Faculty Collaboration Database

High-resolution retinal imaging of cone-rod dystrophy. Ophthalmology 2006 Jun;113(6):1019.e1

Date

05/03/2006

Pubmed ID

16650474

DOI

10.1016/j.ophtha.2006.01.056

Scopus ID

2-s2.0-33646930330 (requires institutional sign-in at Scopus site)   162 Citations

Abstract

PURPOSE: This study examines a patient with cone-rod dystrophy using high-resolution adaptive optics retinal imaging. Conventional ophthalmoscopes provide limited resolution due to their inability to overcome the eye's optical aberrations. In contrast, adaptive optics ophthalmoscopes correct these aberrations to provide noninvasive high-resolution views of the living retina. To date, adaptive optics ophthalmoscopy has been used mainly to examine the normal retina. Here we use adaptive optics ophthalmoscopy to image cone-rod dystrophy in vivo and compare these results with standard clinical tests.

DESIGN: Observational case report.

METHODS: High-resolution retinal images of a patient with cone-rod dystrophy were obtained with the University of Rochester adaptive optics flood-illuminated ophthalmoscope and the adaptive optics scanning laser ophthalmoscope located at the University of Houston and compared with standard clinical tests, including fundus photography, Goldmann visual fields, fluorescein angiography, optical coherence tomography, electroretinography, and multifocal electroretinography.

MAIN OUTCOME MEASURES: Direct measurement of cone density and diameter and comparison of adaptive optics images with standard clinical imaging and functional tests.

RESULTS: Adaptive optics images were acquired at multiple retinal locations throughout a clinically detected bull's-eye lesion. Within the atrophic regions, we observed large areas devoid of wave-guiding cones. In contrast, regions that appeared relatively spared by clinical examination contained a completely tiled cone mosaic. However, in these areas the cones were abnormally large, resulting in a 6.6-fold reduction from the normal peak cone density (patient peak density: 30 100 cones/mm2, normal peak density: 199 200 cones/mm2). Multifocal electroretinography confirmed a 5.5-fold reduction in amplitude of the central peak (10.8 nanovolts/degree2 vs. 59.8 nanovolts/degree2).

CONCLUSIONS: Adaptive optics ophthalmoscopy is a noninvasive technique to observe a patient's retinal pathology directly at a cellular level. It can provide a quantitative measurement of photoreceptor loss in retinal disease.

Author List

Wolfing JI, Chung M, Carroll J, Roorda A, Williams DR

Author

Joseph J. Carroll PhD Director, Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Cell Count
Diagnostic Imaging
Electroretinography
Female
Fluorescein Angiography
Fundus Oculi
Humans
Ophthalmoscopy
Photoreceptor Cells, Vertebrate
Retinal Degeneration
Tomography, Optical Coherence
Visual Acuity
Visual Fields