Adaptive Optics Fundus Camera to Examine Localized Changes in the Photoreceptor Layer of the Fovea
Received 25 November 2007; received in revised form 16 March 2008; accepted 25 March 2008. published online 16 May 2008.
Purpose
To examine highly localized photoreceptor disruptions in the fovea by a high-resolution adaptive optics (AO) fundus camera combined with Fourier-domain optical coherence tomography (FD OCT).
Design
Observational case series.
Participants
Three eyes of 3 patients who showed dark foveal spots by slit-lamp biomicroscopy.
Methods
Three patients who reported metamorphopsia but showed no changes in the retina in conventional fundus photographs were examined. High-resolution retinal images were obtained with the AO fundus camera and by FD OCT. The images were compared with the findings obtained by standard clinical tests, including Amsler charts and fluorescein angiography (FA).
Main Outcome Measures
Quantitative measurements of the area of photoreceptor disruption.
Results
Slit-lamp biomicroscopy revealed an irregularly shaped dark spot in the fovea centralis but no changes in FA in the 3 cases. The photoreceptor mosaic was absent in a highly localized area of the fovea in the images obtained by the AO fundus camera, and the photoreceptor outer segment was absent or disturbed at the corresponding area by FD OCT in all 3 cases. The horizontal and vertical sizes of the area of disturbance of the photoreceptor mosaic in the AO images in the 3 eyes were 400×200 μm, 300×120 μm, and 300×200 μm. These sizes were comparable to the photoreceptor outer segment disturbances in the OCT images which were 330×150 μm, 280×100 μm, 200×150 μm, respectively.
Conclusions
Localized OS disturbances were able to be detected in eyes with a dark foveal spot by AO fundus camera 2-dimensionally and by FD OCT axially. The good correspondence of the sizes of the area of photoreceptor disturbances obtained by AO images to those by FD OCT images indicate that the AO images can be used to evaluate and follow the 2-dimensional area of focal changes of the photoreceptors in the fovea quantitatively.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found after the references.
Available online: May 16, 2008.
1Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
2Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
Correspondence: Takashi Fujikado, MD, Department of Applied Visual Science, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Manuscript no. 2007-1518.
Financial Disclosure(s): The funding organization had no role in the design or conduct of this research.
Supported by the Ministry of Health, Labor and Welfare, Tokyo, Japan (Health Sciences Research grant no.: H19-sensory-001).
Tatsuo Yamaguchi, Naoki Nakazawa, and Toshifumi Mihashi are employees of Topcon.
ABSTRACT