. Patients, aged 14-46, vary as to the inheritance pattern and age of onset of night vision problems. All have reduced amplitude or extinguished photopic and scotopic ERG responses.