Microscopic inner retinal hyper-reflective phenotypes in retinal and neurologic disease. Invest Ophthalmol Vis Sci 2014 Jun 03;55(7):4015-29
Date
06/05/2014Pubmed ID
24894394Pubmed Central ID
PMC4078949DOI
10.1167/iovs.14-14668Scopus ID
2-s2.0-84903641142 (requires institutional sign-in at Scopus site) 37 CitationsAbstract
PURPOSE: We surveyed inner retinal microscopic features in retinal and neurologic disease using a reflectance confocal adaptive optics scanning light ophthalmoscope (AOSLO).
METHODS: Inner retinal images from 101 subjects affected by one of 38 retinal or neurologic conditions and 11 subjects with no known eye disease were examined for the presence of hyper-reflective features other than vasculature, retinal nerve fiber layer, and foveal pit reflex. The hyper-reflective features in the AOSLO images were grouped based on size, location, and subjective texture. Clinical imaging, including optical coherence tomography (OCT), scanning laser ophthalmoscopy, and fundus photography was analyzed for comparison.
RESULTS: Seven categories of hyper-reflective inner retinal structures were identified, namely punctate reflectivity, nummular (disc-shaped) reflectivity, granular membrane, waxy membrane, vessel-associated membrane, microcysts, and striate reflectivity. Punctate and nummular reflectivity also was found commonly in normal volunteers, but the features in the remaining five categories were found only in subjects with retinal or neurologic disease. Some of the features were found to change substantially between follow up imaging months apart.
CONCLUSIONS: Confocal reflectance AOSLO imaging revealed a diverse spectrum of normal and pathologic hyper-reflective inner and epiretinal features, some of which were previously unreported. Notably, these features were not disease-specific, suggesting that they might correspond to common mechanisms of degeneration or repair in pathologic states. Although prospective studies with larger and better characterized populations, along with imaging of more extensive retinal areas are needed, the hyper-reflective structures reported here could be used as disease biomarkers, provided their specificity is studied further.
Author List
Scoles D, Higgins BP, Cooper RF, Dubis AM, Summerfelt P, Weinberg DV, Kim JE, Stepien KE, Carroll J, Dubra AAuthors
Joseph J. Carroll PhD Director, Professor in the Ophthalmology and Visual Sciences department at Medical College of WisconsinRobert F. Cooper Ph.D Assistant Professor in the Biomedical Engineering department at Marquette University
David V. Weinberg MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Follow-Up StudiesHumans
Microscopy, Confocal
Ophthalmoscopy
Optic Nerve Diseases
Phenotype
Reproducibility of Results
Retina
Retinal Diseases
Retrospective Studies
Tomography, Optical Coherence